Boman Lena Engqvist, 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.
Eur J Oncol Nurs. 2018 Dec;37:35-42. doi: 10.1016/j.ejon.2018.09.002. Epub 2018 Oct 30.
To explore how patients experience participation during treatment and care for breast cancer related to their understanding.
Semi-structured individual interviews with 16 women diagnosed with breast cancer. Interpretative qualitative content analysis was performed.
Three main themes describe patient participation. Theme 1 Respectful and personal encounters illustrates how the treatment from health care staff contributed to feelings of being "seen" as a human, a basis for participation. Theme 2 Part-owner in decision making describes the women's varied wishes of participating in treatment decisions. Theme 3 Striving to manage treatment, care and self-care concerns the need to manage self-care for well-being.
Patient participation is both a possibility and an imperative. Patients must be recognized as unique human beings with varying needs of participation. Shared learning and understanding in dialogue with health care staff is a prerequisite. A novel approach where patients and health care staff are both partners and participants is presented.
The results call for an initiation of training programs supporting pedagogical competence in staff and patients' learning in breast cancer care. Access to health care in the outpatient and the hospital settings is needed long term after treatment to support patient participation.
探讨患者在乳腺癌治疗和护理过程中如何基于自身理解体验参与情况。
对16名被诊断为乳腺癌的女性进行半结构化个体访谈。采用解释性定性内容分析法。
三个主要主题描述了患者的参与情况。主题1“尊重且个性化的接触”说明了医护人员的治疗如何促成患者作为一个人被“看见”的感受，这是参与的基础。主题2“决策中的部分所有者”描述了女性参与治疗决策的不同愿望。主题3“努力管理治疗、护理和自我护理”涉及为实现健康而进行自我护理的需求。
患者参与既是一种可能性，也是一种必要。患者必须被视为具有不同参与需求的独特个体。与医护人员进行对话中的共同学习和理解是前提条件。提出了一种患者和医护人员既是合作伙伴又是参与者的新方法。
研究结果呼吁启动培训项目，以支持医护人员的教学能力和患者在乳腺癌护理方面的学习。治疗后长期需要在门诊和医院环境中获得医疗服务，以支持患者参与。
