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功能衰退作为健康不佳的指标:一项关于肺癌发病过程的回顾性案例研究

Functional Decline as an Indicator of Ill-Health: A Retrospective Case Study of the Process Leading to Lung Cancer.

作者信息

Kowalski Lesleigh

机构信息

Department of Family Medicine, University of Washington, Seattle, WA, 98195, USA.

出版信息

J Multidiscip Healthc. 2021 Apr 27;14:919-927. doi: 10.2147/JMDH.S295498. eCollection 2021.

Abstract

PURPOSE

Lung cancer claims more lives than any cancer in the world and remains difficult to diagnosis at early stages. Detecting lung cancer is challenging due to nonspecific symptom presentation. Literature was reviewed to consider functional decline as an indicator for ill-health. This study explored the process experienced from recognition in a change of health to receiving a lung cancer diagnosis from a patient's perspective in order to examine this phase through a biopsychosocial lens.

PATIENTS AND METHODS

A single-case design methodology was used for this study. The method of data collection was semi-structured interviews with people diagnosed with lung cancer utilizing criterion sampling. The case study was bound by diagnostic and geographical factors to frame the single-case: participants were limited to those living in Alaska diagnosed with stage III or stage IV lung cancer.

RESULTS

One (n = 1) person participated in this study. Themes consistent with lung cancer detection process from a patient's perspective include symptom denial, symptom reductionism, and gradual impact on function.

CONCLUSION

Although the number of participants was extremely limited due to the COVID-19 pandemic at the time of recruitment, this case study suggests a decline in function present prior to being diagnosed with lung cancer. Opportunities exist within the provider and patient interface to promote earlier detection include educating medical providers to ask specific, closed-ended, non-disease related functional questions to ascertain more details and a holistic representation of patients' health. Raising public awareness of lung cancer symptoms, such as fatigue and dyspnea, is also warranted.

摘要

目的

肺癌导致的死亡人数超过世界上任何一种癌症,且早期诊断仍很困难。由于症状缺乏特异性,肺癌的检测具有挑战性。回顾文献以将功能下降视为健康不佳的指标。本研究从患者角度探讨了从认识到健康变化到接受肺癌诊断所经历的过程,以便通过生物心理社会视角审视这一阶段。

患者与方法

本研究采用单病例设计方法。数据收集方法是对被诊断为肺癌的患者进行半结构化访谈,采用标准抽样。该病例研究受诊断和地理因素限制以构建单病例:参与者仅限于居住在阿拉斯加且被诊断为III期或IV期肺癌的患者。

结果

一名(n = 1)患者参与了本研究。从患者角度来看,与肺癌检测过程一致的主题包括症状否认、症状简化论以及对功能的逐渐影响。

结论

尽管由于招募时的新冠疫情,参与者数量极其有限,但本病例研究表明在被诊断为肺癌之前就存在功能下降。在医疗服务提供者与患者的互动中,促进早期检测的机会包括教育医疗服务提供者询问特定的、封闭式的、与疾病无关的功能问题,以确定更多细节并全面了解患者的健康状况。提高公众对肺癌症状(如疲劳和呼吸困难)的认识也很有必要。

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