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应对乳腺癌后的认知障碍:女性想要什么?

Addressing Cognitive Impairment After Breast Cancer: What Do Women Want?

作者信息

Crouch Adele, Von Ah Diane, Storey Susan

机构信息

Author Affiliations: Pre-doctoral student (Ms Crouch), Associate Professor, Chair, Department of Community & Health Systems (Dr Voh Ah), and Assistant Scientist, Office of Research Support (Dr Storey), Indiana University School of Nursing, Indianapolis.

出版信息

Clin Nurse Spec. 2017 Mar/Apr;31(2):82-88. doi: 10.1097/NUR.0000000000000279.

Abstract

PURPOSE

Cognitive symptoms in breast cancer survivors (BCSs) are common and have a disruptive impact on daily life. Breast cancer survivors frequently engage in self-management strategies to lessen the impact of these cognitive symptoms. There is little information from the perspective of BCS as to their preference of interventions. The purpose of this study was to explore how BCSs cope and self-manage the symptoms associated with cognitive changes, their preferences for the type of intervention(s), and perceived facilitators and barriers to interventions.

METHODS

A qualitative descriptive study using content analysis was conducted. Semistructured telephone interviews were conducted with 13 BCSs.

RESULTS

Breast cancer survivors articulated that validation and self-management strategies were used to relieve cognitive symptoms. Nonpharmacologic, evidence-based interventions that use a combined onlinein-person approach and include follow-up with healthcare providers are preferred by BCSs. Ease of use, accessibility, and convenience were identified by BCSs as most important to facilitate participation. Cost, time intensiveness, and distance to travel hampered participation.

CONCLUSIONS

Patient-centered interventions tailored to meet the needs of BCSs should be considered when implementing programs or interventions to maximize their utilization and benefit. The process of implementation should be dynamic and include an ongoing collaboration between BCSs and clinical nurse specialists.

摘要

目的

乳腺癌幸存者(BCS)的认知症状很常见,对日常生活有破坏性影响。乳腺癌幸存者经常采用自我管理策略来减轻这些认知症状的影响。从乳腺癌幸存者的角度来看,关于他们对干预措施的偏好的信息很少。本研究的目的是探讨乳腺癌幸存者如何应对和自我管理与认知变化相关的症状、他们对干预类型的偏好,以及对干预的感知促进因素和障碍。

方法

采用内容分析法进行定性描述性研究。对13名乳腺癌幸存者进行了半结构化电话访谈。

结果

乳腺癌幸存者表示,通过确认和自我管理策略来缓解认知症状。乳腺癌幸存者更喜欢采用在线和面对面相结合的方式且包括与医疗服务提供者随访的非药物、循证干预措施。乳腺癌幸存者认为易用性、可及性和便利性对促进参与最为重要。成本、时间投入和出行距离阻碍了参与。

结论

在实施项目或干预措施时,应考虑以患者为中心、满足乳腺癌幸存者需求的干预措施,以最大限度地提高其利用率和效益。实施过程应该是动态的,包括乳腺癌幸存者与临床护士专家之间的持续合作。

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