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探索患者对乳腺癌相关手臂淋巴水肿自我管理中成功与益处的认知。

Exploring patient perception of success and benefit in self-management of breast cancer-related arm lymphoedema.

作者信息

Jeffs Eunice, Ream Emma, Shewbridge Amanda, Cowan-Dickie Siobhan, Crawshaw Diana, Huit Martine, Wiseman Theresa

机构信息

Guy's & St Thomas's NHS Foundation Trust, London, UK; King's College London, UK.

University of Surrey, UK.

出版信息

Eur J Oncol Nurs. 2016 Feb;20:173-83. doi: 10.1016/j.ejon.2015.08.001. Epub 2015 Sep 1.

Abstract

PURPOSE

The aim of this study was to identify factors influencing patient perception of success and benefit with self-management of breast cancer-related lymphoedema (BCRL) and explore how patients decide whether their swollen limb has improved or deteriorated.

METHODS

This qualitative study used a Grounded Theory approach. Twenty-one women in the BCRL self-management phase participated in one in-depth interview exploring their experience and perspective on self-managing their BCRL.

FINDINGS

Seven enablers and blocks to self-management were identified: routine, recognising benefit of self-management and consequences of non-treatment, owning treatment, knowledge and understanding, problem-solving, time required for treatment and aesthetics of hosiery. Women determined treatment outcome by monitoring size, appearance, texture and internal sensations within the affected arm.

CONCLUSIONS

Women who participated in this study showed varying degrees of acceptance and adjustment to life with lymphoedema. This appears to directly impact their ability to self-manage lymphoedema. Lymphoedema practitioners and oncology nurses have a valuable role providing knowledge and support to patients transitioning to independent self-care. A better understanding of factors facilitating patients to become experts in their condition may improve longer term outcomes and reduce cost pressures on lymphoedema services.

摘要

目的

本研究旨在确定影响患者对乳腺癌相关淋巴水肿(BCRL)自我管理的成功感和益处认知的因素,并探讨患者如何判断其肿胀肢体是有所改善还是恶化。

方法

本定性研究采用扎根理论方法。21名处于BCRL自我管理阶段的女性参与了一次深入访谈,探讨她们对BCRL自我管理的经历和看法。

结果

确定了自我管理的七个促进因素和阻碍因素:日常安排、认识到自我管理的益处和不治疗的后果、自主治疗、知识与理解、解决问题、治疗所需时间以及弹力袜美观度。女性通过监测患侧手臂的大小、外观、质地和内部感觉来确定治疗效果。

结论

参与本研究的女性对淋巴水肿生活表现出不同程度的接受和适应。这似乎直接影响她们自我管理淋巴水肿的能力。淋巴水肿治疗师和肿瘤护士在为过渡到独立自我护理的患者提供知识和支持方面发挥着重要作用。更好地理解促进患者成为自身病情专家的因素,可能会改善长期治疗效果,并减轻淋巴水肿服务的成本压力。

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