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“所有决定皆由我自己做出”:乳腺癌治疗决策中的接受者与拒绝者

"I Made All Decisions Myself": Breast Cancer Treatment Decision-Making by Receivers and Decliners.

作者信息

Kim Eunjung, Jang Sou Hyun, Andersen M Robyn, Standish Leanna J

机构信息

Department of Family and Child Nursing, University of Washington, Seattle, USA.

Department of Sociology, Sungkyunkwan University, Seoul, Korea.

出版信息

Asia Pac J Oncol Nurs. 2021 Mar 26;8(3):322-329. doi: 10.4103/apjon.apjon-211. eCollection 2021 May-Jun.

Abstract

OBJECTIVE

Many women with breast cancer refuse adjuvant treatments. How they arrive at their respective decisions and whether they are passively or actively involved in making decisions is less known. We explored the different decision-making behaviors of women who received treatments (receivers) after being diagnosed with breast cancer and those who refused (decliners).

METHODS

Seven women (four receivers and three decliners) were recruited from the Breast Cancer Integrative Oncology Study. We conducted an inductive content analysis based on in-depth semi-structured interviews with open-ended questions.

RESULTS

Receivers reported that doctors and family members influenced their decision-making. Decliners perceived their doctors as supportive of their decisions and reported that the experience of adjuvant therapy of family and friends, the results of Oncotest, and concerns about side effects influenced their decision-making. Receivers expressed discomfort about their decisions, relied on books, whereas decliners used various sources to find information. Both receivers and decliners believed that they had made the decisions themselves. However, receivers were somewhat negative about doctors' advice. Receivers also reported that, sometimes, the decision-making process was lacking and reported discomfort with the treatment process.

CONCLUSIONS

Women with breast cancer need support in understanding the care they are prescribed and getting essential care.

摘要

目的

许多乳腺癌女性拒绝辅助治疗。她们如何做出各自的决定,以及她们是被动还是主动参与决策,目前尚不清楚。我们探讨了被诊断患有乳腺癌后接受治疗的女性(接受者)和拒绝治疗的女性(拒绝者)的不同决策行为。

方法

从乳腺癌综合肿瘤学研究中招募了7名女性(4名接受者和3名拒绝者)。我们基于对开放式问题的深入半结构化访谈进行了归纳性内容分析。

结果

接受者报告称医生和家庭成员影响了她们的决策。拒绝者认为医生支持她们的决定,并报告称家人和朋友的辅助治疗经历、肿瘤检测结果以及对副作用的担忧影响了她们的决策。接受者对自己的决定表示不适,依赖书籍,而拒绝者则通过各种渠道获取信息。接受者和拒绝者都认为自己做出了决定。然而,接受者对医生的建议有些消极。接受者还报告称,有时决策过程存在缺陷,并且对治疗过程感到不适。

结论

乳腺癌女性在理解所开的治疗方案和获得必要护理方面需要支持。

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