刘玲珑 张笑倩 刘长莹

[摘要] 目的 于护理学视角下对癌症自我表露的概念进行界定。 方法 采用Rodgers演化概念分析法，系统检索中国学术期刊全文数据库、中国生物医学文献数据库、万方、维普、PubMed、CINHAL、the Cochrane Library、Web of Science、Embase、和PsycINFO。搜索时限为建库至2019年10月。纳入涉及癌症自我表露的原始研究、系统评价、个案分析等。 结果 癌症自我表露具有健康人格与心理特质、人际关系调节变量、社会关系的核心、动态交互过程、与癌症发展轨迹相关自我定义这5个核心特征。最终定义为癌症患者与其照护或聆听者的一种相处与交流模式。一方面向他人表达自己在患病过程中的认知、情感、意识、经验或困惑;另一方面表达自身对外界情境或对他人的态度与反馈评价。目的即为处理癌症相关的生理与心理困扰，防止癌症影响正常生活轨迹，提供其寻找生命意义与个人成长的机会，造就良好心理与生理健康结局，同时促进与其他照顾者的相互理解与人际交往。结论 通过严格的方法学进行癌症自我表露这一重要概念的澄清和解释，将使其在护理实践中的应用获得有效性和可靠性。

[关键词] 癌症;自我表露;概念分析;护理

[中图分类号] R473.73          [文献标识码] A          [文章编号] 1673-7210（2020）08（b）-0167-06

[Abstract] Objective To define the concept of cancer self-disclosure from the perspective of nursing. Methods The concept analysis method of Rodgers′ evolutionary was used to systematically search in China National Knowledge Internet， China Biology Medicine disc， Wanfang， VIP， PubMed， CINHAL， the Cochrane Library， Web of Science， Embase and PsycINFO. The search period was between the construction date of database and October 2019. The original studies， systematic reviews， case reports and others about cancer self-disclosure were included in this study. Results Cancer self-disclosure has five core characteristics： healthy personality and psychological characteristics， interpersonal relationship regulation variables， core of social relations， dynamic interaction process， and self-definition related to cancer development trajectory. Finally， it is defined as a kind of getting along and communication mode between cancer patients and their caregivers or listeners. On the one hand， express your cognition， emotion， consciousness， experience or confusion to others during the illness. On the other hand， express my attitude and feedback to the external situation or others. The purpose was to deal with the physical and psychological troubles related to cancer， prevent cancer from affecting the normal life trajectory， provide opportunities for them to find the meaning of life and personal growth， create a good mental and physical health outcome， and promote mutual understanding and interpersonal communication with other caregivers. Conclusion The clarification and interpretation of the important concept of cancer self-disclosure through strict methodology will make its application in nursing practice effective and reliable.

[Key words] Cancer; Self-disclosure; Concept analysis; Nursing

根據联合国国际癌症研究机构公开数据显示，2018年有1810万例新癌症病例和960万例癌症死亡病例发生，2030年癌症患病负担将呈现猛烈增长趋势，预计每年将新增2200万例新发病例和1300万例死亡病例[1-2]。在此恶劣趋势之下，众多研究趋向于观察并验证自我表露在癌症中所发挥的积极作用。……