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保乳手术及放射治疗后年轻乳腺癌女性的生活质量、生存情况及心理社会调适

Quality of life, survivorship, and psychosocial adjustment of young women with breast cancer after breast-conserving surgery and radiation therapy.

作者信息

Dow K H, Lafferty P

机构信息

School of Nursing, College of Health and Public Affairs, University of Central Florida, Orlando, USA.

出版信息

Oncol Nurs Forum. 2000 Nov-Dec;27(10):1555-64.

Abstract

PURPOSE/OBJECTIVES: To examine changes in quality of life (QOL), psychosocial adjustment, and survivorship issues over time of women younger than 45 years who underwent breast-conserving surgery and radiation therapy (RT) for breast cancer.

DESIGN

Repeated measures, longitudinal design.

METHODS

Data were collected at four time points: start of RT, midpoint of RT, end of RT, and six months after RT. Three instruments were used to collect data: Quality-of-Life Index, Psychosocial Adjustment to Illness Scale, and the newly developed Adaptation to Survivorship Experience. Subjects also participated in an indepth interview at the start of RT.

SETTING

A large radiation oncology department located in an urban teaching hospital in the Northeast United States.

SAMPLE

23 women with newly diagnosed stage I or II breast cancer who were starting RT following breast-conserving surgery, with a mean age of 37.8 years (range = 25-45 years).

MAIN RESEARCH VARIABLES

QOL, psychosocial adjustment, and adaptation to survivorship experience.

FINDINGS

Although subjects adjusted their lives to accommodate RT, QOL declined from the start of RT to midpoint, with gradual improvement reported six months later. Social and sexual adjustment declined from start of RT to six months later. Negative perceptions of the survivorship experience and worry about cancer increased from the start of RT to six months later.

CONCLUSIONS

Young women with breast cancer experience changes in QOL, psychosocial adjustment, and adaptation to survivorship issues during RT. Changes may not reflect what is observed in clinical practice.

IMPLICATIONS FOR NURSING PRACTICE

Nurses need to be aware of changes in QOL, psychosocial adjustment, and survivorship to better understand and support young women during RT.

摘要

目的/目标:研究45岁以下接受保乳手术及放疗的乳腺癌女性患者,其生活质量(QOL)、心理社会适应情况及生存问题随时间的变化。

设计

重复测量纵向设计。

方法

在四个时间点收集数据:放疗开始时、放疗中期、放疗结束时以及放疗后六个月。使用三种工具收集数据:生活质量指数、疾病心理社会适应量表以及新开发的生存经历适应量表。研究对象在放疗开始时还参与了一次深入访谈。

地点

美国东北部一家城市教学医院的大型放射肿瘤科室。

样本

23名新诊断为I期或II期乳腺癌且保乳手术后开始放疗的女性,平均年龄37.8岁(范围=25 - 45岁)。

主要研究变量

生活质量、心理社会适应情况以及对生存经历的适应情况。

研究结果

尽管研究对象调整生活以适应放疗,但生活质量从放疗开始至中期下降,六个月后报告有逐渐改善。社会和性方面的适应情况从放疗开始至六个月后下降。对生存经历的负面认知以及对癌症的担忧从放疗开始至六个月后增加。

结论

年轻乳腺癌女性在放疗期间生活质量、心理社会适应情况以及对生存问题的适应方面会发生变化。这些变化可能与临床实践中观察到的情况不同。

对护理实践的启示

护士需要了解生活质量、心理社会适应情况以及生存方面的变化,以便在放疗期间更好地理解和支持年轻女性。

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