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患有慢性疼痛的乳腺癌幸存者的心声:对患者疼痛管理挑战的定性主题分析

The voices of breast cancer survivors with chronic pain: A qualitative thematic analysis of patients' challenges to pain management.

作者信息

Filipponi Chiara, Masiero Marianna, Mazzoni Davide, Chichua Mariam, Marceglia Sara, Ferrucci Roberta, Fragale Elisa, Didier Florence, Pravettoni Gabriella

机构信息

Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.

Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy.

出版信息

J Psychosoc Oncol. 2025;43(1):34-58. doi: 10.1080/07347332.2024.2348595. Epub 2024 May 15.

Abstract

OBJECTIVES

Recognizing the limitations of the current pain therapies, the study aimed to explore the unique needs and obstacles related to pain management in Breast Cancer Survivors (BCs) with Chronic Pain (CP).

METHODS

4 focus groups were conducted involving 17 BCs with CP (Mage = 51, SD = 7.99) with varying pain intensities. Thematic analysis was applied to transcribed discussions.

FINDINGS

Three key themes emerged: (1) Challenges to pain management, including "Doctor-patients communications barriers" and "Contextual and societal barriers"; (2) Self-management needs, encompassing "Psycho-social support," "Care-related needs," and "Shared decision-making"; (3) Treatment preferences and perceptions of pain management, with subthemes like "Treatment preferences," "Institution preference," and "Decision role perception."

CONCLUSIONS

This study emphasizes tailored support systems targeting patient hesitancy, countering pain normalization, and addressing healthcare providers' attitudes. It underscores the importance of integrating caregiver and peer support. Findings advocate refining healthcare provider education, adopting a comprehensive multidisciplinary approach, and strategically incorporating eHealth tools into such care.

摘要

目的

认识到当前疼痛治疗的局限性,本研究旨在探索慢性疼痛(CP)的乳腺癌幸存者(BCs)在疼痛管理方面的独特需求和障碍。

方法

开展了4个焦点小组,参与者为17名患有慢性疼痛的乳腺癌幸存者(平均年龄=51岁,标准差=7.99),疼痛强度各不相同。对转录的讨论内容进行了主题分析。

结果

出现了三个关键主题:(1)疼痛管理的挑战,包括“医患沟通障碍”和“背景及社会障碍”;(2)自我管理需求,包括“心理社会支持”“护理相关需求”和“共同决策”;(3)疼痛管理的治疗偏好和认知,其亚主题包括“治疗偏好”“机构偏好”和“决策角色认知”。

结论

本研究强调针对患者犹豫心理、应对疼痛常态化以及解决医疗服务提供者态度问题的量身定制支持系统。它强调了整合护理人员和同伴支持的重要性。研究结果主张完善医疗服务提供者教育,采用全面的多学科方法,并将电子健康工具策略性地纳入此类护理。

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