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“平衡挑战与个人资源”:一项关于乳腺癌腋窝手术后女性上肢功能障碍经历的定性研究

'Balancing Challenges and Personal Resources': A Qualitative Study of Women's Experiences of Arm Impairment After Axillary Surgery for Breast Cancer.

作者信息

Appelgren Matilda, Wengström Yvonne, de Boniface Jana, Sackey Helena

机构信息

Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

Department of Surgery, Capio St Göran's Hospital, Stockholm, Sweden.

出版信息

J Adv Nurs. 2025 Jun;81(6):3156-3165. doi: 10.1111/jan.16517. Epub 2024 Oct 7.

Abstract

AIM

To explore how women previously treated for breast cancer experience living with arm impairment after axillary surgery.

DESIGN

Descriptive qualitative study. The inductive starting point for the analysis was followed by a deductive approach as the categories were related to the components of the sense of coherence framework.

METHODS

Twenty-eight relapse-free Swedish-speaking females participated in six focus group discussions conducted between September and December 2022. All participants had undergone sentinel lymph node biopsy with or without completion axillary dissection 4 years earlier. Data were analysed using qualitative content analysis.

RESULTS

Three categories and an overall theme were identified. The categories 'Sense-making', 'Daily life' and 'Driving force' reflect actions to understand and prevent arm symptoms, adaptations made in daily life and the empowering resources adopted to meet challenges. The overall theme, 'Balancing challenges and personal resources', comprised a process that began at diagnosis and remained ongoing for some participants. Most participants considered their new life situations manageable. However, those with more pronounced arm impairment reported that they did not always receive adequate aid, and that their daily lives were negatively affected.

CONCLUSION

Returning to everyday life after axillary surgery for breast cancer is associated with varying degrees of challenges. Individuals with persistent arm impairment find returning to normal life more challenging. Therefore, further improvements in person-centred care are of utmost importance.

PATIENT AND PUBLIC CONTRIBUTION

Members of the Swedish Breast Cancer Association were involved in the creation of the interview guide.

IMPACT

This study emphasises the requirement for providing further individualised support to those living with more severe arm impairment after axillary surgery.

REPORTING METHOD

This study was reported in accordance with the Standards for Reporting Qualitative Research.

摘要

目的

探讨既往接受过乳腺癌治疗的女性在腋窝手术后伴有手臂功能障碍的生活体验。

设计

描述性定性研究。分析的归纳起点之后采用演绎方法,因为这些类别与连贯感框架的组成部分相关。

方法

28名无复发的瑞典语女性参与了2022年9月至12月期间进行的6次焦点小组讨论。所有参与者在4年前都接受了前哨淋巴结活检,部分还进行了腋窝清扫术。采用定性内容分析法对数据进行分析。

结果

确定了三个类别和一个总体主题。“意义建构”“日常生活”和“驱动力”类别反映了理解和预防手臂症状的行动、在日常生活中做出的调整以及为应对挑战而采用的赋能资源。总体主题“平衡挑战与个人资源”包括一个从诊断开始并在一些参与者中持续存在的过程。大多数参与者认为他们的新生活状况是可以管理的。然而,那些手臂功能障碍更明显的参与者报告说,他们并不总是得到足够的帮助,并且他们的日常生活受到了负面影响。

结论

乳腺癌腋窝手术后回归日常生活伴随着不同程度的挑战。持续存在手臂功能障碍的个体发现回归正常生活更具挑战性。因此,进一步改善以患者为中心的护理至关重要。

患者和公众贡献

瑞典乳腺癌协会的成员参与了访谈指南的制定。

影响

本研究强调需要为腋窝手术后手臂功能障碍更严重的患者提供进一步的个性化支持。

报告方法

本研究按照定性研究报告标准进行报告。

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