实用老年医学 ›› 2026, Vol. 40 ›› Issue (1): 94-98.doi: 10.3969/j.issn.1003-9198.2026.01.019

• 护理园地 • 上一篇    下一篇

老年癌痛病人阿片类药物相关性恶心呕吐症状管理的质性研究

赵云, 周国仁, 羊波, 高福林, 李云容, 张柳柳, 智晓旭, 许勤   

  1. 210009 江苏省南京市,南京医科大学附属肿瘤医院(江苏省肿瘤医院)护理部(赵云,张柳柳,智晓旭);肿瘤科(周国仁);胸外科(羊波);
    211166 江苏省南京市,南京医科大学护理学院(高福林,李云容,许勤)
  • 收稿日期:2025-06-17 发布日期:2026-01-16
  • 通讯作者: 许勤,Email:qinxu@njmu.edu.cn
  • 基金资助:
    江苏省卫生健康委员会老年健康科研项目(LKM2024058)

Management of opioid-induced nausea and vomiting symptoms in elderly patients with cancer pain: a qualitative study

ZHAO Yun, ZHOU Guoren, YANG Bo, GAO Fulin, LI Yunrong, ZHANG Liuliu, ZHI Xiaoxu, XU Qin   

  1. Nursing Department (ZHAO Yun,ZHANG Liuliu, ZHI Xiaoxu);Department of Oncology(ZHOU Guoren);Department of Thoracic Surgery(YANG Bo), Affiliated Cancer Hospital of Nanjing Medical University (Jiangsu Cancer Hospital), Nanjing 210009,China;
    School of Nursing, Nanjing Medical University, Nanjing 211166, China (GAO Fulin, LI Yunrong, XU Qin)
  • Received:2025-06-17 Published:2026-01-16
  • Contact: XU Qin, Email: qinxu@njmu.edu.cn

摘要: 目的 探讨老年癌痛病人阿片类药物相关性恶心呕吐(OINV)的多维症状体验及管理需求,为优化老年癌痛病人症状管理策略提供依据。 方法 采用现象学研究方法,于2025年1—3月采用目的抽样法对江苏省肿瘤医院18例使用阿片类药物后发生恶心呕吐的60岁及以上癌痛病人进行半结构式访谈,以症状管理理论为框架,构建访谈提纲,运用Colaizzi 7步分析法提炼主题。 结果 共提炼出4个主题:症状认知局限与归因偏差、躯体-功能交互影响与多重衰弱风险、自我管理策略的有限性与家庭/医护支持依赖、管理策略的应用现状与困境。 结论 亟需构建以老年病人为中心的OINV全程管理体系,包括动态精准评估症状及风险、优化个体化健康教育、整合多维度干预策略及重构支持网络等方面内容。

关键词: 癌痛, 阿片类药物相关恶心呕吐, 症状管理, 质性研究

Abstract: Objective To explore the symptom experience and management needs of opioid-induced nausea and vomiting (OINV) in the elderly patients with cancer pain. Methods A phenomenological research method was adopted. From January to March 2025, 18 elderly patients with cancer pain who experienced nausea and vomiting after using opioids in Jiangsu Cancer Hospital were interviewed using purposive sampling. Colaizzi method was used for thematic analysis. Results Four main themes were extracted, including limited symptom awareness and attribution bias, somatic-functional interaction and multiple frailty risks, constrained self-management strategies and reliance on family/healthcare support, the application status and dilemmas of management strategies. Conclusions It is urgent to construct a whole-process management system of OINV centered on elderly patients, including dynamic assessment, personalized education, multidimensional interventions and support network reconstruction.

Key words: cancer pain, opioid-induced nausea and vomiting, symptom management, qualitative research

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