Objective:To further explore the symptom experience and coping strategies of patients with multiple myeloma, so as to provide reference for the formulation of symptom management programs.Methods:Objective sampling method was used to conduct semi-structured in-depth interviews on 15 patients with multiple myeloma in Hematology Department of Nanjing Drum Tower Hospital from December 2021 to June 2022 and the model of symptom management theory was used as the framework to construct an interview outline. The Colaizzi 7-step analysis method was used to analyze data and extract themes.Results:Three main themes were summarized: symptom experience (obvious symptom perception, poor symptom assessment ability, negative symptom response); symptom management strategy (vague knowledge of symptom management, hope to get professional guidance, expect to get continuity of management); symptom management outcomes (recurrent anxiety, reordering, adaptive behavior).Conclusions:Patients with multiple myeloma have diverse and complex real symptom experience in different periods. Medical staff should pay attention to patients′ symptom response and coping needs and develop a systematic symptom management plan, so as to help them create better self-management and improve their quality of life.

Objective:To investigate the current status of anticipatory grief among caregivers of major relatives of hospitalized patients with hematological malignancies and analyze its influencing factors.Methods:Convenience sampling method was used to select 208 primary relatives and caregivers of patients with hematological malignancies who were hospitalized in the Department of Hematology, Nanjing Drum Tower Hospital from March to November 2020. Self-designed general information questionnaire, Chinese version of Anticipatory Grief Scale, caregiver burden scale and simple coping style questionnaire were used. The current status and influencing factors of anticipatory grief among caregivers of major relatives of hospitalized patients with hematological diseases were also analyzed.Results:The expected sadness score of caregivers of major relatives of hospitalized patients with hematological malignancies was 79(72, 91). The results of multiple linear regression analysis showed that the main influencing factors of anticipatory grief among caregivers of major relatives of hospitalized patients with hematological malignancies were the stage of treatment, the severity of subjective symptoms, whether to seek medical treatment in other places, the working status of caregivers of major relatives was unemployed, relationships with patients were parents, caregiver burden, and negative coping styles, which explained 83.1% of the total variation.Conclusions:Anticipatory grief is more serious among the caregivers of major relatives of hospitalized patients with hematological malignancies. It is recommended that nurses in the Hematology Department detect and assess the level of anticipatory grief of caregivers in a timely manner, and give corresponding interventions according to individual differences, so as to improve the physical and mental health of the caregivers, and then improve the quality of care and promote the recovery of patients.

目的 调查多发性骨髓瘤患者疲劳现况并分析其影响因素,为制订和实施针对性干预护理措施或科研人员开展高证据等级的护理研究提供科学依据.方法 采用一般资料问卷、多维疲劳量表、匹兹堡睡眠质量指数量表、Zung焦虑自评量表、Zung抑郁自评量表及自我感受负担量表对126例多发性骨髓瘤患者进行调查.结果 多发性骨髓瘤患者总体疲劳得分为(67.20±10.65)分,属重度疲劳;多重线性回归分析显示,多发性骨髓瘤患者疲劳的影响因素为家庭人均年收入、化疗疗程数量、睡眠指数、抑郁、自我感受负担(均P<0.05).结论 多发性骨髓瘤患者疲劳感处于较高水平,护理人员可基于疲劳感因素和症状评估,制订个性化干预策略,提高睡眠质量;提供个性化的心理护理等来改善患者的疲劳现况,提高其生活质量.

目的 探究老年多发性骨髓瘤住院病人自我感受负担状况并分析其影响因素. 方法 运用一般资料表、中文版自我感受负担量表(SPBS)、焦虑自评量表、Barthel指数量表及简易应对方式问卷对南京鼓楼医院血液科103例老年多发性骨髓瘤住院病人开展调查.采用多重线性逐步回归分析老年多发性骨髓瘤住院病人自我感受负担的影响因素. 结果 103例老年多发性骨髓瘤住院病人均存在自我感受负担,SPBS平均分为(33.08±5.48)分,处于中度水平.多重线性逐步回归分析结果显示,临床分期、焦虑及消极应对方式是老年多发性骨髓瘤住院病人自我感受负担的主要影响因素. 结论 老年多发性骨髓瘤住院病人自我感受负担处于中度水平且普遍存在,因此,为了减轻病人的自我负担水平,医护人员可通过控制原发病、实施相应的心理护理、促进病人积极应对等进行针对性的干预.

总结1例淋巴瘤病人经外周静脉置入中心静脉导管后41 d体内断管漂移入心脏的护理.护理要点包括断管后的紧急处理、病情观察、心理护理、健康宣教等.通过多学科合作急救和护理,导管断端顺利取出,病人安全出院.

从全程护理的角度,综述了嵌合性抗原受体T细胞(CAR-T)治疗的流程及相关并发症的护理,以期为今后建立规范统一的血液系统肿瘤CAR-T治疗护理规范提供依据.