Rosedale Mary, Fu Mei R
College of Nursing, New York University, New York City, USA.
Oncol Nurs Forum. 2010 Jan;37(1):E28-33. doi: 10.1188/10.ONF.E28-E33.
PURPOSE/OBJECTIVES: To describe women's unexpected and distressing symptom experiences after breast cancer treatment.
Qualitative and descriptive.
Depending upon their preference, participants were interviewed in their homes or in a private office space in a nearby library.
Purposive sample of 13 women 1-18 years after breast cancer treatment.
Secondary analysis of phenomenologic data (constant comparative method).
Breast cancer symptom distress, ongoing symptoms, and unexpected experiences.
Women described experiences of unexpected and distressing symptoms in the years following breast cancer treatment. Symptoms included pain, loss of energy, impaired limb movement, cognitive disturbance, changed sexual experience, and lymphedema. Four central themes were derived: living with lingering symptoms, confronting unexpected situations, losing precancer being, and feeling like a has-been. Distress intensified when women expected symptoms to disappear but symptoms persisted instead. Increased distress also was associated with sudden and unexpected situations or when symptoms elicited feelings of loss about precancer being and feelings of being a has been. Findings suggest that symptom distress has temporal, situational, and attributive dimensions.
Breast cancer survivors' perceptions of ongoing and unexpected symptoms have important influences on quality of life. Understanding temporal, situational, and attributive dimensions of symptom distress empowers nurses and healthcare professionals to help breast cancer survivors prepare for subsequent ongoing or unexpected experiences in the years after breast cancer treatment.
Follow-up care for breast cancer survivors should foster dialogue about ways that symptoms might emerge and that unexpected situations might occur. Prospective studies are needed to examine symptom distress in terms of temporal, situational, and attributive dimensions and explore the relationship between symptom distress and psychological distress after breast cancer treatment.
目的/目标：描述乳腺癌治疗后女性意外出现的痛苦症状体验。
定性和描述性研究。
根据参与者的意愿，她们在自己家中或附近图书馆的私人办公区域接受访谈。
选取了13名乳腺癌治疗后1至18年的女性作为目的抽样样本。
对现象学数据进行二次分析（持续比较法）。
乳腺癌症状困扰、持续症状和意外经历。
女性描述了乳腺癌治疗后数年出现的意外和痛苦症状体验。症状包括疼痛、精力丧失、肢体活动障碍、认知障碍、性体验改变和淋巴水肿。归纳出四个核心主题：与持续症状共存、面对意外情况、失去癌症前的自我、感觉像个过时的人。当女性期望症状消失但症状却持续存在时，困扰加剧。困扰加剧还与突发和意外情况相关，或者当症状引发对癌症前自我的失落感以及感觉像个过时的人时。研究结果表明，症状困扰具有时间、情境和归因维度。
乳腺癌幸存者对持续和意外症状的认知对生活质量有重要影响。了解症状困扰的时间、情境和归因维度，能使护士和医护人员帮助乳腺癌幸存者为乳腺癌治疗后数年可能出现的后续持续或意外经历做好准备。
对乳腺癌幸存者的后续护理应促进关于症状可能出现的方式以及可能发生意外情况的对话。需要进行前瞻性研究，从时间、情境和归因维度审视症状困扰，并探讨乳腺癌治疗后症状困扰与心理困扰之间的关系。
