Lee Pei-Shan, Lee Chyi-Long, Hu Shui-Tao, Tsao Lee-Ing
Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
J Clin Nurs. 2014 Sep;23(17-18):2481-9. doi: 10.1111/jocn.12429. Epub 2013 Dec 18.
To generate a descriptive theoretical framework about the experiences of women who discontinued hormone replacement therapy.
Some menopausal women would depend on hormone replacement therapy for relieving their menopausal symptoms. However, most of them feared of hormone replacement therapy's side effects and tried to discontinue hormone replacement therapy immediately. How did these women self-manage their discomforts without using dependent medicine--hormone replacement therapy? There are few studies conducted on this issue.
A grounded theory research was applied.
Nineteen Taiwanese women discontinuing hormone replacement therapy for three months, aged 45 to 67 years, participated in face-to-face audio-taped interviews. Data collection, and coding of interviews, and data analysis occurred simultaneously. All conversations were audio-recorded and then transcribed as verbatim text. The constant comparative method was used to analyse the interview data.
'Relieving my discomforts safely' was the core theme for describing and guiding the process of discontinuing hormone replacement therapy. 'Immediately discontinuing hormone replacement therapy--it would hurt my body' was identified as the antecedent condition. Analyses showed five dimensions to the women's relieving my discomforts safely: (1) symptoms bothered me again, (2) negative emotions, (3) learning to let it go, (4) trying to use nonhormone replacement therapy or products and (5) choosing safely therapies as first priority. Finally, some women would choose their suitable nonhormone replacement therapy way, and some women would reuse hormone replacement therapy cautiously.
'Relieving my discomforts safely' was the first-priority consideration for the menopausal women discontinuing hormone replacement therapy. It is the challenge to establish the health programme or management for helping these women felt safety and security to relieve their menopausal symptoms by using hormone replacement therapy or nonhormone replacement therapy.
Healthcare providers need to empower women the rights of decision-making of using hormone replacement therapy and assist them in monitoring their health status to reduce their fear and uncertainty.
构建一个关于停止激素替代疗法的女性经历的描述性理论框架。
一些更年期女性会依赖激素替代疗法来缓解更年期症状。然而，她们中的大多数人担心激素替代疗法的副作用，并试图立即停止使用激素替代疗法。这些女性在不使用依赖性药物——激素替代疗法的情况下，是如何自我管理不适症状的呢？针对这个问题的研究很少。
采用扎根理论研究方法。
19名年龄在45至67岁、已停止激素替代疗法三个月的台湾女性参与了面对面的录音访谈。数据收集、访谈编码和数据分析同步进行。所有对话都进行了录音，然后逐字转录为文本。采用持续比较法对访谈数据进行分析。
“安全缓解不适”是描述和指导停止激素替代疗法过程的核心主题。“立即停止激素替代疗法——这会伤害我的身体”被确定为前提条件。分析表明，女性安全缓解不适有五个维度：（1）症状再次困扰我，（2）负面情绪，（3）学会释怀，（4）尝试使用非激素替代疗法或产品，（5）将安全疗法作为首要选择。最后，一些女性会选择适合自己的非激素替代疗法，一些女性会谨慎地重新使用激素替代疗法。
“安全缓解不适”是停止激素替代疗法的更年期女性的首要考虑因素。建立健康计划或管理措施，帮助这些女性通过使用激素替代疗法或非激素替代疗法安全缓解更年期症状，是一项挑战。
医疗保健提供者需要赋予女性使用激素替代疗法的决策权利，并协助她们监测健康状况，以减少她们的恐惧和不确定性。
