新加坡乳腺癌的表现、患者的求诊行为和癌症治疗经历：一项定性研究。
Presentation of breast cancer, help seeking behaviour and experience of patients in their cancer journey in Singapore: a qualitative study.
机构信息
Department of Surgery, National University Health System, 1E Kent Ride Road, Tower Block, University Surgical Cluster, Level 8, Singapore City, 119228, Singapore.
Institure of Health, Faculty of Education, Health, and Wellbeing, University of Wolverhampton, Wulfruna Street, WV1 1LY, Wolverhampton, UK.
出版信息
BMC Cancer. 2020 Nov 10;20(1):1080. doi: 10.1186/s12885-020-07585-8.
BACKGROUND
Little is known about the presentation, help seeking behaviour for breast cancer in Singapore. Nor was there a study exploring the experience of patients in their breast cancer journey.
METHODS
A qualitative interview study with thematic analysis, conducted with 36 patients.
RESULTS
There is no clear pattern of presentation for breast cancer by cancer stage at diagnosis, age and ethnicity in the cancer journey of this group of patients. Patients were diagnosed with early to advanced stages cancer regardless of when they presented or took up treatment in their cancer journey. The reasons patients sought medical attention also did not appear to differ between the stages of cancer diagnosed, ethnic and age. Without setting a measure to define early and late presentation, we found that women shared similar experience in their breast cancer journey, regardless of age, ethnicity and stage of cancer at diagnosis. Poor knowledge of breast cancer (symptoms and causes); few practised regular BSE; denial of symptom; fear of hospitalisation, diagnosis and treatment; worries and stress over financial burden of treatment; misinformation in magazine and online sources; diet; stress; caring responsibility; support network; and use of alternative medicine before and after diagnosis were identified in patients' narratives. Strong social support; fear of being an emotional and financial burden for the family; and financial worries during treatment were also the recurring themes after diagnosis.
CONCLUSION
A measure of breast cancer presentation - that accounts for the patient's experience in the cancer journey, the time interval and tumour biology - that is meaningful to patients, clinicians and researchers is needed. For research on late and delayed presentation, details on BSE practice - how often, when and was it done correctly - will improve the accuracy of time delay interval. For the public, concerted efforts to improve knowledge of breast cancer, survival and prognosis for early-diagnosed cancer, and the importance of regular and correct technique to perform BSE, are critical and urgent to address the rising breast cancer incidence in the country.
背景
对于新加坡乳腺癌的表现形式和寻求帮助的行为，人们知之甚少。也没有研究探索过患者在乳腺癌治疗过程中的经历。
方法
对 36 名患者进行了定性访谈研究和主题分析。
结果
在这组患者的癌症历程中，没有明显的因癌症分期、年龄和种族而导致的乳腺癌表现模式。患者被诊断出患有早期到晚期癌症，无论他们何时出现或开始接受治疗。患者寻求医疗关注的原因似乎也与癌症分期、种族和年龄无关。如果没有设定一个定义早期和晚期就诊的标准，我们发现，无论年龄、种族和诊断时的癌症分期如何，女性在乳腺癌治疗过程中都有相似的经历。患者在叙述中提到了对乳腺癌（症状和病因）知识的缺乏；很少定期进行 BSE；对症状的否认；对住院、诊断和治疗的恐惧；对治疗经济负担的担忧和压力；杂志和在线资源中的错误信息；饮食；压力；照顾责任；支持网络；以及在诊断前后使用替代药物。强烈的社会支持；担心成为家庭的情感和经济负担；以及治疗期间的经济担忧，这些也是诊断后反复出现的主题。
结论
需要一种衡量乳腺癌表现的方法——这种方法要考虑到患者在癌症治疗过程中的经历、时间间隔和肿瘤生物学，对患者、临床医生和研究人员都有意义。对于晚期和延迟就诊的研究，详细了解 BSE 实践情况——频率、何时进行以及是否正确进行——将提高时间延迟间隔的准确性。对于公众而言，需要共同努力，提高对乳腺癌、早期诊断癌症的生存和预后以及定期正确进行 BSE 技术的重要性的认识，这对于解决该国乳腺癌发病率上升的问题至关重要和紧迫。
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