Clayton Margaret F, Mishel Merle H, Belyea Michael
College of Nursing, University of Utah, Salt Lake City, Utah 84112-5880, USA.
Res Nurs Health. 2006 Feb;29(1):18-39. doi: 10.1002/nur.20108.
Among older, long-term breast cancer survivors, symptoms from previous treatment can generate uncertainty about whether they represent co-morbid conditions, recurrence, or normal aging. This uncertainty can result in emotional distress and thoughts of recurrence. Communication with health care providers may help women reduce uncertainty and improve both emotional and cognitive well-being. To assess the influence of symptoms, uncertainty, and communication with providers on well-being, data from 203 Caucasian and African American survivors, 5-9 years post treatment, were tested using structural equation modeling. Symptoms, age, and uncertainty had the strongest influence on well-being, regardless of race. There was an unexpected positive association between patient-provider communication and thoughts of recurrence. Descriptive analysis revealed that 52% of women were unable to achieve their desired decision-making role with health care providers.
在年龄较大的长期乳腺癌幸存者中，既往治疗产生的症状会让人不确定这些症状是代表合并症、复发还是正常衰老。这种不确定性会导致情绪困扰和复发的念头。与医疗服务提供者沟通可能有助于女性减少不确定性，改善情绪和认知健康。为了评估症状、不确定性以及与提供者的沟通对健康的影响，我们使用结构方程模型对203名治疗后5至9年的白种人和非裔美国幸存者的数据进行了测试。无论种族如何，症状、年龄和不确定性对健康的影响最大。患者与提供者的沟通与复发念头之间存在意外的正相关。描述性分析显示，52%的女性无法在与医疗服务提供者的决策中发挥她们期望的作用。
