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孕期癌症:澳大利亚女性医疗体验的定性研究。

Cancer during pregnancy: A qualitative study of healthcare experiences of Australian women.

机构信息

Centre for Women's Mental Health, Royal Women's Hospital, Parkville, VIC, Australia.

Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia.

出版信息

Eur J Cancer Care (Engl). 2021 Jul;30(4):e13425. doi: 10.1111/ecc.13425. Epub 2021 Feb 10.

DOI:10.1111/ecc.13425
PMID:33569843
Abstract

OBJECTIVES

To identify features enhancing the quality of healthcare experiences for women with gestational cancer, and explore the impact of the heterogeneous Australian healthcare system on those experiences.

METHODS

Semi-structured, qualitative interviews were conducted with women diagnosed with any cancer during pregnancy in the last five years. Recruitment occurred during 2018-2019 via social media and professional, clinical and community networks. Questions related to women's experiences of their healthcare, wellbeing and psychosocial needs. Interviews were analysed thematically.

RESULTS

Study participants (n = 23) received treatment in the private sector (n = 10), public sector (n = 8), or both (n = 5). Five interview themes were found: Control over healthcare; Trust in clinicians, hospitals and systems; Coordination of care; An uncommon diagnosis; Holistic, future-oriented care. Women were most likely to have had a positive healthcare experience when (a)care was well-coordinated and adjusted to meet their unique needs/challenges, and (b)women perceived their care went beyond their immediate medical needs and encompassed future psychosocial wellbeing, including preparation for postpartum challenges.

CONCLUSION

Existing 'usual care' in the public and/or private sector for both the pregnancy and the cancer is insufficient to meet these women's needs. Prioritising psychological wellbeing including psychosocial needs, and communication and planning around fertility and postnatal challenges are essential for this population.

摘要

目的

确定提高妊娠癌症女性医疗体验质量的特征,并探讨澳大利亚异质医疗体系对这些体验的影响。

方法

采用半结构式定性访谈,对过去五年中被诊断为妊娠期癌症的女性进行访谈。2018 年至 2019 年,通过社交媒体以及专业、临床和社区网络进行招募。问题涉及女性对其医疗保健、健康和社会心理需求的体验。对访谈进行主题分析。

结果

研究参与者(n=23)在私营部门(n=10)、公共部门(n=8)或两者(n=5)接受治疗。发现五个访谈主题:医疗保健控制;对临床医生、医院和系统的信任;护理协调;不常见的诊断;整体、面向未来的护理。当(a)护理得到很好的协调,并调整以满足其独特的需求/挑战,以及(b)女性认为她们的护理超出了她们的直接医疗需求,包括未来的社会心理健康,包括为产后挑战做准备时,女性最有可能获得积极的医疗体验。

结论

公共和/或私营部门现有的“常规护理”既不能满足这些女性的需求,也不能满足妊娠和癌症的需求。优先考虑心理健康,包括社会心理需求,以及围绕生育和产后挑战进行沟通和规划,对这一人群至关重要。

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引用本文的文献

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Support Care Cancer. 2024 May 27;32(6):384. doi: 10.1007/s00520-024-08570-8.
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What do we know about the psychosocial issues associated with cancer during pregnancy? A scoping review and gap analysis.我们对与妊娠期间癌症相关的社会心理问题了解多少?系统评价和差距分析。
BMJ Open. 2023 Mar 3;13(3):e063283. doi: 10.1136/bmjopen-2022-063283.
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J Adv Nurs. 2023 Feb;79(2):502-518. doi: 10.1111/jan.15510. Epub 2022 Nov 29.
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