Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
Department of Psychology, Kenyatta University, Nairobi, Kenya; Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.
Patient Educ Couns. 2024 Mar;120:108129. doi: 10.1016/j.pec.2023.108129. Epub 2023 Dec 29.
Many breast cancer survivors experience long-term complaints following treatment, such as pain, which are often not addressed in a sufficient way. To empower survivors in talking about their pain and related complaints and in searching for appropriate support when needed, we developed two written guides. With this study, we aimed to pilot test the guides and gain insight into the implementation process and influencing mechanisms through the perspective of a realist evaluation.
Nine survivors were interviewed at two time points (i.e., post-intervention and at three-month follow-up). The data were thematically analysed and categorized into a context-implementation-mechanisms-outcomes hypothesis.
The guides empowered the participants to discuss pain with medical specialists and initiate support-seeking behaviour through underlying mechanisms such as awareness, acknowledgment, hope, reduced isolation, and motivation. Nonetheless, mechanisms and outcomes differed according to a survivor's unique context.
Written guides can offer a feasible way to empower survivors in their management of chronic pain. However, a one-size-fits-all approach is not desirable and other strategies might be necessary.
It is pivotal to engage survivors as well as professionals in adopting new interventions. As such, the role of nurses in introducing and endorsing the guides should be further explored.
许多乳腺癌幸存者在治疗后会长期出现疼痛等不适症状，但这些症状往往没有得到充分的重视。为了增强幸存者谈论自身疼痛及相关不适症状的能力，并在需要时寻求适当的支持，我们编写了两份书面指南。本研究旨在通过实际评估的视角对指南进行试点测试，深入了解实施过程和影响机制。
在两个时间点（干预后和三个月随访时）对 9 名幸存者进行了访谈。对数据进行了主题分析，并将其归类为一个背景-实施-机制-结果假设。
指南通过增强意识、承认、希望、减少孤立感和激发动机等潜在机制，使参与者能够与医疗专家讨论疼痛问题，并主动寻求支持。然而，根据幸存者独特的背景，机制和结果存在差异。
书面指南为增强幸存者对慢性疼痛的管理能力提供了一种可行的方法。然而，一刀切的方法并不理想，可能需要其他策略。
让幸存者和专业人员共同参与新干预措施的采用至关重要。因此，应进一步探索护士在引入和支持指南方面的作用。
