长期卵巢癌幸存者的生存归因和应对方法：一项定性研究。
Attributions of survival and methods of coping of long-term ovarian cancer survivors: a qualitative study.
机构信息
Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
Memory Keepers Medical Discover Team, University of Minnesota Medical School, Duluth, MN, USA.
出版信息
BMC Womens Health. 2021 Oct 28;21(1):376. doi: 10.1186/s12905-021-01476-1.
BACKGROUND
Only 8-23% of advanced epithelial ovarian cancer patients survive for 10 years or longer. Given the need for targeted interventions to improve survival, we interviewed this relatively rare survivor population to gain personalized insights into the reasons for their survival. The aim of this study was to characterize subjective attributions of survival and specific coping mechanisms long-term survivors of ovarian cancer.
METHODS
Twenty-two semi-structured, qualitative interviews assessing survival attributions and coping strategies were conducted from April to November 2014. Data were analyzed in a multistep process using ATLAS.ti.8: codes were identified during review of the transcripts and refined with literature review; the frequency of codes and code co-occurrence was calculated, and codes were grouped into themes. Resulting themes were checked by a national leader of an ovarian cancer advocacy organization and compared against available literature.
RESULTS
Thematic analysis found that participants credited their long-term survival to a variety of factors including medical, social, religious/spiritual, and lifestyle/personal characteristics. Some participants rejected these same attributions, concluding that the reason for survival was due to luck or unknowable. Several of Carver et al.'s theoretical dimensions of coping were evident in our sample: planning, positive reinterpretation, social support, religion and acceptance whereas three relatively new strategies were uncovered: conserving emotional energy, value-based activity coping, and self-care.
CONCLUSIONS
Long-term survivors' perspectives were largely consistent with those of newly diagnosed ovarian cancer patients and ovarian cancer survivors of shorter duration. However, the long-term survivors were also willing to reject conventional attributions for survival and recognized the importance of disciplined self-preservational coping strategies.
背景
仅有 8-23%的晚期上皮性卵巢癌患者能存活 10 年或更长时间。鉴于需要有针对性的干预措施来提高生存率，我们采访了这一相对罕见的幸存者群体，以深入了解他们生存的原因。本研究的目的是描述卵巢癌长期幸存者的主观生存归因和特定应对机制。
方法
2014 年 4 月至 11 月期间进行了 22 次半结构化、定性访谈，评估生存归因和应对策略。使用 ATLAS.ti.8 分多个步骤分析数据：在审查抄本期间识别代码，并通过文献回顾进行完善；计算代码和代码共同出现的频率，并将代码分组为主题。通过全国卵巢癌宣传组织的领导人对得出的主题进行检查，并与现有文献进行比较。
结果
主题分析发现，参与者将其长期生存归因于多种因素，包括医疗、社会、宗教/精神和生活方式/个人特征。一些参与者拒绝了这些归因，认为生存的原因是运气或未知的。我们的样本中出现了 Carver 等人的应对理论维度的几个方面：计划、积极重新解释、社会支持、宗教和接受，而发现了三个相对较新的策略：节约情绪能量、基于价值的活动应对和自我保健。
结论
长期幸存者的观点与新诊断的卵巢癌患者和生存时间较短的卵巢癌幸存者的观点基本一致。然而，长期幸存者也愿意拒绝传统的生存归因，并认识到自律的自我保护应对策略的重要性。
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