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目的:探讨影响农村恶性肿瘤患儿疾病及时诊断的因素,为制订促进农村恶性肿瘤患儿及时诊断策略提供依据。方法:采用质性研究中的现象学研究方法,用立意取样法选取安徽省12例农村恶性肿瘤患儿家长,采用深入访谈法收集资料,Colaizzi法分析资料并形成主题。结果:在农村恶性肿瘤患儿疾病诊断的过程中有四大主题,分别是先兆症状或体征,促发事件,首诊时间和诊断经历。结论:该次调查对象多数患儿存在不同程度的就医和诊断延误。影响疾病诊断延误的因素有症状或体征特点、社会心理因素、人口学特征、医生诊断水平等。一方面需要在农村地区家长中建立积极健康的儿童保健行为和就医行为;另一方面需要提高基层医院的儿童恶性肿瘤识别能力,在医疗系统规范首诊医生负责制及转诊制度。
Objective: To explore the factors influencing the timely diagnosis of diseases in children with malignant tumors in rural areas, and to provide the basis for making timely diagnosis strategies in promoting children with malignant tumors in rural areas. Methods: Using phenomenological methods in qualitative research, parents of 12 rural children with malignant tumors in Anhui Province were selected by deliberate sampling method. Data were collected by in-depth interviews and analyzed by Colaizzi method. Results: There are four main themes in the diagnosis of disease in children with malignant tumors in rural areas: aura symptom or sign, incident, time of first visit and diagnosis. Conclusion: Most children in this survey have different degrees of medical treatment and diagnosis delay. Factors affecting the delay in diagnosis of the disease symptoms or signs, social psychological factors, demographic characteristics, the level of diagnosis of doctors. On the one hand, it is necessary to establish active and healthy child health care behaviors and medical practices among parents in rural areas; on the other hand, it is necessary to enhance the ability of children’s cancer identification in primary hospitals and to standardize the doctor’s responsibility system and referral system in the medical system.