Koldjeski Dixie, Kirkpatrick Mary K, Everett Lou, Brown Sylvia, Swanson Melvin
Schools of Nursing, Rivers Building, East Carolina University, Greenville, NC 27858, USA.
Cancer Nurs. 2004 Sep-Oct;27(5):370-8; quiz 379-80. doi: 10.1097/00002820-200409000-00006.
Critical review of general health-seeking models showed a need for expansion to include the early and atypical symptom period associated with ovarian cancer and the role of self and primary care in the diagnostic process. Data from family functioning research showed that in the self-care phase, the initial gastrointestinal symptoms were unrecognized as serious, given common sense labels, and self-managed. When primary care provider care was sought, misdiagnoses occurred three fourth of the time. Diagnostic delays occurred in these 2 phases of care. An expansion of a model of health seeking links personal and family risks and adds early symptom data may be obtained through monthly self-monitoring by women using a symptom checklist. Organization of risks and symptom information assists in interpretation of disparate streams of data and gives a recommended outcome: high personal risk level + high family risk level + high early and persistent symptoms presence = high need for a prompt gynecological evaluation. The restructured health-seeking process requires women be taught how to monitor their ovarian health. Nurses and primary care providers need frequent continuing education updates and the health media need current and accurate information about this malignancy.
对一般健康寻求模式的批判性回顾表明，有必要进行扩展，以纳入与卵巢癌相关的早期和非典型症状期，以及自我和初级保健在诊断过程中的作用。家庭功能研究数据显示，在自我护理阶段，最初的胃肠道症状未被视为严重问题，被贴上常识性标签并进行自我管理。当寻求初级保健提供者的护理时，四分之三的情况会出现误诊。在这两个护理阶段都出现了诊断延迟。扩展健康寻求模式，将个人和家庭风险联系起来，并添加早期症状数据，可以通过女性每月使用症状清单进行自我监测来实现。组织风险和症状信息有助于解释不同的数据流，并给出推荐结果：高个人风险水平 + 高家庭风险水平 + 高早期和持续症状存在 = 急需进行快速妇科评估。重新构建的健康寻求过程需要教导女性如何监测她们的卵巢健康。护士和初级保健提供者需要频繁的继续教育更新，健康媒体需要有关这种恶性肿瘤的最新和准确信息。
