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加拿大医疗延误和预防措施对乳腺癌体验的影响:被 COVID-19 大流行掩盖的无声战斗。

The Impact of Canadian Medical Delays and Preventive Measures on Breast Cancer Experience: A Silent Battle Masked by the COVID-19 Pandemic.

机构信息

Department of Psychology, 14845Université du Québec à Montréal, Montreal, Quebec, Canada.

Centre de recherche de l'Institut en santé mentale de Montréal, 439499CIUSSS-de-l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada.

出版信息

Can J Nurs Res. 2023 Mar;55(1):55-67. doi: 10.1177/08445621221097520. Epub 2022 Apr 28.

Abstract

BACKGROUND

The COVID-19 pandemic led to the prioritization of breast cancer services towards patients who are currently in treatment or diagnosed with advanced stages of breast cancer, and the self-assessment of both tumor growth and treatment side effects. Alongside the stress associated with cancer itself, delays and complications due to COVID-19 may impact patients' mental health.

PURPOSE

To describe the experiences of Canadians living with breast cancer who received a diagnosis and/or treatment during the pandemic, and to identify their recommendations for improving patients well-being during future pandemics.

METHODS

Semi-structured interviews were conducted with eighteen women living with breast cancer who also completed the Distress Thermometer questionnaire. The transcripts were analyzed using a descriptive thematic content methodology.

RESULTS

Women who started their breast cancer screening or treatment before the pandemic reported fewer delays and less psychological distress than those who started during the pandemic. Participants reported feeling dehumanized while receiving their medical care, being unable to be accompanied during medical visits, and fearing treatment interruption during the pandemic. Patient recommendations for improving care and psychological support included the presence of family caregivers at consultations to receive the diagnosis and for the first treatment session.

CONCLUSION

Study findings provide new insights on how healthcare restrictions during the pandemic impacted on patient experiences and their well-being during screening and treatment for breast cancer. The need for cancer nursing practices and care delivery strategies that promote the delivery of compassionate, patient-centred care and the provision of psychological support during future pandemics are identified.

摘要

背景

COVID-19 大流行导致乳腺癌服务的优先级向当前正在接受治疗或被诊断为晚期乳腺癌的患者倾斜,并对肿瘤生长和治疗副作用进行自我评估。除了癌症本身带来的压力外,COVID-19 导致的延迟和并发症可能会影响患者的心理健康。

目的

描述在大流行期间接受诊断和/或治疗的加拿大乳腺癌患者的经历,并确定他们对改善未来大流行期间患者幸福感的建议。

方法

对 18 名患有乳腺癌的女性进行了半结构化访谈,这些女性也完成了困境温度计问卷。使用描述性主题内容方法对转录本进行分析。

结果

在大流行之前开始乳腺癌筛查或治疗的女性报告的延迟和心理困扰比在大流行期间开始的女性要少。参与者报告在接受医疗护理时感到被非人化,在医疗访问期间无法有人陪伴,并担心在大流行期间治疗中断。患者对改善护理和心理支持的建议包括在咨询时让家属照顾者在场,以便接受诊断和进行第一次治疗。

结论

研究结果提供了新的见解,说明大流行期间的医疗保健限制如何影响患者在筛查和治疗乳腺癌期间的体验和幸福感。确定了在未来大流行期间需要癌症护理实践和护理提供策略,以促进提供富有同情心、以患者为中心的护理和提供心理支持。

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