Zhao Fei-Yi, Xu Peijie, Kennedy Gerard A, Yue Li-Ping, Zhang Wen-Jing, Wang Yan-Mei, Ho Yuen-Shan, Fu Qiang-Qiang, Conduit Russell
Department of Nursing, School of International Medical Technology, Shanghai Sanda University, Shanghai, 201209, People's Republic of China.
Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2050, Australia.
J Cancer Surviv. 2025 May 9. doi: 10.1007/s11764-025-01808-2.
Traditional Chinese Medicine (TCM)-based self-care is widely practiced among cancer survivors worldwide, particularly in China. For Chinese breast cancer survivors (BCSs), it embodies both an expression of ethnomedical cultural identity and a means of health self-empowerment. However, this practice often occurs without professional supervision, posing potential risks. This study aims to explore BCSs' experiences and perspectives to elucidate the purposes and influencing factors behind their home-based TCM self-care engagement, thereby informing future optimization strategies.
A focused ethnographic design was utilized, with a research framework integrating the COM-B model and Theoretical Domains Framework (TDF). Results were mapped onto constructs of a behavioral wheel derived from the COM-B/TDF matrix. Data analysis followed conventional qualitative content analysis procedures.
Participants viewed TCM-based self-care as a complement to rather than a substitute for standard care, primarily for relapse prevention. Facilitators of this practice included (1) strong cultural beliefs and confidence in ethnic medicine, (2) a sense of health responsibility, (3) heightened internal health locus of control, (4) prior beneficial experiences, (5) incentives from online key opinion leaders and fellow survivors, (6) support from family and peers, and (7) reduced time and financial costs. Barriers were (1) insufficient TCM knowledge and skills and (2) uncertainty about efficacy; and (3) safety concerns. Additionally, (1) the home-based treatment setting and (2) the immature internet-based TCM nurse service acted as both barriers and facilitators.
The interrelated facilitators and barriers underscore that BCSs' home-based TCM self-care constitutes a complex medical-sociological issue involving cultural, economic, information communication, and healthcare service delivery dimensions. Only a minority of survivors are aware of the possible adverse medical consequences. Within a patient-centered framework, healthcare providers must identify the unique health-deviation self-care requisites of BCSs in a culturally sensitive manner, and partner with them in their self-health management, such as telemonitoring their home-based TCM self-care using eHealth technologies. There is also an urgent need to develop clinical guidelines or expert consensus to support these practices.
BCSs' TCM self-care represents an intentional health autonomy strategy beyond conventional biomedical dominance, necessitating professional supervision to equilibrate health self-empowerment and iatrogenic risk.
基于传统中医（TCM）的自我保健在全球癌症幸存者中广泛应用，尤其是在中国。对于中国乳腺癌幸存者（BCS）而言，这既是民族医学文化身份的一种表达，也是健康自我赋权的一种方式。然而，这种做法往往在没有专业监督的情况下进行，存在潜在风险。本研究旨在探索BCS的经历和观点，以阐明其在家中进行中医自我保健行为的目的和影响因素，从而为未来的优化策略提供参考。
采用聚焦人种志设计，研究框架整合了COM - B模型和理论领域框架（TDF）。结果映射到从COM - B/TDF矩阵衍生的行为轮结构上。数据分析遵循常规定性内容分析程序。
参与者将基于中医的自我保健视为标准护理的补充而非替代，主要用于预防复发。这种做法的促进因素包括：（1）对民族医学有强烈的文化信仰和信心；（2）健康责任感；（3）更强的内部健康控制点；（4）既往有益经历；（5）在线关键意见领袖和其他幸存者的激励；（6）家人和同伴的支持；（7）时间和经济成本降低。障碍包括：（1）中医知识和技能不足；（2）对疗效的不确定性；（3）安全担忧。此外，（1）家庭治疗环境和（2）不成熟的基于互联网的中医护理服务既是障碍也是促进因素。
相关的促进因素和障碍表明，BCS在家中进行中医自我保健是一个复杂的医学 - 社会学问题，涉及文化、经济、信息传播和医疗服务提供等多个维度。只有少数幸存者意识到可能的不良医疗后果。在以患者为中心的框架内，医疗服务提供者必须以文化敏感的方式识别BCS独特的健康偏差自我保健需求，并与他们合作进行自我健康管理，例如使用电子健康技术远程监测他们在家中的中医自我保健情况。此外，迫切需要制定临床指南或专家共识来支持这些做法。
BCS的中医自我保健代表了一种超越传统生物医学主导的有意的健康自主策略，需要专业监督以平衡健康自我赋权和医源性风险。
