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向加蓬女性披露乳腺癌或子宫颈癌病情所带来的心理影响。

Psychological repercussions of breast or uterine cervical cancer disclosure to women in Gabon.

作者信息

Ndjengue Bengone Béa-Christelle, Toniolo Jean, Filankembo Kava Angela-Christie, Ngoungou Edgard Brice, Belembaogo Ernest, Preux Pierre-Marie

机构信息

Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Omega Health, Limoges, France.

Research Unit of Chronic Diseases and Environmental Health (UREMCSE), University of Health Sciences, Libreville, Gabon.

出版信息

PLoS One. 2025 Jun 20;20(6):e0326378. doi: 10.1371/journal.pone.0326378. eCollection 2025.

Abstract

BACKGROUND

Breast and cervical cancers are major health issues globally, with particularly high burdens in sub-Saharan Africa, including Gabon. Limited epidemiological data and insufficient attention to the psychological impacts of these cancers highlight critical research gaps. This study aimed to explore the psychological repercussions experienced by Gabonese women following the disclosure of a breast or cervical cancer diagnosis.

METHODS

A mixed-methods cross-sectional study was conducted from March to May 2023 at the Institut de Cancérologie d'Akanda. Women recently diagnosed with breast or cervical cancer were recruited using a consecutive sampling method. Data were collected through semi-structured individual interviews and one focus group to explore emotional responses, coping strategies, and perceptions of patient-provider interactions. In addition, the Patient Health Questionnaire-9 (PHQ-9) was administered to assess depressive symptoms.

RESULTS

Thirteen Gabonese women diagnosed with breast (n = 10) or cervical cancer (n = 3) participated in this mixed-methods study. Following the disclosure, all patients reported depressive symptoms ranging from minimal to moderately severe (PHQ-9). Qualitative analysis revealed intense emotional distress, including anxiety, sadness, sleep disturbances, and despair. The diagnosis affected participants' identity, body image, and social relationships, reinforcing feelings of stigma, isolation, and loss. Beliefs about disease etiology and social representations shaped emotional responses. While some relied on spirituality, social support, or personal resilience to cope, others expressed unmet psychological needs. Participants emphasized the importance of clear, compassionate communication from healthcare professionals, highlighting the need for empathy, trust, and active listening during diagnosis disclosure.

CONCLUSION

This pioneering study in Gabon identifies profound psychological effects associated with breast and cervical cancer diagnosis disclosure. The findings underscore the urgent need for improved psychosocial support, effective communication training for healthcare providers, and culturally tailored interventions to address mental health concerns in this population.

摘要

背景

乳腺癌和宫颈癌是全球主要的健康问题,在撒哈拉以南非洲地区,包括加蓬,负担尤为沉重。有限的流行病学数据以及对这些癌症心理影响的关注不足凸显了关键的研究空白。本研究旨在探讨加蓬女性在得知乳腺癌或宫颈癌诊断结果后所经历的心理影响。

方法

2023年3月至5月,在阿坎达癌症研究所进行了一项混合方法的横断面研究。采用连续抽样方法招募最近被诊断为乳腺癌或宫颈癌的女性。通过半结构化的个人访谈和一个焦点小组收集数据,以探讨情绪反应、应对策略以及对医患互动的看法。此外,使用患者健康问卷-9(PHQ-9)评估抑郁症状。

结果

13名被诊断为乳腺癌(n = 10)或宫颈癌(n = 3)的加蓬女性参与了这项混合方法研究。在得知诊断结果后,所有患者均报告有从轻度到中度严重程度不等的抑郁症状(PHQ-9)。定性分析显示出强烈的情绪困扰,包括焦虑、悲伤、睡眠障碍和绝望。诊断影响了参与者的身份认同、身体形象和社会关系,强化了耻辱感、孤立感和失落感。对疾病病因的信念和社会认知塑造了情绪反应。一些人依靠精神寄托、社会支持或个人韧性来应对,而另一些人则表示心理需求未得到满足。参与者强调了医疗保健专业人员进行清晰、富有同情心沟通的重要性,突出了在诊断告知过程中需要同理心、信任和积极倾听。

结论

这项在加蓬开展的开创性研究确定了与乳腺癌和宫颈癌诊断告知相关的深刻心理影响。研究结果强调迫切需要改善心理社会支持、为医疗保健提供者提供有效的沟通培训,以及开展针对该人群心理健康问题的文化适应性干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e7d/12180733/7b0a00bd240d/pone.0326378.g001.jpg

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