Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
Collaboration for Outcomes Research and Evaluation, Vancouver, British Columbia, Canada.
Cancer Med. 2024 Sep;13(17):e70203. doi: 10.1002/cam4.70203.
With the burden of colorectal cancer in Canada, there is a need to address the psycho-oncologic challenges, including mental health. This study aims to explore the lived mental health experiences in patients with CRC across the phases of the CRC care continuum.
We employed a patient-oriented constructivist grounded theory design and recruited English speaking participants ≥18 years, diagnosed with CRC within the last 10 years, residing in Canada. We collected data through semi-structured individual interviews using a guide co-constructed with patient research partners. Data collection and analysis were iterative, employed theoretical sampling, and culminated in a theoretical model.
Twenty-eight participants diagnosed with CRC (18 females, 10 males), aged 18-63 years at time of diagnosis were interviewed, with representation across all CRC stages. There were 10 participants (36%) in treatment, 12 participants (43%) in follow-up, and 6 participants (21%) in the beyond phase. We constructed a patient-oriented theory illustrating the dynamic nature between one's self-identity and their mental health experiences across the CRC care continuum. Mental health experiences encompass emotional and cognitive-behavioral responses, expressed differently across phases. Mental health care experiences are also shaped by barriers, facilitators, and individual contextual factors, all of which influence their access to care.
Our theory provides insight into the mental health experiences of patients with CRC across phases of the CRC care continuum. Understanding patients' emotional and cognitive-behavioral responses and care experiences can help identify opportunities to integrate mental health into CRC care.
在加拿大，结直肠癌的负担沉重，因此需要解决包括心理健康在内的心理肿瘤学挑战。本研究旨在探索结直肠癌患者在结直肠癌护理连续体各阶段的心理健康的真实体验。
我们采用以患者为中心的建构主义扎根理论设计，招募了 18 岁及以上、在过去 10 年内被诊断患有结直肠癌、居住在加拿大的英语患者。我们使用与患者研究伙伴共同构建的指南进行半结构化的个体访谈收集数据。数据收集和分析是迭代的，采用理论抽样，并最终形成理论模型。
共对 28 名被诊断患有结直肠癌（18 名女性，10 名男性）的患者进行了访谈，他们在诊断时的年龄为 18-63 岁，代表了所有结直肠癌阶段。有 10 名患者（36%）正在接受治疗，12 名患者（43%）在随访中，6 名患者（21%）在结束治疗后。我们构建了一个以患者为中心的理论，说明了患者自我认同和心理健康体验在结直肠癌护理连续体中的动态关系。心理健康体验包括情绪和认知行为反应，在不同阶段表现不同。心理健康护理体验也受到障碍、促进因素和个体背景因素的影响，这些因素都影响着他们获得护理的机会。
我们的理论深入了解了结直肠癌患者在结直肠癌护理连续体各阶段的心理健康体验。了解患者的情绪和认知行为反应以及护理体验，可以帮助确定将心理健康纳入结直肠癌护理的机会。
