Balneaves Lynda G, Truant Tracy L O, Kelly Mary, Verhoef Marja J, Davison B Joyce
School of Nursing, University of British Columbia, 302-6190 Agronomy Road, Vancouver, British Columbia, Canada.
Support Care Cancer. 2007 Aug;15(8):973-83. doi: 10.1007/s00520-007-0282-3. Epub 2007 Jul 3.
The purpose of this study was to explore the personal and social processes women with breast cancer engaged in when making decisions about complementary and alternative medicine (CAM). The overall aim was to develop a conceptual model of the treatment decision-making process specific to breast cancer care and CAM that will inform future information and decision support strategies.
Grounded theory methodology explored the decisions of women with breast cancer using CAM. Semistructured interviews were conducted with 20 women diagnosed with early-stage breast cancer. Following open, axial, and selective coding, the constant comparative method was used to identify key themes in the data and develop a conceptual model of the CAM decision-making process.
The final decision-making model, Bridging the Gap, was comprised of four core concepts including maximizing choices/minimizing risks, experiencing conflict, gathering and filtering information, and bridging the gap. Women with breast cancer used one of three decision-making styles to address the paradigmatic, informational, and role conflict they experienced as a result of the gap they perceived between conventional care and CAM: (1) taking it one step at a time, (2) playing it safe, and (3) bringing it all together.
Women with breast cancer face conflict and anxiety when making decisions about CAM within a conventional cancer care context. Information and decision support strategies are needed to ensure women are making safe, informed treatment decisions about CAM. The model, Bridging the Gap, provides a conceptual framework for future decision support interventions.
本研究的目的是探究乳腺癌女性在对补充和替代医学(CAM)做出决策时所涉及的个人和社会过程。总体目标是建立一个针对乳腺癌护理和补充替代医学的治疗决策过程概念模型,为未来的信息和决策支持策略提供依据。
扎根理论方法用于探究乳腺癌女性使用补充替代医学的决策情况。对20名被诊断为早期乳腺癌的女性进行了半结构化访谈。经过开放式编码、主轴编码和选择性编码后,采用持续比较法来识别数据中的关键主题,并建立补充替代医学决策过程的概念模型。
最终的决策模型“弥合差距”由四个核心概念组成,包括最大化选择/最小化风险、经历冲突、收集和筛选信息以及弥合差距。乳腺癌女性采用三种决策方式之一来应对她们因感知到传统护理与补充替代医学之间的差距而经历的范式、信息和角色冲突:(1)一步一个脚印,(2)谨慎行事,(3)统筹兼顾。
乳腺癌女性在传统癌症护理背景下对补充替代医学做出决策时面临冲突和焦虑。需要信息和决策支持策略来确保女性对补充替代医学做出安全、明智的治疗决策。“弥合差距”模型为未来的决策支持干预提供了一个概念框架。