癌症护理中的症状管理：数字协作框架的进化概念分析

摘要(中文译文)

本研究采用Rodgers演化概念分析法，旨在厘清“症状管理”的核心属性、前因、后果及其与相关概念的区别，并在此基础上构建融合数字健康与协同照护的更新概念框架。通过系统检索Web of Science、PubMed、Embase、Cochrane Library、CINAHL及中文数据库中与癌症症状管理相关的文献，最终纳入23项符合标准的研究进行概念分析。研究识别出症状管理的六大核心属性，即动态性、连续性、多维性、多主体协作性、干预方式多样性及个体差异性；明确了关键前因（包括患者自我管理能力、健康素养、专业评估及系统支持）与主要结局（如生活质量改善、症状负担减轻，以及过度治疗和不公平的潜在风险）。此外，研究将症状管理与“症状控制”“姑息照护”“自我管理”等相关概念进行了概念区分，并提出了以数字赋能和多主体协同为特征的症状管理新范式。癌症症状管理是一个多维、动态、复杂的过程，需要多专业协作。本概念分析为该领域提供了清晰的定义和理论框架，可为未来研究、干预开发及临床实践提供参考，尤其为推进数字健康技术与协同照护模式的融合奠定了概念基础。未来研究应聚焦于跨情境验证、测量工具的标准化，以及技术方案与以患者为中心照护的平衡整合。

Abstract

An evolutionary concept analysis was conducted to clarify the core attributes, antecedents, consequences, and distinctions of "symptom management". Based on this analysis, an updated conceptual framework was developed to integrate digital health and collaborative care. This study employed Rodgers' evolutionary concept analysis method. Through a systematic search of the literature related to cancer symptom management in databases including Web of Science, PubMed, Embase, the Cochrane Library, CINAHL and Chinese databases, a total of 23 studies that met the inclusion criteria were included in the conceptual analysis. Research has identified six core attributes of symptom management, namely dynamism, continuity, multidimensionality, multi-stakeholder collaboration, diversity of intervention methods, and individual variability. Key antecedents (including patient self-management capacity, health literacy, professional assessment, and systemic support) and primary outcomes (such as improved quality of life, reduced symptom burden, as well as potential risks of overtreatment and inequity) have been clearly delineated. In addition, symptom management has been conceptually distinguished from related concepts such as "symptom control", "palliative care", and "self-management". Furthermore, a novel paradigm for symptom management has been proposed, characterized by digital empowerment and multi-stakeholder collaboration. Cancer symptom management is a multidimensional, dynamic, complex process requiring multi-professional collaboration. This conceptual analysis provides a clear definition and theoretical framework for the field, informing future research, intervention development, and clinical practice. In particular, a conceptual foundation is established for advancing the integration of digital health technologies and collaborative care models. Future research should focus on cross-contextual validation, standardization of measurement instruments, and the balanced integration of technological solutions with patient-centered care.

如何引用

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