同伴促进者在赋予乳腺癌患者权力方面的核心作用：一项定性研究。
The central role of peers facilitators in the empowerment of breast cancer patients: a qualitative study.
机构信息
University of Montpellier, IDESP, 641 avenue du Doyen Gaston Giraud, 34090, Montpellier, France.
Department of General Practice, Faculté de Médecine Montpellier 641 Av. du Doyen Gaston Giraud, 34000, Montpellier, France.
出版信息
BMC Womens Health. 2022 Jul 24;22(1):308. doi: 10.1186/s12905-022-01892-x.
BACKGROUND
In 2020, the number of new cancer cases was estimated at 20 490 862 worldwide up from 18.1 million in 2018 and 14.1 million in 2012. Since the 2000s, cancer treatments have significantly improved, allowing either a cure or control of the disease. Patients share their experience of the disease and use supportive care solutions through involvement in patient associations and online forums. All the associations were built on the principle of "peer support," which is based on mutual aid between people who suffer or have suffered from the same somatic or psychological illness or had the same life experience. This experiential knowledge can be explored to understand the role of peers and associations in the appropriation of their cancer.
METHODS
A qualitative phenomenological study was undertaken through semi-structured interviews with 12 participants. Interviews were audio-recorded, transcribed verbatim, then analyzed by means of triangulation up to the point of theoretical saturation by a semio-pragmatic method.
RESULTS
Four categories emerged: (1) "Transforms a painful experience into a positive one. It mobilizes the human values of sharing, love, and humility, which facilitates resilience"; (2) "The characteristics of the association, a non-medical place between people sharing a common destiny, resonates with patients' needs and improves their well-being"; (3) "The association transforms the patients' experiences by facilitating engagement that leads to a patient-expert (empowerment)"; and (4) "Understanding what is happening to them is soothing, reassuring, because patients' concerns need to be heard and their care understood".
CONCLUSIONS
This study highlights patient associations can serve as the mediator of NPI and facilate the empowerment of breast cancer patients.
PRACTICE IMPLICATIONS
Educating health professionals in initial and continuing education about non-pharmacological interventions will be a major issue. Teaching the patient-centred approach to health professionals is one of the priorities in initial and continuing medical education.
背景
2020 年，全球新增癌症病例估计为 2049.0862 万例，高于 2018 年的 1810 万例和 2012 年的 1410 万例。自 21 世纪初以来，癌症治疗方法取得了显著进展，能够治愈或控制疾病。患者通过参与患者协会和在线论坛分享他们的疾病经历并使用支持性护理解决方案。所有的协会都是建立在“同伴支持”的原则之上的，这是基于患有相同躯体或心理疾病或有相同生活经历的人之间的互助。这种经验性知识可以被探索，以了解同伴和协会在他们癌症的适应过程中的作用。
方法
通过对 12 名参与者进行半结构化访谈，进行了定性现象学研究。访谈被录音、逐字转录，然后通过半语义语用方法进行三角分析，直到达到理论饱和点。
结果
出现了四个类别：(1)“将痛苦的经历转化为积极的经历。它调动了分享、爱和谦逊的人类价值观，促进了韧性”；(2)“协会的特点，是一个人们分享共同命运的非医疗场所，与患者的需求产生共鸣，改善了他们的幸福感”；(3)“协会通过促进参与来改变患者的经历，从而使患者成为专家(赋权)”；和(4)“理解正在发生的事情是舒缓的，令人安心的，因为患者的担忧需要被倾听，他们的护理需要被理解”。
结论
这项研究强调，患者协会可以作为非药物干预的中介，促进乳腺癌患者的赋权。
实践意义
在初始和继续教育中向卫生专业人员教授非药物干预将是一个主要问题。向卫生专业人员教授以患者为中心的方法是初始和继续医学教育的重点之一。
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