Eraso Yolanda, Stefler Denes, Moon Zoe, Rossi Leda, Assefa Sidona
School of Social Professions, London Metropolitan University, London N7 8DB, UK.
Department of Epidemiology and Public Health, University College London, London WC1E 7HB, UK.
Healthcare (Basel). 2021 Jun 7;9(6):688. doi: 10.3390/healthcare9060688.
An additional 5 years of treatment with adjuvant hormonal therapy, to complete 10 years of medication, is recommended to reduce the risk of breast cancer recurrence. Yet professionals and patients should balance this benefit against side effects and toxicities. Little is known about women's decision making regarding persistence with extended endocrine therapy. In this study, we collected data from a UK online breast cancer forum to analyse patterns of persistence and its associated factors. A mixed-methods exploratory sequential design was used, with a qualitative analysis of text ( = 61 individuals) informing the development of a quantitative instrument to statistically analyse the prevalence of the findings ( = 130). Our findings identified three different groups of women who had to make decisions regarding persistence with treatment: those about to complete 5 years of therapy, those who decided to extend treatment, and those who were initially prescribed 10 years. Factors affecting persistence were, lack of self-efficacy in managing side effects, lack of reassurance about individual risk of recurrence, and impact on quality of life. Interventions such as training of healthcare professionals including risk communication, medication reviews by clinical pharmacists, and re-planning of services in follow-up care, should better support women's needs in extended hormonal therapy.
建议额外进行5年的辅助激素治疗，以完成10年的用药疗程，从而降低乳腺癌复发风险。然而，专业人员和患者应权衡这种益处与副作用和毒性。对于女性在坚持延长内分泌治疗方面的决策情况，我们知之甚少。在本研究中，我们从英国一个在线乳腺癌论坛收集数据，以分析坚持治疗的模式及其相关因素。我们采用了混合方法探索性序列设计，对文本（n = 61人）进行定性分析，以指导开发一种定量工具，用于对研究结果的普遍性进行统计分析（n = 130）。我们的研究结果确定了三组不同的女性，她们必须就坚持治疗做出决策：即将完成5年治疗的女性、决定延长治疗的女性以及最初被开了10年药的女性。影响坚持治疗的因素包括，应对副作用时缺乏自我效能感、对个人复发风险缺乏安心感以及对生活质量的影响。诸如对医疗保健专业人员进行培训（包括风险沟通）、临床药剂师进行药物审查以及重新规划后续护理服务等干预措施，应能更好地满足女性在延长激素治疗方面的需求。
