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头颈部癌症症状的评估、寻求帮助和外行咨询。

Symptom appraisal, help seeking, and lay consultancy for symptoms of head and neck cancer.

机构信息

Cancer Research Institute at Queen's University, Kingston, Ontario, Canada.

University of Guelph, Guelph, Ontario, Canada.

出版信息

Psychooncology. 2018 Jan;27(1):286-294. doi: 10.1002/pon.4458. Epub 2017 Jul 13.

Abstract

OBJECTIVE

Early diagnosis is important in head and neck cancer (HNC) patients to maximize the effectiveness of the treatments and minimize the debilitation associated with both the cancer and the invasive treatments of advanced disease. Many patients present with advanced disease, and there is little understanding as to why. This study investigated patients' symptom appraisal, help seeking, and lay consultancy up to the time they first went to see a health care professional (HCP).

METHODS

We interviewed 83 patients diagnosed with HNC. The study design was cross sectional and consisted of structured telephone interviews and a medical chart review. We gathered information on the participant's personal reactions to their symptoms, characteristics of their social network, and the feedback they received.

RESULTS

We found that 18% of the participants thought that their symptoms were urgent enough to warrant further investigation. Participants rarely (6%) attributed their symptoms to cancer. Eighty-nine percent reported that they were unaware of the early warning signs and symptoms of HNC. Fifty-seven percent of the participants disclosed their symptoms to at least one lay consultant before seeking help from an HCP. The lay consultants were usually their spouse (77%), and the most common advice they offered was to see a doctor (76%). Lastly, 81% of the participants report that their spouse influenced their decision to see an HCP.

CONCLUSIONS

The results of this study suggest that patients frequently believe that their symptoms were nonurgent and that their lay consultants influence their decision to seek help from an HCP.

摘要

目的

在头颈部癌症(HNC)患者中,早期诊断非常重要,这可以最大限度地提高治疗效果,并最大限度地减少癌症和晚期疾病侵袭性治疗相关的衰弱。许多患者就诊时已处于疾病晚期,而人们对此知之甚少。本研究调查了患者在首次就诊于医疗保健专业人员(HCP)之前的症状评估、寻求帮助和咨询情况。

方法

我们对 83 名被诊断为 HNC 的患者进行了访谈。研究设计为横断面研究,包括结构化电话访谈和病历回顾。我们收集了参与者对自身症状的个人反应、其社交网络的特征以及他们所获得的反馈的信息。

结果

我们发现,18%的参与者认为他们的症状足够紧急,需要进一步调查。参与者很少(6%)将症状归因于癌症。89%的人报告说,他们不知道 HNC 的早期预警症状和体征。57%的参与者在向 HCP 寻求帮助之前至少向一位非专业顾问透露了他们的症状。这些非专业顾问通常是他们的配偶(77%),他们提供的最常见建议是去看医生(76%)。最后,81%的参与者表示,他们的配偶影响了他们决定去看 HCP 的决定。

结论

本研究结果表明,患者经常认为他们的症状不紧急,并且他们的非专业顾问会影响他们向 HCP 寻求帮助的决定。

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