Gorman Jessica R, Usita Paula M, Madlensky Lisa, Pierce John P
Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA 92093-0901, USA.
J Cancer Surviv. 2009 Sep;3(3):181-91. doi: 10.1007/s11764-009-0089-y. Epub 2009 May 22.
This is an exploratory, qualitative investigation of breast cancer survivors' experiences with breastfeeding. Previous studies have focused on the physiology of lactation after surgery and treatment, but have not explored factors influencing breastfeeding decisions and behavior.
We used purposeful sampling to identify 11 breast cancer survivors who had a child after their diagnosis and treatment. Participants were recruited from among those in the Women's Healthy Eating and Living (WHEL) study and a Young Survival Coalition (YSC) affiliate. We conducted semi-structured, open-ended telephone interviews lasting 45-75 min. We used social cognitive theory (SCT) to structure questions regarding influences on breastfeeding behavior. We transcribed interviews and used cross-case, inductive analysis to identify themes.
Ten of 11 participants initiated breastfeeding. The following main themes emerged: 1) Cautiously hopeful, 2) Exhausting to rely on one breast, 3) Motivated despite challenges, 4) Support and lack of support, and 5) Encouraging to others.
DISCUSSION/CONCLUSIONS: Study participants were highly motivated to breastfeed but faced considerable challenges. Participants described problems that are not unique to women with breast cancer, but experienced these to a much greater degree because they relied mostly or entirely on one lactating breast. This study revealed a need for improved access to information and support and greater sensitivity to the obstacles faced by breast cancer survivors.
Results of this qualitative analysis indicate that interventions to support the efforts of breast cancer survivors who are interested in breastfeeding are warranted. Additional research would aid in the development of such interventions.
这是一项对乳腺癌幸存者母乳喂养经历的探索性定性研究。以往的研究主要关注手术和治疗后泌乳的生理情况，但尚未探讨影响母乳喂养决策和行为的因素。
我们采用目的抽样法，确定了11名在确诊和治疗后生育子女的乳腺癌幸存者。参与者从女性健康饮食与生活（WHEL）研究及一个青年生存联盟（YSC）分支机构的成员中招募。我们进行了时长45 - 75分钟的半结构化、开放式电话访谈。我们运用社会认知理论（SCT）来构建有关母乳喂养行为影响因素的问题。我们对访谈进行了转录，并采用跨案例归纳分析来确定主题。
11名参与者中有10人开始进行母乳喂养。出现了以下主要主题：1）谨慎乐观，2）仅靠一侧乳房哺乳令人疲惫，3）尽管面临挑战仍有动力，4）支持与缺乏支持，5）对他人起到鼓舞作用。
讨论/结论：研究参与者母乳喂养的积极性很高，但面临诸多挑战。参与者描述的问题并非乳腺癌女性所独有，但由于她们大多或完全依赖一侧泌乳乳房，这些问题的体验程度要大得多。本研究表明，需要改善信息获取和支持渠道，并对乳腺癌幸存者所面临的障碍给予更高的敏感度。
这项定性分析的结果表明，有必要对有意进行母乳喂养的乳腺癌幸存者提供支持干预措施。更多研究将有助于此类干预措施的开发。
