Meng Karin, Fahmer Natascha, Engehausen Dirk, Hass Holger G, Reuss-Borst Monika, Duelli Kristin, Wöckel Achim, Heuschmann Peter U, Faller Hermann
Institut für Klinische Epidemiologie und Biometrie, Julius-Maximilians-Universität Würzburg.
Sinntalklinik Bad Brückenau.
Psychother Psychosom Med Psychol. 2023 May;73(5):187-196. doi: 10.1055/a-1956-9153. Epub 2022 Nov 22.
The study explores challenges, competencies, and helpful support in coping with the disease of patients with breast cancer and gynaecological cancer and how patient competence as an interaction of these factors might be promoted.
Semi-structured interviews were conducted with 19 patients in acute care, 20 patients undergoing rehabilitation, and 16 participants in a self-help group and evaluated using qualitative content analysis.
The challenges are summarised in the main categories - diagnosis processing, treatment/recurrence fears, illness processing and adaptation, worries about relatives, reactions of the social environment, and worries about the workplace. The named personal competencies in dealing with these challenges were assigned to the following main categories: cognition-related coping, action-related coping, self-regulation illness processing, obtaining and accepting support, self-determined communication of the illness, identifying and applying helpful strategies, illness-related experience, favourable life circumstances, openness to offers of help. Helpful emotional, informational or instrumental support is perceived by relatives, friends, animals, colleagues/employers, treatment providers, rehabilitation, fellow patients, self-help, and counselling facilities.
The women describe a variety of competencies, which corresponds to a needs-oriented, self-directed coping process. The individuality and complexity of the interaction of the components of patient competence underline the relevance of patient-oriented care. Empowerment and an active patient role are necessary to promote their coping skills according to their needs. Support from practitioners or the private environment can reduce challenges or promote competencies and application.
本研究探讨乳腺癌和妇科癌症患者在应对疾病过程中所面临的挑战、具备的能力以及获得的有益支持，以及如何促进作为这些因素相互作用结果的患者能力。
对19名急症患者、20名正在接受康复治疗的患者以及16名自助小组参与者进行了半结构式访谈，并采用定性内容分析法进行评估。
挑战主要归纳为以下几类——诊断处理、对治疗/复发的恐惧、疾病处理与适应、对亲属的担忧、社会环境的反应以及对工作场所的担忧。应对这些挑战所提及的个人能力主要分为以下几类：认知相关应对、行动相关应对、自我调节疾病处理、获得并接受支持、自主传达病情、识别并应用有益策略、与疾病相关的经历、有利的生活环境、对帮助提议持开放态度。亲属、朋友、动物、同事/雇主、治疗提供者、康复机构、病友、自助组织及咨询机构提供了有益的情感、信息或工具性支持。
这些女性描述了多种能力，这与以需求为导向、自我主导的应对过程相符。患者能力各组成部分相互作用的个体性和复杂性凸显了以患者为中心的护理的重要性。根据患者需求增强其能力并让患者发挥积极作用对于提升其应对技能而言是必要的。从业者或个人环境提供的支持可减少挑战或促进能力及应用。
