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将乳腺癌预防和早期检测纳入癌症姑息治疗模式。

Integration of breast cancer prevention and early detection into cancer palliative care model.

机构信息

Discipline of Nursing, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.

Department of Nursing, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

出版信息

PLoS One. 2019 Mar 20;14(3):e0212806. doi: 10.1371/journal.pone.0212806. eCollection 2019.

Abstract

BACKGROUND

Breast cancer is common among Ghanaian women. Late stage presentation has been credited to knowledge deficit and lack of breast cancer prevention and early detection services for women.

OBJECTIVE

This study aimed to develop a model to facilitate the integration of breast cancer prevention and early detection into cancer palliative care.

METHOD

This study used synthesized concepts emerging from a single case study research. The case was a tertiary health care facility, embedded with sub-units of analysis. Mixed-method approach was used to collect data from 102 participants. The study examined the experiences and views of the participants on breast cancer and screening pathways in Ghana. Thematic analysis and descriptive statistics ware used to analyze the qualitative and quantitative data respectively. This was followed with a cross-case analysis across the sub-units of analysis. A theory development approach was further used towards the development of a model, following three steps: concept analysis, statement synthesis and theory synthesis.

RESULTS

Six key concepts synthesized from the data were used to develop the model: initiate and sustain breast cancer prevention and early detection program, collaboration of health professionals, patients, families and micro-communities, conducive environment of the health care facility and needed resources, actions, services, and lastly diffusing innovation into the community through agents.

CONCLUSION

A model has been developed based on the experiences shared by women diagnosed with advanced breast cancer, their first degree relatives, micro-communities as well as clinicians working in a palliative care setting. This model will aid clinicians to provide breast cancer education, teach breast self-examination and offer clinical breast examination to families and micro-communities of advanced breast cancer patients receiving supportive care in a resource-limited setting.

摘要

背景

乳腺癌在加纳女性中较为常见。晚期发现归因于知识匮乏以及缺乏针对女性的乳腺癌预防和早期检测服务。

目的

本研究旨在建立一个模型,以促进将乳腺癌预防和早期检测纳入癌症姑息治疗。

方法

本研究使用单一案例研究中出现的综合概念。该案例是一家三级保健机构,嵌入了分析的子单位。采用混合方法从 102 名参与者中收集数据。本研究检查了参与者对加纳乳腺癌和筛查途径的经验和看法。使用主题分析和描述性统计分别对定性和定量数据进行分析。然后对分析的子单位进行跨案例分析。进一步使用理论发展方法来开发模型,遵循三个步骤:概念分析、陈述综合和理论综合。

结果

从数据中综合出六个关键概念,用于开发模型:启动和维持乳腺癌预防和早期检测计划、卫生专业人员、患者、家庭和微型社区的协作、医疗保健机构的有利环境和所需资源、行动、服务,最后通过代理人将创新扩散到社区。

结论

根据在姑息治疗环境中接受支持性护理的晚期乳腺癌患者、其一级亲属、微型社区以及临床医生分享的经验,开发了一个模型。该模型将帮助临床医生为家庭和微型社区的晚期乳腺癌患者提供乳腺癌教育、教授乳房自我检查并提供临床乳房检查,在资源有限的环境中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16ea/6426220/483e6f518cb4/pone.0212806.g001.jpg

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