Clinical Psychology Unit, The University of Sydney, Sydney, New South Wales, Australia.
Ovarian Cancer Australia, Melbourne, Victoria, Australia.
Psychooncology. 2021 Feb;30(2):212-220. doi: 10.1002/pon.5551. Epub 2020 Sep 24.
Ovarian cancer remains an understudied cancer with poor prognosis, few effective treatments and little understanding of the how individuals and their families face the challenges and uncertainty following diagnosis. This study synthesized the subjective experiences of individuals and their caregivers in the face of the uncertainty produced by the disease.
Qualitative data were obtained from the Ovarian Cancer Australia 2017 Consumer Survey. An inductive thematic analysis was conducted on responses from 219 individuals with ovarian cancer and 78 caregivers.
Nine themes were identified from the individual's responses and seven themes from the caregivers. For both groups, the uncertainty created at diagnosis led to a cascade of complex responses. For the individuals, uncertainty gave rise to fears for the future, which were exacerbated by unmet healthcare needs or treatment-related difficulties. For some individuals, these fears led to disruption to their lives, isolation and emotional distress. For others, helpful coping styles and social support protected them from these negative consequences. For caregivers, the processes were similar, but uncertainty predominantly led to feelings of hopelessness and "survivor guilt."
Our results identified processes that may guide future interventions and research targeting unmet needs and protective factors for individuals with ovarian cancer and their caregivers. Findings also suggest the potential to facilitate effective support between individuals and their caregivers.
卵巢癌仍然是一种研究不足的癌症,预后较差,治疗方法有限,对个体及其家庭在诊断后如何面对挑战和不确定性的了解甚少。本研究综合了个体及其护理人员在疾病带来的不确定性面前的主观体验。
定性数据来自 2017 年澳大利亚卵巢癌消费者调查。对 219 名卵巢癌患者和 78 名护理人员的回答进行了归纳主题分析。
从个体的回答中确定了 9 个主题,从护理人员的回答中确定了 7 个主题。对于这两组人,诊断时产生的不确定性导致了一系列复杂的反应。对于个体来说,不确定性引发了对未来的恐惧,而未满足的医疗保健需求或与治疗相关的困难加剧了这种恐惧。对一些个体来说,这些恐惧导致了生活的混乱、孤立和情绪困扰。对另一些人来说,有益的应对方式和社会支持使他们免受这些负面影响。对于护理人员来说,这个过程类似,但不确定性主要导致了无助感和“幸存者内疚感”。
我们的研究结果确定了一些可能指导未来干预和研究的过程,这些干预和研究针对的是卵巢癌患者及其护理人员的未满足需求和保护因素。研究结果还表明,有潜力促进个体及其护理人员之间的有效支持。