主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
《中文核心期刊要目总览》核心期刊

中国护理管理 ›› 2025, Vol. 25 ›› Issue (5): 742-747.doi: 10.3969/j.issn.1672-1756.2025.05.020

• 循证护理 • 上一篇    下一篇

基于实施性研究综合框架的乳腺癌患者血脂管理障碍因素研究

张雪慧 裘佳佳 汤立晨 邢唯杰   

  1. 复旦大学护理学院,200032 上海市(张雪慧,邢唯杰);复旦大学附属肿瘤医院护理部(裘佳佳);乳腺外科(汤立晨)
  • 出版日期:2025-05-15 发布日期:2025-05-15
  • 通讯作者: 汤立晨,博士在读,副主任医师,E-mail:forever_drawer@163.com;邢唯杰,博士,副教授,E-mail:xingweijie@fudan.edu.cn
  • 作者简介:张雪慧,硕士在读
  • 基金资助:
    上海市卫生健康委卫生行业临床研究专项面上项目(202340089)

Barriers to lipid management in breast cancer patients: a qualitative study using the Consolidates Framework for Implementation Research

ZHANG Xuehui, QIU Jiajia, TANG Lichen, XING Weijie   

  1. School of Nursing, Fudan University, Shanghai, 200032, China
  • Online:2025-05-15 Published:2025-05-15
  • Contact: E-mail:forever_drawer@163.com;E-mail:xingweijie@fudan.edu.cn

摘要: 目的:分析影响乳腺癌患者血脂管理的障碍因素,以制定有针对性的实施策略,促进乳腺癌患者血脂管理水平的提升。方法:采用描述性质性研究,以实施性研究综合框架2.0为指导制定访谈提纲,分别对乳腺癌患者及相关医务工作者进行半结构化访谈,然后对访谈资料进行演绎内容分析。结果:共访谈了16名乳腺癌患者及11名医务工作者,提取出11个主要障碍因素。其中,创新障碍因素包括乳腺癌血脂管理证据实践复杂及试用性不足;内部障碍因素包括乳腺专科血脂管理优先性不足、医务人员血脂管理知识信息获取有限、医院缺乏血脂管理网络及专科医院血脂管理资源受限;外部障碍因素为缺乏院际间合作与联络;个体障碍因素包括乳腺癌患者血脂关注度低及管理机会缺失、动力缺失、能力受限。结论:乳腺癌患者的血脂管理尚未引起广泛关注,医院诊疗护理及患者自我管理过程均存在一定障碍,呼吁医疗机构积极开展跨院跨学科交流合作、规范乳腺癌患者血脂管理流程,并完善相应资源体系,为患者提供血脂管理指导,以减少乳腺癌患者的血脂异常情况。

关键词: 实施性研究; 乳腺癌; 血脂管理; 障碍因素; 质性研究

Abstract: Objective: To identify the key barriers to effective lipid management in breast cancer patients in order to inform developing targeted strategies, and ultimately enhancing lipid management practices. Methods: A descriptive qualitative design was employed. Semi-structured interviews were conducted with breast cancer patients and healthcare professionals, using an interview guide informed by the updated Consolidated Framework for Implementation Research. Data were analyzed through content analysis to extract key themes. Results: A total of 16 breast cancer patients and 11 healthcare professionals participated in the study. Eleven primary barriers to lipid management for breast cancer patients were identified. Innovation-related barriers included the complexity of evidence-based practices and the limited trialability of lipid management interventions. Internal barriers encompassed inadequate prioritization of lipid management in hospitals, restricted access to knowledge and information, and the absence of lipid management networks and limited lipid management resources in specialized hospitals. External barriers included insufficient inter-hospital collaboration and communication. Individual-level barriers were characterized by patients' low awareness of lipid management, as well as limited opportunities, motivation, and capability for self-management. Conclusion: Lipid management in breast cancer patients remains underemphasized, with obstacles observed across diagnostic, therapeutic, nursing, and self-management domains. To address these challenges, medical institutions should promote interdisciplinary and inter-hospital collaboration, standardize lipid management protocols, and enhance resource allocation to provide tailored, patient-centered lipid management guidance.

Key words: implementation research; breast cancer; blood lipid management; obstacle factor; qualitative research

中图分类号:  R47;R197