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针对年轻乳腺癌女性的医院及社区支持性护理:一项范围综述与环境扫描

Hospital and community supportive care for young women with breast cancer: a scoping review and environmental scan.

作者信息

Yufe Shira J, Fergus Karen D, Norton Lucas G S

机构信息

Psychosocial Oncology Laboratory, Department of Psychology, York University, Toronto, ON, Canada.

Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

出版信息

J Cancer Surviv. 2025 Jul 9. doi: 10.1007/s11764-025-01846-w.

Abstract

PURPOSE

This study is an up-to-date review of supportive care available to young women with breast cancer (YWBCs) in both hospital-based and community organizations. This review describes the types of psychosocial programming for YWBCs in English-speaking regions and is inclusive of community organizations which are generally not captured in reviews.

METHODS

We used a PRISMA-guided scoping review with a snowball search method (pulled from three databases: (1) PsycINFO, (2) CINAHL, and (3) PubMed) in conjunction with a web-based environmental scan using an online search engine strategy and including grey literature. The initial searches were performed from July 2020 to January 2021, and results were updated in April 2023 and January 2025. In addition to describing the models of care available, we explored the differing praxis associated with each support domain (hospital and community) that underlies the development of YWBC care.

RESULTS

A total of 6228 journal articles were screened by two researchers who engaged in continuous consensus discussions, and 22 were identified to be consistent with our inclusion criteria. The web-based environmental scan identified 24 organizations catering to YWBCs using the following keywords: "breast cancer," "young women," "breast cancer young women's online community program," "breast cancer support," "under 50 young women breast cancer," and "online program breast cancer for young women." While academic and hospital-based programs were more likely to offer empirically supported psychological interventions, community organizations were more likely to provide informal social support and practical assistance (e.g., childcare and finances). A "hybrid-type" model of care was identified and deemed to be optimal because of its comprehensiveness and ability to integrate both hospital and community resources.

CONCLUSIONS

This study provided a descriptive review, with a comparison framework, of the interventions that currently exist from hospital-based and community-based paradigms. It is recommended that hybrid models be made available to YWBCs to support their unique needs.

IMPLICATIONS FOR CANCER SURVIVORS

Hybrid-type models of care identified in this review, which integrate community and hospital resources, may provide more comprehensive support than either model alone. The provision of timely, appropriate psychosocial support may aid in the transition to survivorship by mitigating the deleterious effect of issues specific to YWBCs, including concerns around fertility, body image, relationships, and fear of cancer recurrence.

摘要

目的

本研究是对医院和社区组织中为年轻乳腺癌患者(YWBCs)提供的支持性护理的最新综述。本综述描述了英语地区为YWBCs提供的心理社会项目类型,包括一般在综述中未涉及的社区组织。

方法

我们采用PRISMA指导的范围综述和滚雪球搜索方法(从三个数据库中检索:(1)PsycINFO,(2)CINAHL,(3)PubMed),并结合使用在线搜索引擎策略的基于网络的环境扫描,包括灰色文献。初始搜索于2020年7月至2021年1月进行,结果于2023年4月和2025年1月更新。除了描述现有的护理模式外,我们还探讨了与YWBC护理发展相关的每个支持领域(医院和社区)的不同实践。

结果

两名研究人员对总共6228篇期刊文章进行了筛选,并进行了持续的共识讨论,确定其中22篇符合我们的纳入标准。基于网络的环境扫描通过以下关键词确定了24个为YWBCs提供服务的组织:“乳腺癌”、“年轻女性”、“乳腺癌年轻女性在线社区项目”、“乳腺癌支持”、“50岁以下年轻女性乳腺癌”和“年轻女性乳腺癌在线项目”。虽然学术和医院项目更有可能提供经实证支持的心理干预,但社区组织更有可能提供非正式的社会支持和实际帮助(如儿童保育和财务支持)。一种“混合型”护理模式被确定并被认为是最佳的,因为它具有全面性以及整合医院和社区资源的能力。

结论

本研究提供了一个描述性综述,并带有一个比较框架,介绍了目前基于医院和社区范式的干预措施。建议为YWBCs提供混合型模式以满足他们的独特需求。

对癌症幸存者的启示

本综述中确定的整合社区和医院资源的混合型护理模式可能比单独的任何一种模式提供更全面的支持。提供及时、适当的心理社会支持可能有助于向幸存者身份的转变,减轻YWBCs特有的问题的有害影响,包括对生育、身体形象、人际关系以及对癌症复发的恐惧等问题。

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