Research Unit of General Practice, Department of Public Health, Faculty of Health Sciences, University of Southern Denmark, Odense C, Denmark.
Department of Gynecology and Obstetrics, University Hospital of Zealand, Roskilde, Denmark.
J Clin Nurs. 2019 Jan;28(1-2):245-256. doi: 10.1111/jocn.14615. Epub 2018 Aug 1.
To explore endometrial cancer patients' perceptions of the disease and the influence of favourable prognoses on their experiences.
Endometrial cancer is associated with favourable prognoses, which may imply that patients experience distress to a lesser extent than other cancer patients with less positive treatment outcomes. However, most people with cancer report reduced quality of life and, despite endometrial cancer being prevalent worldwide, experiences of the disease have been little explored.
Ethnographic fieldwork with participant observations and interviews.
Observations during clinical consultations at two Danish hospitals and interviews with women with endometrial cancer (n = 18) over a period of 6 months. The article adheres to the COREQ guidelines for reporting qualitative research.
We identify how patients consider cancer in general very likely to be fatal, while clinicians in contrast characterise endometrial cancer specifically as "good" because of favourable prognoses. We employ the concept of bricolage to illustrate how bits and pieces of biomedical knowledge and statistical evidence become intertwined with patients' past experiences and subjective ways of knowing, suggesting that patients' perceptions of endometrial cancer as a disease are somewhat dynamic.
Public stories and everyday life experiences of cancer provide a central framework for illness perceptions. As a result, patients retain the idea of a close connection between cancer and death, while also adopting the notion of endometrial cancer as "good". This influenced how women responded to treatment and care. Framing endometrial cancer as "good" is not always helpful, as the impact of a cancer diagnosis per se is rarely favourable.
In providing women with endometrial cancer with optimal support through diagnosis and treatment, clinicians should attend to the complexity of patients' illness understandings and be aware that assuring patients of a good prognosis not always has the expected impact.
探讨子宫内膜癌患者对疾病的认知以及有利预后对其体验的影响。
子宫内膜癌的预后良好，这可能意味着与其他治疗效果不太理想的癌症患者相比，患者的痛苦程度较低。然而，大多数癌症患者报告生活质量下降，尽管子宫内膜癌在全球范围内普遍存在，但对该疾病的体验却鲜有研究。
采用参与式观察和访谈的民族志实地工作方法。
在丹麦的两家医院进行临床会诊期间进行观察，并在 6 个月的时间内对 18 名患有子宫内膜癌的女性进行访谈。本文遵循 COREQ 报告定性研究的指南。
我们发现患者普遍认为癌症很可能致命，而临床医生则将子宫内膜癌具体描述为“良好”，因为其预后良好。我们运用拼凑的概念来说明生物医学知识和统计证据的碎片如何与患者的过去经历和主观认知方式交织在一起，这表明患者对子宫内膜癌作为一种疾病的认知有些动态。
公众对癌症的故事和日常生活经历为疾病认知提供了一个核心框架。因此，患者保留了癌症与死亡之间紧密联系的观念，同时也接受了子宫内膜癌“良好”的概念。这影响了女性对治疗和护理的反应。将子宫内膜癌描述为“良好”并不总是有帮助的，因为癌症诊断本身的影响很少是有利的。
在通过诊断和治疗为患有子宫内膜癌的女性提供最佳支持时，临床医生应关注患者疾病理解的复杂性，并意识到向患者保证良好的预后并不总是产生预期的影响。
