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乳腺癌幸存者复发后接受经历的定性内容分析。

Breast Cancer Survivors' Experiences of Acceptance Following Recurrence: A Qualitative Content Analysis.

机构信息

Author Affiliations: Student Research Committee, School of Nursing and Midwifery (Ms Matbouei), and Nursing Care Research Center (Dr Soleimani), Semnan University of Medical Sciences, Semnan; and Cancer Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran (Dr Samsami).

出版信息

Cancer Nurs. 2024;47(4):E226-E235. doi: 10.1097/NCC.0000000000001217. Epub 2023 Mar 3.

Abstract

BACKGROUND

Breast cancer recurrence is a traumatic event for patients, and its treatment depends on the patient's ability to accept the circumstances.

OBJECTIVE

The aim of this study was to explore how patients experience breast cancer recurrence and go through a process of negotiating acceptance.

METHODS

This study explored the experiences of 16 patients with breast cancer recurrence regarding the acceptance of recurrence in a hospital in Tehran, Iran. Purposive sampling with maximum diversity was used. Data were collected through semistructured telephone interviews from November 2020 to November 2021 and analyzed using the qualitative content analysis.

RESULTS

Four themes emerged that described the process of accepting cancer recurrence: (1) response to recurrence (emotional reactions and loss of trust); (2) psychological preparedness (confirmation of medical diagnosis and acceptance of fate); (3) mobilizing supports (using spiritual capacities, utilizing supportive resources, and seeking relationships to promote knowledge); and (4) return to the path of treatment (rebuilding trust and continuation of treatment).

CONCLUSIONS

The acceptance of breast cancer recurrence is a process that begins with emotional reactions and ends with returning to the treatment path. The patient's psychological preparation, support systems, behavior of healthcare providers, and rebuilding trust are the determining factors in acceptance of recurrence.

IMPLICATIONS FOR PRACTICE

Nurses can compensate for the failures created in the primary treatment of breast cancer by spending time with patients and paying attention to their concerns, providing effective education, strengthening communication between patients with similar conditions and using the spiritual capacities of patients, and mobilizing the support of family and relatives.

摘要

背景

乳腺癌复发对患者来说是一个创伤性事件,其治疗取决于患者接受情况的能力。

目的

本研究旨在探讨患者如何体验乳腺癌复发,并经历接受的过程。

方法

本研究在伊朗德黑兰的一家医院探索了 16 名乳腺癌复发患者对复发的接受情况。采用最大差异的目的性抽样。数据于 2020 年 11 月至 2021 年 11 月通过半结构化电话访谈收集,并使用定性内容分析进行分析。

结果

出现了四个主题,描述了接受癌症复发的过程:(1)对复发的反应(情绪反应和信任丧失);(2)心理准备(确认医学诊断和接受命运);(3)调动支持(利用精神能力、利用支持资源和寻求关系以促进知识);和(4)回归治疗路径(重建信任和继续治疗)。

结论

乳腺癌复发的接受是一个从情绪反应开始,最终回归治疗路径的过程。患者的心理准备、支持系统、医护人员的行为以及重建信任是接受复发的决定因素。

实践意义

护士可以通过与患者共度时光并关注他们的问题、提供有效的教育、加强患者之间的沟通,以及利用患者的精神能力,并调动家属和亲戚的支持,来弥补乳腺癌治疗初期的失败。

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