Hsieh P-L, Huang S-M, Chien L-Y, Lee C-F, Hsiung Y, Tai C-J
Department of Nursing, Mackay Medical College, New Taipei City, Taiwan.
Institute of Community Health care, National Yang-Ming University, Taipei, Taiwan.
Eur J Cancer Care (Engl). 2018 Mar;27(2):e12696. doi: 10.1111/ecc.12696. Epub 2017 Apr 25.
Helping breast cancer patients who desire a pregnancy after cancer treatment is a vital issue. Little is known about the complex context of the decision to become pregnant after breast cancer treatment. The purpose of this study was to understand the risk-benefit perception of choosing conception or contraception after treatment in Taiwan. We applied grounded theory to guide this exploratory qualitative study. Data were collected through in-depth interviews with 16 breast cancer patients. Pregnancy was addressed in the context of cancer as a potentially life-threatening diagnosis and its treatment. The verbatim transcriptions were analysed using constant comparative analysis and methods of open, axial and selective coding. The core theme that described the risk perception of pregnancy among patients with breast cancer after treatment focused on "reaching the balance of life." Seven dimensions of risk-benefit perception of pregnancy, including perceived health status, safety, expected gain, harm, loading, support and time were explored among women treated for breast cancer. We found that women treated for breast cancer applied risk-benefit perceptions to decide whether to become pregnant. Implementing contextual counselling could help to decrease perceived barriers to choose pregnancy and increase the quality of pregnancy care.
帮助那些在癌症治疗后渴望怀孕的乳腺癌患者是一个至关重要的问题。对于乳腺癌治疗后决定怀孕这一复杂背景，人们了解甚少。本研究的目的是了解台湾地区乳腺癌患者治疗后选择受孕或避孕的风险效益认知情况。我们运用扎根理论来指导这项探索性定性研究。通过对16名乳腺癌患者进行深入访谈收集数据。在癌症这一潜在危及生命的诊断及其治疗背景下探讨怀孕问题。采用持续比较分析法以及开放式、轴心式和选择性编码方法对逐字记录进行分析。描述乳腺癌治疗后患者怀孕风险认知的核心主题集中在“实现生活平衡”。在接受乳腺癌治疗的女性中探索了怀孕风险效益认知的七个维度，包括感知健康状况、安全性、预期收益、危害、负担、支持和时间。我们发现，接受乳腺癌治疗的女性运用风险效益认知来决定是否怀孕。实施情境咨询有助于减少选择怀孕时感知到的障碍，并提高孕期护理质量。
