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患者对癌前状态的看法:意义未明的单克隆丙种球蛋白血症(MGUS)。

Patient's perspectives of living with a precancerous condition: Monoclonal gammopathy of undetermined significance (MGUS).

机构信息

Institute for Global Food Security (IGFS), School of Biological Sciences, Queen's University Belfast, UK.

Centre for Public Health, Queen's University Belfast, UK.

出版信息

Eur J Oncol Nurs. 2021 Apr;51:101901. doi: 10.1016/j.ejon.2021.101901. Epub 2021 Jan 17.

Abstract

PURPOSE

The aim of this study was to investigate patient experiences of living with monoclonal gammopathy of undetermined significance (MGUS). Living with a premalignant condition such as MGUS may elicit negative psychosocial effects including increased anxiety and fear of progression to cancer. To date, no study utilising qualitative methodology has explored the lived experiences of MGUS patients.

METHODS

Data was collected via two focus groups and six telephone interviews. MGUS patients (n=14) were recruited via nurse-led haematology telephone-clinics in Northern Ireland. Interviews were transcribed verbatim and the data subjected to thematic analysis.

OUTCOME

Thematic analysis identified 3 overarching themes; (1) The psychosocial impact of an MGUS diagnosis, (2) Knowledge of MGUS and (3) Experiences of MGUS health services. Patients with MGUS reported experiencing poor psychological adjustment to their condition particularly at the point of diagnosis and approaching follow-up appointments. Feelings of isolation, poor information-provision, increased uncertainty and limited psychosocial support for MGUS patients were also reported. Patients did however reflect positively on their experience of being followed up via nurse-led telephone clinics.

CONCLUSIONS

Provision of patient friendly information guides at diagnosis, and additional psychosocial support services such as nurse-led telephone clinics and coordinated patient groups may help MGUS patients adjust better to their diagnosis and in doing so improve quality of life in this patient population.

摘要

目的

本研究旨在调查单克隆丙种球蛋白病(MGUS)患者的生活体验。患有 MGUS 等癌前疾病可能会产生负面的心理社会影响,包括增加焦虑和对癌症进展的恐惧。迄今为止,尚无研究利用定性方法探讨 MGUS 患者的生活体验。

方法

通过两个焦点小组和六次电话访谈收集数据。MGUS 患者(n=14)通过北爱尔兰的护士主导的血液电话诊所招募。访谈逐字记录下来,并对数据进行主题分析。

结果

主题分析确定了 3 个总体主题;(1)MGUS 诊断的心理社会影响,(2)MGUS 知识和(3)MGUS 卫生服务体验。MGUS 患者报告说,他们对自己的病情在诊断时和接近随访预约时的心理调整不佳。他们还报告了孤立感、信息提供不足、不确定性增加以及对 MGUS 患者的心理社会支持有限。然而,患者对通过护士主导的电话诊所进行随访的体验评价较高。

结论

在诊断时提供对患者友好的信息指南,以及额外的心理社会支持服务,如护士主导的电话诊所和协调的患者小组,可能有助于 MGUS 患者更好地适应诊断,并在这一患者群体中提高生活质量。

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