医疗服务不足的激素受体阳性乳腺癌幸存者内分泌治疗依从性的障碍与促进因素：一项定性研究
Barriers and facilitators to endocrine therapy adherence among underserved hormone-receptor-positive breast cancer survivors: a qualitative study.
作者信息
Wells Kristen J, Pan Tonya M, Vázquez-Otero Coralia, Ung Danielle, Ustjanauskas Amy E, Muñoz Dariana, Laronga Christine, Roetzheim Richard G, Goldenstein Marissa, Carrizosa Claudia, Nuhaily Sumayah, Johnson Kenneth, Norton Marilyn, Sims Elizabeth, Quinn Gwendolyn P
机构信息
Department of Psychology, San Diego State University, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120-4913, USA.
University of California, San Diego Moores Cancer Center, La Jolla, CA, USA.
出版信息
Support Care Cancer. 2016 Oct;24(10):4123-30. doi: 10.1007/s00520-016-3229-8. Epub 2016 May 5.
PURPOSE
To evaluate the barriers and facilitators to taking anti-hormonal medications among medically and historically underserved breast cancer survivors within the first 5 years post chemotherapy, radiation, and/or surgery.
METHODS
The current study was framed within the National Institutes of Health Centers for Population Health and Health Disparities Model (NIHCPHHD Model). Twenty-five historically or medically underserved breast cancer survivors participated in an in-depth interview, in either English or Spanish. Interviews were audio recorded and transcribed verbatim. Interview data were analyzed using content analysis.
RESULTS
Anti-hormonal medication adherence was facilitated in several ways, including establishing a routine of medication taking, leaving the medicine in a visible or easily accessible place, taking the medication with other medications, reducing the cost of medicine, using a pillbox, understanding the negative consequences of lack of adherence, and having positive interactions with physicians. Side effects were the most commonly mentioned barrier to medication adherence.
CONCLUSIONS
Similar to other research, this qualitative study of medically and historically underserved breast cancer survivors in the USA found that side effects are the most frequently endorsed barrier to anti-hormonal medication adherence. Conversely, there were a number of facilitators of correct and consistent anti-hormonal medication use. The management of side effects is critically important to increase adherence to anti-hormonal medications. Health care providers, support providers, and caregivers can encourage breast cancer survivors to better adhere to anti-hormonal medications using a number of approaches that have been successful for other women.
目的
评估在化疗、放疗和/或手术后的头5年内，医疗和历史上服务不足的乳腺癌幸存者服用抗激素药物的障碍和促进因素。
方法
本研究以美国国立卫生研究院人口健康与健康差异中心模型（NIHCPHHD模型）为框架。25名历史上或医疗上服务不足的乳腺癌幸存者参加了深度访谈，访谈语言为英语或西班牙语。访谈进行了录音并逐字转录。使用内容分析法对访谈数据进行分析。
结果
抗激素药物的依从性通过多种方式得到促进，包括建立服药常规、将药物放在显眼或容易拿到的地方、与其他药物一起服用、降低药物成本、使用药盒、了解不依从的负面后果以及与医生进行积极互动。副作用是最常被提及的影响药物依从性的障碍。
结论
与其他研究类似，这项对美国医疗和历史上服务不足的乳腺癌幸存者的定性研究发现，副作用是抗激素药物依从性最常被认可的障碍。相反，有许多因素促进了正确和持续使用抗激素药物。副作用的管理对于提高抗激素药物的依从性至关重要。医疗保健提供者、支持提供者和护理人员可以采用一些对其他女性有效的方法，鼓励乳腺癌幸存者更好地坚持服用抗激素药物。
Zotero 插件