Older patients' experiences following initial diagnosis of acute myeloid leukemia: A qualitative study.
Older patients' experiences following initial diagnosis of acute myeloid leukemia: A qualitative study.
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DOI：
10.1016/j.jgo.2022.08.017
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发表时间：
2022-11
影响因子：
3
通讯作者：
Loh, Kah Poh
中科院分区：
文献类型：
--
作者：
Abdallah, Maya;Kadambi, Sindhuja;Parsi, Meghana;Rai, Maitreyee;Mendler, Jason H.;Wittink, Marsha;Duberstein, Paul R.;Tsang, Mazie;Klepin, Heidi D.;Loh, Kah Poh
急性髓性白血病（AML）的症状和诊断往往突然发生，并可能导致一系列的情绪反应。了解患者的经历和情绪状态，使临床医生能够根据患者的需求量身定制护理。以前的研究主要集中在接受强化化疗的患者在诊断时和缓解后的经历。在这项研究中，我们评估了在门诊和住院环境中接受或正在接受不同强度治疗的老年AML患者的经历，并且在我们采访时处于治疗过程的不同阶段。我们进行了一项单中心定性研究，旨在了解影响老年患者治疗决策的因素，研究结果已被报道。本分析专门探讨了老年患者在AML诊断后不同阶段的经历。我们有目的地根据治疗强度和治疗阶段（接受诱导治疗、缓解后治疗或异体造血干细胞移植后）对患者进行抽样。我们招募了15名年龄≥60岁的AML患者。样本量是在达到主要研究目标的数据饱和的基础上确定的。对于本分析，第14篇稿件达到数据饱和。对记录和转录的深度半结构化访谈进行再分析，采用归纳主题分析来探讨患者的经历。使用Atlas.ti进行编码。我们确定主题的目的是捕捉最常见的共享体验。15例患者平均年龄72.1岁；所有患者均接受了一种或多种治疗，包括强化诱导治疗（10/15）、低强度治疗（7/15）和/或造血干细胞移植（3/15）。患者经历了强烈的负面情绪反应，包括震惊，这是处理信息和有意义的沟通的障碍。患者还分享了他们与医疗保健专业人员沟通的观点（包括对所提供信息是否充足的看法）和应对策略。了解老年患者的经历，包括AML诊断时的情绪反应、沟通障碍和决策障碍，以及整个疾病轨迹，使临床医生能够在这一困难时期满足患者的支持性护理需求。
The onset of symptoms and the diagnosis of acute myeloid leukemia (AML) often occur suddenly and may lead to a range of emotional responses. Understanding patients’ experiences and emotional states allows clinicians to tailor care to patients’ needs. Previous studies have largely focused on patients’ experiences at diagnosis and after remission has achieved among those who received intensive chemotherapy. In this study, we evaluated experiences of older patients with AML who had received or were receiving treatments of varying intensity, in both outpatient and inpatient settings, and who were at different stages in their treatment course at the time of our interviews. We conducted a single center qualitative study which aimed to understand factors influencing older patients’ treatment decision-making and the findings were previously reported. This analysis specifically explored older patients’ experiences at various stages after AML diagnosis. We purposively sampled patients based on treatment intensity and stage of treatment (undergoing induction treatment, post-remission treatment, or post-allogeneic hematopoietic stem cell transplant). We recruited 15 patients aged ≥60 years with AML. The sample size was determined based on reaching data saturation for the primary study aim. For this analysis, data saturation was reached by the 14th manuscript. In-depth semi-structured interviews that had been recorded and transcribed were re-analyzed using inductive thematic analysis to explore patients’ experiences. Coding was performed using Atlas.ti. We identified themes with the aim of capturing the most commonly shared experiences. Mean age of the 15 patients was 72.1 years; all had received one or more treatments including intensive induction therapy (10/15), lower-intensity treatment (7/15), and/or hematopoietic stem cell transplant (3/15). Patients experienced strong negative emotional responses including shock that were barriers to processing information and meaningful communication. Patients also shared their perspectives on communication with healthcare professionals (including thoughts on adequacy of information provided) and coping strategies. Understanding older patients’ experiences including emotional responses and barriers to communication and decision making at AML diagnosis and throughout the illness trajectory allows clinicians to address patients’ supportive care needs during this difficult period.
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影响因子：
4.7
作者：
Abdallah M;Xie Z;Ready A;Manogna D;Mendler JH;Loh KP
通讯作者：
Loh KP
影响因子：
3.5
作者：
Epstein, Ronald M.
通讯作者：
Epstein, Ronald M.
影响因子：
7.5
作者：
Loh, Kah Poh;Tsang, Mazie;Lee, Stephanie J.
通讯作者：
Lee, Stephanie J.
DOI：
10.1177/1937586718772615
发表时间：
2018-04-01
影响因子：
2.2
作者：
Peditto, Kathryn
通讯作者：
Peditto, Kathryn
影响因子：
2.7
作者：
Nissim, Rinat;Zimmermann, Camilla;Rodin, Gary
通讯作者：
Rodin, Gary