Engqvist Boman Lena, Sandelin Kerstin, Wengström Yvonne, Silén Charlotte
Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, 171 77 Stockholm, Sweden.
Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna, P9:03, 171 76 Stockholm, Sweden.
Patient Educ Couns. 2017 May;100(5):795-804. doi: 10.1016/j.pec.2016.12.024. Epub 2016 Dec 23.
To explore how women learn and understand their disease, treatment, care, and life-situation during a breast cancer trajectory.
Semi-structured individual interviews were performed with 16 women suffering from breast cancer. Qualitative content analysis of data was performed.
Three themes describe the women's learning; Interacting with a diversity of information: women interact with a vast amount of information, including perceptions of bodily sensations and events. Concealed and expressed understandings: women interpret information that results in understanding which is either concealed or expressed. Struggling to understand and manage the new life situation: pre-understanding, driving forces to learn, contemplation and dialogue with healthcare staff influence the women's learning.
General theories of learning are applicable to learning during a breast cancer trajectory. Significant features of learning during a life-threatening illness are strong personal drivers to understand and deal with all that occurs. Vulnerability remains a challenge in developing understanding as a cancer diagnosis infers uncertainty.
Patients need time to assimilate and process complex bodies of information in dialogue with health care staff. Patients' understanding needs to be assessed and pedagogical competence in the interprofessional team is assumed to facilitate patients' learning and participation in treatment and care.
探讨女性在乳腺癌病程中如何学习并理解自身疾病、治疗、护理及生活状况。
对16名乳腺癌女性患者进行半结构化个体访谈。对数据进行定性内容分析。
三个主题描述了女性的学习情况；与多样信息互动：女性与大量信息互动，包括对身体感觉和事件的认知。隐藏与表达的理解：女性解读信息后产生隐藏或表达的理解。努力理解和应对新生活状况：先入之见、学习的驱动力、思考以及与医护人员的对话影响女性的学习。
一般学习理论适用于乳腺癌病程中的学习。危及生命疾病期间学习的显著特征是有强烈的个人驱动力去理解和应对所发生的一切。由于癌症诊断意味着不确定性，在形成理解方面，脆弱性仍然是一个挑战。
患者需要时间与医护人员对话，以吸收和处理复杂的信息。需要评估患者的理解情况，并且假定跨专业团队中的教学能力有助于患者学习并参与治疗和护理。
