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乳腺癌化疗女性患者的体验:定性研究的系统评价。

Experience of women with breast cancer undergoing chemotherapy: a systematic review of qualitative research.

机构信息

Nanfang Hospital, Southern Medical University, NO.1838 North Guangzhou Avenue, Baiyun District, Guangzhou, People's Republic of China.

出版信息

Qual Life Res. 2021 May;30(5):1249-1265. doi: 10.1007/s11136-020-02754-5. Epub 2021 Jan 18.

Abstract

PURPOSE

Chemotherapy exerts adverse effects on physical, psychological and social functioning in women with breast cancer, which may trigger adaptive activities. For a better understanding of the experience of symptoms associated with chemotherapy and the development of targeted interventions, this study aimed to (a) explore the patient experience of chemotherapy, (b) identify patients' strategies to cope with the side effects and distress and (c) explore the link between their experience and coping strategies.

METHODS

Qualitative studies were included if they explored the experience or coping strategies of women with breast cancer receiving chemotherapy. Instruments from the Joanna Briggs Institute were used to critically appraise the methodological quality, extract data and aggregate findings from the included studies.

RESULTS

Twelve studies presenting findings from 184 women with breast cancer who had received chemotherapy were included in this review. Three synthesized findings were identified from 8 categories based on 91 original findings: (1) Women living with chemotherapy experienced various stressful side effects, and their lives were changed. (2) Supportive care to address needs is essential to help women get through this difficult time. (3) They engaged in numerous types of coping strategies to deal with side effects and adapt to this difficult journey. Moreover, the link between experience of chemotherapy and coping strategies is based on the Lazarus' stress and coping theory.

CONCLUSIONS

Although the experience of women with breast cancer undergoing chemotherapy is individualized, we concluded that the distressing experience related to chemotherapy as a stimulus was viewed as a stressor that demands coping or adaptation. Based on the Lazarus stress and coping theory, the ability of a woman to appraise how chemotherapy changed her life and how she appraises her resources to cope with chemotherapy are essential. The results highlight that pre-chemotherapy care programmes, information support systems, social support groups and individual effective coping strategies are helpful in reducing treatment-related distress levels and enhance self-care effects at home.

摘要

目的

化疗会对乳腺癌女性的身体、心理和社会功能产生不良影响,从而引发适应性活动。为了更好地了解与化疗相关的症状体验和发展有针对性的干预措施,本研究旨在:(a) 探讨乳腺癌患者接受化疗的体验;(b) 确定患者应对副作用和痛苦的策略;(c) 探讨其体验与应对策略之间的联系。

方法

如果研究探讨了接受化疗的乳腺癌女性的体验或应对策略,则纳入定性研究。使用 Joanna Briggs 研究所的工具对纳入研究的方法学质量进行批判性评价、提取数据并综合发现。

结果

本综述纳入了 12 项研究,共纳入了 184 名接受化疗的乳腺癌女性的研究结果。根据 91 项原始发现,从 8 个类别中确定了 3 个综合发现:(1) 接受化疗的女性经历了各种有压力的副作用,生活发生了变化。(2) 提供满足需求的支持性护理对于帮助女性度过这段艰难时期至关重要。(3) 她们采用了多种应对策略来应对副作用,以适应这段艰难的旅程。此外,化疗体验与应对策略之间的联系基于 Lazarus 的应激和应对理论。

结论

尽管接受化疗的乳腺癌女性的体验是个体化的,但我们得出结论,与化疗相关的痛苦体验作为一种刺激,被视为需要应对或适应的应激源。基于 Lazarus 的应激和应对理论,女性评估化疗如何改变她的生活的能力以及她评估自己应对化疗的资源的能力至关重要。研究结果强调,化疗前护理方案、信息支持系统、社会支持团体和个体有效的应对策略有助于降低治疗相关的痛苦水平,并增强在家中的自我护理效果。

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