Fortin Justine, Defer Clarisse, Brunet Alain, Montreuil Marjorie, Marin Marie-France
Département de psychologie, Université du Québec à Montréal, Québec, Canada.
Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l'Île-de-Montréal, Québec, Canada.
Sante Ment Que. 2024 Spring;49(1):27-48.
Background The experience of breast cancer diagnosis leads to being confronted with the unknown and uncertainty. In some cases, patients develop symptoms of psychological distress after the diagnosis, which can have a negative influence during and after treatment. In Quebec, there are several breast cancer clinics that appear to offer psychological assessment to patients and psychosocial services during the different phases of the disease. To our knowledge, few Quebec studies have looked at the effectiveness of and access to psychosocial services in times of non-crisis. The COVID-19 pandemic also led to changes in breast clinics (e.g., closure of screening clinics, reception of diagnosis remotely, changes in treatment plans). However, no Canadian study has qualitatively examined patients' experiences of the impact of the pandemic on access and effectiveness of these services. Objectives The first objective of this qualitative study is to describe the perspectives of Quebec women who received a breast cancer diagnosis and/or treatment during the pandemic on the access to and effectiveness of psychosocial services. In addition, the second objective is to identify patient recommendations for improving the well-being of patients receiving psychosocial oncology services. Method As part of this larger project, we conducted semi-structured interviews with 18 Quebec patients (M = 47.05 years, SD = 9.07) diagnosed and/or treated for breast cancer before and during the pandemic. Descriptive analyses performed in MaxQDA allowed us to establish a thematic guide and narrative summaries. Results A minority of participants (n = 6) were offered psychosocial services at the time of their diagnosis. Although not all of them used the resources offered, they appreciated having them available. In contrast, 12 participants did not receive psychosocial resources, and more than half of these women were unsatisfied as they experienced intense psychological distress following diagnosis, which continued during treatment. Many women (n = 12) had to seek help on their own. Conclusion In order to improve the long-term experience of patients in times of crisis and non-crisis in Quebec, the results show that it could be beneficial to offer psychosocial services based on the needs of users, rather than solely on the severity of psychological symptoms.
背景 乳腺癌诊断的经历会让人面对未知和不确定性。在某些情况下，患者在诊断后会出现心理困扰症状，这在治疗期间及之后都会产生负面影响。在魁北克，有几家乳腺癌诊所似乎在疾病的不同阶段为患者提供心理评估和社会心理服务。据我们所知，魁北克很少有研究关注非危机时期社会心理服务的有效性和可及性。新冠疫情也导致了乳腺癌诊所的变化（例如，筛查诊所关闭、远程接收诊断、治疗计划改变）。然而，尚无加拿大的研究对患者关于疫情对这些服务的可及性和有效性影响的经历进行定性研究。
目的 这项定性研究的首要目标是描述在疫情期间接受乳腺癌诊断和/或治疗的魁北克女性对社会心理服务可及性和有效性的看法。此外，第二个目标是确定患者对改善接受社会心理肿瘤学服务患者福祉的建议。
方法 作为这个更大项目的一部分，我们对18名在疫情之前和期间被诊断和/或治疗乳腺癌的魁北克患者（M = 47.05岁，SD = 9.07）进行了半结构化访谈。在MaxQDA中进行的描述性分析使我们能够建立一个主题指南和叙述性总结。
结果 少数参与者（n = 6）在诊断时获得了社会心理服务。尽管并非所有人都使用了提供的资源，但他们对有这些资源可用表示感激。相比之下，12名参与者没有获得社会心理资源，这些女性中有一半以上不满意，因为她们在诊断后经历了强烈的心理困扰，并且在治疗期间持续存在。许多女性（n = 12）不得不自行寻求帮助。
结论 为了改善魁北克患者在危机和非危机时期的长期体验，结果表明，根据用户需求而非仅根据心理症状的严重程度提供社会心理服务可能是有益的。
