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女性对导管原位癌的体验和认知的变化本质。

The shifting nature of women's experiences and perceptions of ductal carcinoma in situ.

机构信息

Sheffield Hallam University, UK.

出版信息

J Adv Nurs. 2012 Apr;68(4):856-67. doi: 10.1111/j.1365-2648.2011.05788.x. Epub 2011 Jul 25.

Abstract

AIM

This paper is a report of a descriptive qualitative study of the evolution of women's perceptions and experiences of ductal carcinoma in situ from the period near to diagnosis to 1 year later.

BACKGROUND

Ductal carcinoma in situ is a non-invasive breast condition where cancer cells are detected but confined to the ducts of the breast. With treatment, the condition has a positive prognosis but ironically patients undergo treatment similar to that for invasive breast cancer. There is a lack of longitudinal qualitative research studying women's experiences of ductal carcinoma in situ, especially among newly diagnosed patients, and how experiences change over time.

METHODS

Forty-five women took part in an initial interview following a diagnosis of ductal carcinoma in situ and 27 took part in a follow-up interview 9-13 months later. Data were collected between January 2007 and October 2008. Transcripts were analysed using a hybrid approach to thematic analysis.

FINDINGS

Women's early perceptions of ductal carcinoma in situ merged and sometimes conflicted with their lay beliefs of breast cancer. Perceptions and experiences of the condition shifted over time. These overriding aspects were evident in four themes identified across the interviews: (i) perceptions of ductal carcinoma in situ vs. breast cancer, (ii) from paradox to acceptance, (iii) personal impact, and (iv) support and interactions with others.

CONCLUSION

This study represents one of the few longitudinal qualitative studies with newly diagnosed patients, capturing women's initial and shifting experiences and perceptions of the condition. The issues identified need to be recognized in clinical practice and supported appropriately.

摘要

目的

本论文报告了一项关于女性对导管原位癌(DCIS)认知和体验演变的描述性定性研究,研究时间从接近诊断时到 1 年后。

背景

DCIS 是一种非浸润性乳腺癌,癌细胞已被检测到,但局限于乳腺导管内。经过治疗,该疾病具有良好的预后,但具有讽刺意味的是,患者接受的治疗与浸润性乳腺癌相似。目前缺乏对 DCIS 患者体验进行纵向定性研究,特别是对新诊断患者的研究,也缺乏对体验随时间变化的研究。

方法

45 名女性在诊断为 DCIS 后参加了首次访谈,其中 27 名女性在 9-13 个月后参加了随访访谈。数据收集于 2007 年 1 月至 2008 年 10 月之间。采用混合主题分析方法对转录本进行分析。

结果

女性对 DCIS 的早期认知与她们对乳腺癌的通俗观念融合,有时会发生冲突。随着时间的推移,对疾病的认知和体验也发生了变化。这些主导方面在四个贯穿访谈的主题中得到体现:(i)对 DCIS 与乳腺癌的认知,(ii)从矛盾到接受,(iii)个人影响,以及(iv)支持和与他人的互动。

结论

本研究是为数不多的对新诊断患者进行的纵向定性研究之一,该研究捕捉到了女性对该疾病的初始和不断变化的认知和体验。需要在临床实践中认识到这些问题,并给予适当的支持。

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