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乳腺癌辅助化疗患者的认知干预:需求分析。

Cognitive intervention for breast cancer patients undergoing adjuvant chemotherapy: a needs analysis.

机构信息

Work and Health Research Centre, Division of Psychology, School of Sport, Exercise & Health Sciences, Loughborough University, Leicestershire, UK.

出版信息

Cancer Nurs. 2011 Sep-Oct;34(5):385-92. doi: 10.1097/NCC.0b013e31820254f3.

Abstract

BACKGROUND

Evidence suggests women with breast cancer who had received chemotherapy experienced cognitive problems. Although these are largely subtle deficits, they can negatively impact a patient's quality of life, ability to work, and subsequent employment decisions.

OBJECTIVE

The present study explored what healthcare information and support are available to help women understand the effects of chemotherapy on daily functioning at home and at work. It also explored what information and support they would find useful as interventions.

METHODS

Qualitative interviews were carried out with 31 patients attending a breast cancer clinic 4 months after treatment completion (phase 1) and with 5 oncology health professionals (phase 2). Fifteen women who took part in the interviews completed a short questionnaire on suitable interventions (phase 3).

RESULTS

Participants reported problems with fatigue, low mood, memory, and attention. Problems with remembering tasks at work were most common. Participants requested more information and support on cognitive difficulties. Oncology health professionals discussed the need for information and support for patients on managing cognitive problems. From the findings, 4 interventions and delivery modes were identified and validated. These were information and activities on cognitive strategies, help with emotional distress associated with cognitive difficulties, and advice for families and employers.

CONCLUSION

Despite mixed evidence for cognitive problems associated with chemotherapy, there is a need for an intervention, and this may be related to managing emotional distress associated with perceived cognitive problems.

IMPLICATIONS FOR PRACTICE

Nurses should include potential cognitive problems when providing information to patients.

摘要

背景

有证据表明,接受过化疗的乳腺癌女性会出现认知问题。尽管这些问题在很大程度上是细微的缺陷,但它们会对患者的生活质量、工作能力和后续就业决策产生负面影响。

目的

本研究探讨了哪些医疗保健信息和支持可帮助女性了解化疗对家庭和工作中日常功能的影响。它还探讨了她们认为哪些信息和支持作为干预措施是有用的。

方法

在治疗完成后 4 个月(第 1 阶段)对 31 名参加乳腺癌诊所的患者和 5 名肿瘤学健康专业人员(第 2 阶段)进行了定性访谈。在访谈中,有 15 名女性完成了一份关于合适干预措施的简短问卷(第 3 阶段)。

结果

参与者报告了疲劳、情绪低落、记忆力和注意力方面的问题。工作中最常见的问题是记不住任务。参与者要求提供更多关于认知困难的信息和支持。肿瘤学健康专业人员讨论了为患者提供管理认知问题的信息和支持的必要性。根据研究结果,确定并验证了 4 种干预措施和交付模式。这些干预措施和交付模式包括认知策略信息和活动、帮助应对与认知困难相关的情绪困扰,以及为家人和雇主提供建议。

结论

尽管与化疗相关的认知问题的证据不一,但仍需要一种干预措施,而这种干预措施可能与管理与认知问题相关的情绪困扰有关。

实践意义

护士在向患者提供信息时应考虑潜在的认知问题。

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