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以人为中心的体重和体重管理沟通:在患有非转移性乳腺癌和肥胖的多样化女性样本中的焦点小组讨论。

Person-centered communication about weight and weight management: Focus group discussions in a diverse sample of women with nonmetastatic breast cancer and obesity.

机构信息

School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

出版信息

Cancer. 2021 Nov 15;127(22):4266-4276. doi: 10.1002/cncr.33843. Epub 2021 Aug 10.

Abstract

BACKGROUND

Women with obesity are at higher risk for high-grade and/or advanced-stage breast cancer in comparison with women without obesity. Many women with a high body mass index (BMI) at breast cancer diagnosis experience further weight gain during and after treatment. This study investigated Black and White patient perspectives on conversations with their oncologists about weight and weight management.

METHODS

Focus groups using a virtual platform (Zoom) were conducted with women after primary treatment for stage I to III breast cancer who were 21 years or older and had a BMI ≥ 30 kg/m : 2 with Black women (n = 12) and 2 with White women (n = 14).

RESULTS

Participants asked that their oncologists be "transparent" about weight gain as a potential side effect of their cancer treatment and how excess weight might affect their prognosis and survival. They asked to be "seen as an individual" to facilitate both person-centered and culturally appropriate conversations about behavioral changes needed for weight management. Participants urged clinicians to take the lead in initiating conversations about weight to underscore its importance in cancer care and survivorship. They welcomed actionable recommendations about nutrition and exercise from either the oncology clinician or a specialist. Participants offered specific suggestions on how clinicians could initiate weight-related conversations, beginning with questions eliciting patients' perspectives on their weight and lifestyle.

CONCLUSIONS

Many women with early-stage breast cancer and obesity have concerns about weight and weight gain and urge their oncologists to use an active and personalized approach in recommending and supporting efforts at weight management.

LAY SUMMARY

Focus group discussions with Black and White women with early-stage breast cancer and obesity have elicited patient perspectives on conversations with their oncologists about weight and weight management. Many patients have concerns about weight and weight gain and urge their oncologists to use an active and personalized approach in recommending and supporting efforts at weight management.

摘要

背景

与非肥胖女性相比,肥胖女性罹患高级别和/或晚期乳腺癌的风险更高。许多在乳腺癌诊断时 BMI 较高的女性在治疗期间和治疗后会进一步增重。本研究调查了黑人和白人患者对与肿瘤医生就体重和体重管理进行对话的看法。

方法

使用虚拟平台(Zoom)对接受过 I 期至 III 期乳腺癌初始治疗且年龄在 21 岁及以上、BMI≥30kg/m 的女性进行了焦点小组讨论:2 组为黑人女性(n=12),2 组为白人女性(n=14)。

结果

参与者要求他们的肿瘤医生“透明”地说明体重增加是癌症治疗的潜在副作用,以及超重可能如何影响他们的预后和生存。他们要求被“视为个体”,以便促进针对行为改变的以患者为中心且文化适宜的对话,这些改变是管理体重所必需的。参与者敦促临床医生带头就癌症护理和生存中体重的重要性展开对话。他们欢迎肿瘤临床医生或专家提供有关营养和运动的可操作建议。参与者就临床医生如何开始与体重相关的对话提出了具体建议,首先提出问题以了解患者对其体重和生活方式的看法。

结论

许多早期乳腺癌和肥胖的女性对体重和体重增加感到担忧,并敦促他们的肿瘤医生在推荐和支持体重管理方面采取积极和个性化的方法。

非医学背景的人可以理解的简单描述

对患有早期乳腺癌和肥胖的黑人和白人女性进行焦点小组讨论,以了解患者对与肿瘤医生就体重和体重管理进行对话的看法。许多患者对体重和体重增加感到担忧,并敦促他们的肿瘤医生在推荐和支持体重管理方面采取积极和个性化的方法。

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