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| 癌症患儿的入院适应以及应对策略研究
摘要
近年来，随着科学的进步和社会的发展，癌症的患病人数也在不断攀升，并且正趋于低龄化。癌症患儿治愈疾病需要较长一段时间的入院治疗，并面临着生理及心理方面的变化以及对环境的变化，这就有可能造成患儿的入院不适应，由于不适应导致各种问题再次加重患儿及家属的生理心理问题，从而造成一系列的恶性循环。笔者在上海某儿童医院血液科进行了为期半年的实习，开始关注并了解这个群体，患病儿童的年龄从几个月到十几岁不等，整个治疗过程是漫长且煎熬的。在实习过程中，笔者亲眼目睹了许多癌症患儿的诊治历程，根据患病情况不同，大多数患病孩子都要经历化疗、手术、放疗以及化疗的治疗流程，孩子除了要忍受身体上的疼痛和不适，还要经历生活环境的不断变化。然而入院不适应是患儿面临的很大的问题，造成入院不适应的原因很多，其中包含生理方面的疾病导致，也有可能是因为内心情绪变化导致，或者是环境的极大变化而导致各个方面的不适应，如果不能及时调试，入院不适应将会带来很多的负面影响，比如：疾病的恶化、心理的焦虑抑郁情绪的加重、甚至影响到癌症患儿正常的社交关系。于是，解决癌症患儿的入院适应问题迫在眉睫。
本研究采用定性研究方法，通过对13名儿童癌症患儿进行深入访谈，探讨其在入院以后的生理及心理变化、面临的困境以及应对方式等。同时，探寻儿童因入院不适应而产生的影响，鼓励儿童和其家庭保持“正常”的环境，增强患儿适应能力，最终可以帮助儿童应对自己的疾病，保持整个家庭系统的平稳运行。
针对上述研究发现，本研究从社会工作专业角度出发，提出癌症患儿应对入院适应问题的应对策略，打造“医社+医护+医院志愿者”团队，倡导“全人照顾”理念，促进相关政策制度的建立与完善发挥了一定的作用。
关键词：癌症患儿；入院适应；社会工作
Abstract
In recent years, with the progress of science and the development of society,the number of cancer patients is also rising, and is tending to be younger. Children with cancer need to be hospitalized for a long period of time to cure thedisease, and they are faced with physiological and psychological changes as well aschanges in the environment, which may lead to children's maladjustment to admission. As a result, a variety of problems will aggravate the physiological and psychological problems of children and their families, resulting in a series of nausea cycle.The author has been practicing in the Hematology Department of a children's Hospitalin Shanghai for half a year, and began to pay attention to and understand this group. The age of the sick children varies from several months to teenagers, and the whole treatment process is long and painful. In the process of practice,the author witnessed the diagnosis and treatment process of many children with cancer. According to the different conditions of the disease,most of the sick children have to go through the treatment process of chemotherapy, surgery, radiotherapy and chemotherapy. In addition to the physical pain and discomfort,the children also have to experience the continuous changes of their living environment.However, admission maladjustment is a big problem faced by children.There are many reasons for the maladjustment, including physiological diseases.It may also be caused by the change of inner emotion or the great change of environment.If it is not adjusted in time, it will bring a lot of negative effects,such as: the evil of the disease The aggravation of anxiety and depression may even affect the normal social relations of children with cancer. Therefore, it is urgent to solve the problem of hospitalized children with cancer.
In this study, qualitative research method was used to investigate the physiological and psychological changes, difficulties and coping styles of 13 children with cancer after admission. At the same time, explore the impact of children's maladjustment on admission.Encouraging children and their families to maintain a "normal" environment and enhance their adaptability can help children cope with their own diseases and maintain the smooth operation of the whole family system.
In view of the above findings, this study, from the perspective of social work,proposed coping strategies for children with cancer to cope with admission problems, built a team of "Medical Society + medical care + hospital volunteers",advocated the concept of "whole person care", and played a certain role in promoting the establishment and improvement of relevant policies and systems.
Keywords: Children with cancer；Social work；Admission adjustment
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