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新确诊乳腺癌患者融入共同决策过程的二元体验:一项定性分析。

The Dyadic Experience of a New Breast Cancer Diagnosis Into the Shared Decision-Making Process: A Qualitative Analysis.

作者信息

Cincidda Clizia, Oliveri Serena, Sebri Valeria, Pravettoni Gabriella

机构信息

Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy.

Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.

出版信息

Psychooncology. 2025 Sep;34(9):e70277. doi: 10.1002/pon.70277.

Abstract

OBJECTIVE

This study explores the dyadic experience of patients newly diagnosed with breast cancer and their caregivers, focusing on emotional responses, informational needs, and shared involvement in clinical decision-making.

METHODS

Twenty-three patient-caregiver dyads participated in semi-structured interviews conducted by psychologists specializing in clinical and health psychology. The interviews were analyzed using Qualitative Thematic Analysis to identify core themes reflecting the dyadic experience.

RESULTS

Findings highlighted the central role of the patient-caregiver relationship in coping with diagnosis and treatment planning. Both patients and caregivers valued sharing medical information, participating together in medical consultation and jointly engaging in treatment decisions, which fostered a sense of unity, reduced anxiety and improved understanding of treatment choice. Trust in healthcare providers, particularly their clarity, empathy, and expertise, emerged as a critical factor in alleviating patients' decisional regret and sustaining caregivers' confidence in supporting the patient. Although both patients and caregivers faced emotional challenges, their fears and concerns often differed, underscoring the need for individualized emotional support. Inclusion of caregivers in clinical discussions was considered essential for promoting a cohesive and supportive care experience.

CONCLUSIONS

The study underscores the emotional complexity and interdependence of the patient-caregiver dynamic following a breast cancer diagnosis. Being the patient-caregiver relationship central to cancer care, it is important to encourage coordinated involvement of both parties in the clinical process may reduce psychological distress, alleviate decisional conflict, and enhance overall quality of life. These findings support the adoption of a person-centered, relational model of care that recognizes the dyad as a unit of support and decision-making.

摘要

目的

本研究探讨新诊断为乳腺癌的患者及其照护者的二元体验,重点关注情绪反应、信息需求以及在临床决策中的共同参与。

方法

23对患者-照护者参与了由专门从事临床和健康心理学的心理学家进行的半结构式访谈。采用定性主题分析法对访谈进行分析,以确定反映二元体验的核心主题。

结果

研究结果突出了患者-照护者关系在应对诊断和治疗规划中的核心作用。患者和照护者都重视分享医疗信息、共同参与医疗咨询以及共同做出治疗决策,这增强了团结感、减轻了焦虑并增进了对治疗选择的理解。对医疗服务提供者的信任,尤其是他们的清晰沟通、同理心和专业知识,成为减轻患者决策后悔感以及维持照护者支持患者信心的关键因素。尽管患者和照护者都面临情绪挑战,但他们的恐惧和担忧往往不同,这凸显了提供个性化情感支持的必要性。让照护者参与临床讨论被认为对于促进连贯且支持性的照护体验至关重要。

结论

该研究强调了乳腺癌诊断后患者-照护者动态关系中的情绪复杂性和相互依存性。鉴于患者-照护者关系在癌症照护中至关重要,鼓励双方协调参与临床过程可能会减少心理困扰、缓解决策冲突并提高总体生活质量。这些发现支持采用以患者为中心的关系型照护模式,该模式将二元组视为一个支持和决策单位。

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