An Jinghua, Hershberger Patricia E, Ferrans Carol Estwing
Author Affiliations: College of Nursing, University of Illinois at Chicago.
Cancer Nurs. 2023;46(3):217-232. doi: 10.1097/NCC.0000000000001074. Epub 2022 Mar 11.
Delays before treatment initiation increase the likelihood of later-stage diagnosis of breast cancer and reduce survival. Among Chinese women living in mainland China, Hong Kong, and Taiwan, the amount of time lost in delay and the factors influencing it are unclear.
This integrative review aimed to characterize delay intervals among Chinese women, identify factors contributing to delay, and develop a conceptual model of these factors.
Using Whittemore and Knafl's methodology for integrative reviews, PubMed, CINAHL, Web of Science, SCOPUS, PsycINFO, and China National Knowledge Infrastructure were searched for primary research articles. For 15 selected studies, quality evaluation was performed employing the Crowe Critical Appraisal Tool. A narrative synthesis was developed to summarize and explain the findings.
Total delay intervals (from first discovery of breast symptoms to treatment initiation) exceeded 3 months for 50.2% to 52% of breast cancer patients. The greatest delay occurred between symptom discovery and first presentation (patient intervals). Factors affecting delay in presentation, diagnosis, and treatment included symptom appraisal, Chinese cultural factors, knowledge of breast cancer symptoms and screening, health history, personality, social and healthcare factors, and background factors.
Half of Chinese breast cancer patients delayed long enough to lower their chances of survival. Our review sheds light on how the reviewed factors contribute to delay and their unique influences in this population.
Factors identified can inform nursing interventions that raise breast cancer awareness and promote timely diagnosis and treatment in Chinese women.
治疗开始前的延迟会增加乳腺癌晚期诊断的可能性并降低生存率。在居住于中国大陆、香港和台湾的中国女性中，延迟所造成的时间损失量及其影响因素尚不清楚。
本整合性综述旨在描述中国女性的延迟间隔，确定导致延迟的因素，并构建这些因素的概念模型。
采用惠特莫尔和克纳夫的整合性综述方法，在PubMed、CINAHL、科学引文索引、Scopus、心理学文摘数据库和中国知网中检索原发性研究文章。对15项选定研究，采用克劳批判性评价工具进行质量评估。开展叙述性综合分析以总结和解释研究结果。
50.2%至52%的乳腺癌患者的总延迟间隔（从首次发现乳房症状到开始治疗）超过3个月。最大的延迟发生在症状发现和首次就诊（患者间隔）之间。影响就诊、诊断和治疗延迟的因素包括症状评估、中国文化因素、乳腺癌症状及筛查知识、健康史、性格、社会和医疗因素以及背景因素。
一半的中国乳腺癌患者延迟时间过长，降低了其生存几率。我们的综述揭示了所审查的因素如何导致延迟及其在该人群中的独特影响。
所确定的因素可为护理干预提供信息，这些干预可提高中国女性对乳腺癌的认识并促进其及时诊断和治疗。
