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乳腺癌后管理更年期症状的信息及决策支持需求的定性评估

Qualitative assessment of information and decision support needs for managing menopausal symptoms after breast cancer.

作者信息

Balneaves Lynda G, Panagiotoglou Dimitra, Brazier Alison S A, Lambert Leah K, Porcino Antony, Forbes Margaret, Van Patten Cheri, Truant Tracy L O, Seely Dugald, Stacey Dawn

机构信息

Centre for Integrative Medicine, Leslie Dan Faculty of Pharmacy, 144 College St., Room 737, Toronto, ON, M5S 3M2, Canada.

Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

出版信息

Support Care Cancer. 2016 Nov;24(11):4567-75. doi: 10.1007/s00520-016-3296-x. Epub 2016 Jun 8.

Abstract

PURPOSE

For breast cancer (BrCa) survivors, premature menopause can result from conventional cancer treatment. Due to limited treatment options, survivors often turn to complementary therapies (CTs), but struggle to make informed decisions. In this study, we identified BrCa survivors' CT and general information and decision-making needs related to menopausal symptoms.

METHODS

The needs assessment was informed by interpretive descriptive methodology. Focus groups with survivors (n = 22) and interviews with conventional (n = 12) and CT (n = 5) healthcare professionals (HCPs) were conducted at two Canadian urban cancer centers. Thematic, inductive analysis was conducted on the data.

RESULTS

Menopausal symptoms have significant negative impact on BrCa survivors. Close to 70 % of the sample were currently using CTs, including mind-body therapies (45.5 %), natural health products (NHPs) and dietary therapies (31.8 %), and lifestyle interventions (36.4 %). However, BrCa survivors reported inadequate access to information on the safety and efficacy of CT options. Survivors also struggled in their efforts to discuss CT with HCPs, who had limited time and information to support women in their CT decisions. Concise and credible information about CTs was required by BrCa survivors to support them in making informed and safe decisions about using CTs for menopausal symptom management.

CONCLUSIONS

High quality research is needed on the efficacy and safety of CTs in managing menopausal symptoms following BrCa treatment. Decision support strategies, such as patient decision aids (DAs), may help synthesize and translate evidence on CTs and promote shared decision-making between BrCa survivors and HCPs about the role of CTs in coping with menopause following cancer treatment.

摘要

目的

对于乳腺癌幸存者而言,传统癌症治疗可能导致过早绝经。由于治疗选择有限,幸存者常常求助于补充疗法,但难以做出明智的决策。在本研究中,我们确定了乳腺癌幸存者的补充疗法以及与绝经症状相关的一般信息和决策需求。

方法

需求评估采用解释性描述方法。在加拿大的两个城市癌症中心,对幸存者进行了焦点小组访谈(n = 22),并对传统医疗保健专业人员(n = 12)和补充疗法医疗保健专业人员(n = 5)进行了访谈。对数据进行了主题归纳分析。

结果

绝经症状对乳腺癌幸存者有显著负面影响。近70%的样本目前正在使用补充疗法,包括身心疗法(45.5%)、天然保健品和饮食疗法(31.8%)以及生活方式干预(36.4%)。然而,乳腺癌幸存者报告称,他们难以获取有关补充疗法选择的安全性和有效性的信息。幸存者在与医疗保健专业人员讨论补充疗法时也遇到困难,这些专业人员时间和信息有限,无法在补充疗法决策方面为女性提供支持。乳腺癌幸存者需要简洁可靠的补充疗法信息,以支持他们就使用补充疗法管理绝经症状做出明智和安全的决策。

结论

需要对补充疗法在乳腺癌治疗后管理绝经症状方面的疗效和安全性进行高质量研究。决策支持策略,如患者决策辅助工具,可能有助于综合和转化有关补充疗法的证据,并促进乳腺癌幸存者与医疗保健专业人员之间就补充疗法在癌症治疗后应对绝经方面的作用进行共同决策。

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