Liao Mei-Nan, Chen Miin-Fu, Chen Shin-Cheh, Chen Ping-Ling
Graduate Institute of Medical Sciences, College of Medicine [corrected] Taipei Medical University, Taipei, Taiwan.
J Adv Nurs. 2007 Nov;60(3):289-98. doi: 10.1111/j.1365-2648.2007.04410.x. Epub 2007 Sep 11.
This paper is a report of a study to investigate changes in the healthcare and support needs during the diagnostic period, and factors that affect these needs in women with suspected breast cancer.
Although the needs of women with breast cancer are well recognized, few studies have examined the needs of women with suspected breast cancer during the diagnostic period.
This longitudinal study used an investigator-developed, self-administered questionnaire to collect data from 127 women in Taiwan on three occasions: notification of need for breast biopsy, before biopsy and after diagnosis. The data were collected from November 2004 to April 2005.
Participants had high need levels before and after diagnosis, with their top needs in the domains of healthcare services for diagnosis, follow-up and consultation, and information about the disease. They needed disease- and treatment-related information more than emotional support. Need levels were higher (P < 0.01) before diagnosis than after, highest before biopsy, and lowest after diagnosis. Furthermore, needs were higher (P < 0.01) before than after diagnosis for diagnostic services, disease information, and involvement of family and friends. Higher needs were found in married women with more education and no history of benign tumours. Need level did not differ statistically significantly by age, religious status, degree of social support, family history and breast symptoms.
Need levels of women with suspected breast cancer vary during the diagnostic period, are highest before breast biopsy, and related to personal characteristics and cultural context. Therefore, during this period, nursing staff should provide patients and families with culturally sensitive, individualized, supportive care.
本文报告一项研究,旨在调查疑似乳腺癌女性在诊断期间医疗保健和支持需求的变化,以及影响这些需求的因素。
尽管乳腺癌女性的需求已得到充分认识,但很少有研究探讨疑似乳腺癌女性在诊断期间的需求。
这项纵向研究使用研究者自行编制的自填式问卷,在三个时间点收集了台湾127名女性的数据:接到乳房活检通知时、活检前和诊断后。数据收集时间为2004年11月至2005年4月。
参与者在诊断前后的需求水平较高,其首要需求在诊断、随访和咨询的医疗服务领域以及疾病信息方面。她们对疾病和治疗相关信息的需求超过情感支持。诊断前的需求水平高于诊断后(P<0.01),活检前最高,诊断后最低。此外,诊断前在诊断服务、疾病信息以及家人和朋友的参与方面的需求高于诊断后(P<0.01)。受教育程度较高且无良性肿瘤病史的已婚女性需求更高。需求水平在年龄、宗教信仰、社会支持程度、家族史和乳房症状方面无统计学显著差异。
疑似乳腺癌女性在诊断期间的需求水平各不相同,在乳房活检前最高,且与个人特征和文化背景有关。因此,在此期间,护理人员应向患者及其家人提供具有文化敏感性、个性化的支持性护理。