Maliski Sally L, Heilemann MarySue V, McCorkle Ruth
Department of Urology, UCLA Jonsson Comprehensive Cancer Center, Box 956900, Los Angeles, CA 90095-6900, USA.
Nurs Res. 2002 Nov-Dec;51(6):391-7. doi: 10.1097/00006199-200211000-00007.
While little is known about the couple's process of moving from diagnosis of prostate cancer to treatment, it is acknowledged that cancer-and prostate cancer in particular-affects the couple, not just the patient. This highlighted the need to illuminate this process as a foundation for development of nursing interventions.
To describe the experience of men who are diagnosed with prostate cancer and their wives, from the time of diagnosis through staging to the completion of radical prostatectomy.
A qualitative cross-sectional approach was used to elicit couples' experiences from diagnosis to the time of the interview including their response to diagnosis, their treatment decision-making process, and how the couple moved from the decision to have surgery through the staging process to the time that the surgery was completed. A total of 20 couples participated.
Analysis of the data revealed that a number of themes related to the couples' process of moving from diagnosis to treatment. Initially, the diagnosis of prostate cancer represented a loss of control that led these couples to put themselves through a "crash course" on prostate cancer. The information gathered led these couples to conclude that prostate cancer was "good cancer." This enabled them to refocus their energies and start their "quest for the best" treatment and surgeon. Once this was accomplished, the couples began to prepare for surgery that culminated in the turning over of complete control to the surgeon and hospital staff at the time of surgery.
The participants discovered they were able to manage the demands presented by the intrusion of a cancer diagnosis and mount a response to what at first threatened to be a "death sentence." By engaging in the challenge of gathering a volume of facts and a variety of details, they could make informed decisions. Couples were able to regain a sense of control through the engagement in decision-making related to treatment, surgeon, and hospital, and through the transformation of the meaning of the malignant diagnosis to that of a "good cancer."
虽然对于夫妻从前列腺癌诊断到治疗的过程了解甚少，但人们认识到癌症——尤其是前列腺癌——不仅影响患者本人，还会对夫妻双方产生影响。这凸显了阐明这一过程的必要性，以此作为制定护理干预措施的基础。
描述被诊断为前列腺癌的男性及其妻子从诊断到分期再到根治性前列腺切除术完成期间的经历。
采用定性横断面研究方法，了解夫妻从诊断到访谈时的经历，包括他们对诊断的反应、治疗决策过程，以及夫妻如何从决定手术到完成分期过程直至手术结束。共有20对夫妻参与。
数据分析显示，有若干主题与夫妻从诊断到治疗的过程相关。最初，前列腺癌的诊断意味着失去控制，这使得这些夫妻开始对前列腺癌进行“速成学习”。所收集的信息让这些夫妻得出结论，认为前列腺癌是“幸运癌”。这使他们能够重新集中精力，开始“寻找最佳”治疗方法和外科医生。一旦完成这一步，夫妻便开始为手术做准备，最终在手术时将完全控制权交给外科医生和医院工作人员。
参与者发现他们能够应对癌症诊断带来的各种要求，并对最初看似是“死刑判决”的情况做出反应。通过积极应对收集大量事实和各种细节的挑战，他们能够做出明智的决定。夫妻通过参与与治疗、外科医生和医院相关的决策，并将恶性诊断的意义转变为“幸运癌”的意义，重新获得了控制感。
