Health Services and Policy Analysis Program, University of California, Berkeley, Berkeley, CA 94720-7360, USA.
Psychooncology. 2011 May;20(5):506-16. doi: 10.1002/pon.1749.
The study addresses: (1) what women regret about their breast cancer treatment 5 years later, and (2) what characteristics of disease and treatment predict post-treatment regret.
Interviews were conducted with breast cancer survivors in the San Francisco Bay Area. Participants were interviewed following diagnosis. Five years later, women were asked whether they had any regrets about their cancer treatment (N=449). Qualitative analysis was used to identify regret content, and logistic regression was used to determine what characteristics of treatment predicted regret.
Forty two point five percent women in the sample regretted some aspect of the treatment. The most common regrets were primary surgery (24.1%), chemotherapy and/or radiation (21.5%), reconstruction (17.8%), and problems with providers (13.1%). In addition, women regretted inactions (59.2%) (actions that they did not take) more than actions that they did take (30.4%). This represents a novel finding in the study of post-treatment regret, which has largely focused on regrets over actions. Quantitative analysis revealed that women who were anxious about the future (OR=1.32; p=0.03) or had problems communicating with physicians (OR=1.26; p=0.02) during treatment were more likely to express regret 5 years later. In addition, women with new or recurrent cancers 5 years later were significantly more likely to regret some aspect of their primary treatment (OR=5.81; p<0.001).
This research supports addressing the psychosocial aspects of cancer care and improving physician-patient communication. Evidence is also provided for addressing the unique emotional needs of women with recurrent cancers, who may experience an undue burden of regret.
本研究旨在:(1)探讨女性在乳腺癌治疗 5 年后对哪些方面感到遗憾;(2)探讨哪些疾病和治疗特征可预测治疗后遗憾。
对旧金山湾区的乳腺癌幸存者进行了访谈。参与者在诊断后接受了访谈。5 年后,询问女性是否对癌症治疗有任何遗憾(N=449)。采用定性分析识别遗憾内容,采用逻辑回归分析确定治疗的哪些特征可预测遗憾。
在样本中,42.5%的女性对治疗的某些方面感到遗憾。最常见的遗憾是初次手术(24.1%)、化疗和/或放疗(21.5%)、重建(17.8%)以及与提供者的问题(13.1%)。此外,女性对不作为(59.2%)(未采取的行动)的遗憾程度大于对已采取的行动(30.4%)的遗憾程度。这是治疗后遗憾研究中的一个新发现,该研究主要集中在对行动的遗憾上。定量分析显示,在治疗过程中对未来感到焦虑(OR=1.32;p=0.03)或与医生沟通有问题(OR=1.26;p=0.02)的女性,5 年后更有可能表达遗憾。此外,5 年后出现新发或复发性癌症的女性对其初次治疗的某些方面更有可能感到遗憾(OR=5.81;p<0.001)。
这项研究支持解决癌症治疗的社会心理方面的问题,并改善医患沟通。还为解决复发性癌症女性的独特情感需求提供了证据,这些女性可能会经历不必要的遗憾负担。