Webb C, Koch T
University of Plymouth, England.
J Adv Nurs. 1997 Mar;25(3):514-25. doi: 10.1046/j.1365-2648.1997.t01-1-1997025514.x.
A review of the post-1990 literature on breast cancer has identified a large body of psychosocial research focusing on coping styles, quality of life and women's participation in choice of treatment. However, numerous methodological problems were found, including a variety of different diagnoses included in samples both within studies and between studies, making comparisons difficult. In particular, no article was traced which focused on non-invasive breast cancer, or ductal carcinoma in situ (DCIS). Therefore a small exploratory study was conducted using qualitative methods to explore women's experience of DCIS, in an attempt to begin exploration of possible similarities or differences in the way women experience invasive and non-invasive breast cancer. A convenience sample of 10 women treated at two hospitals in an Australian state capital city was interviewed, and three themes which emerged from these interviews are discussed in this article. These are discovering the problem, reaction to the diagnosis, and information. Most women unexpectedly reacted in a calm and accepting way to receiving the diagnosis of DCIS, and this may be because they had had no signs of disease but been recalled for further tests after routine screening. They felt well and had no cause to assume a poor prognosis. It is possible also that their reactions were affected by a television health education campaign at the time, which gave a very optimistic picture of the benefits of early detection of breast cancer. Information-giving, as reported by the women, seemed deficient. None of them knew that they had had a non-invasive condition, one thought her disease had been benign, and another that hers was "evasive'. Findings are discussed in relation to the literature on information-giving and on the role of the nurse in this area, and suggestions are made for further research to systematically compare women's reactions to having invasive and non-invasive breast cancer in order that nurses may be aware of their possibly different needs and respond to them appropriately.
一项对1990年后乳腺癌相关文献的综述发现，有大量社会心理研究聚焦于应对方式、生活质量以及女性在治疗选择中的参与情况。然而，研究发现了诸多方法学问题，包括研究内部和研究之间样本中包含的各种不同诊断，这使得比较变得困难。特别值得一提的是，未找到专注于非浸润性乳腺癌或原位导管癌（DCIS）的文章。因此，开展了一项小型探索性研究，采用定性方法探究女性患DCIS的经历，试图初步探索女性在经历浸润性和非浸润性乳腺癌时可能存在的异同。对澳大利亚一个州首府城市两家医院接受治疗的10名女性进行了便利抽样访谈，本文讨论了从这些访谈中浮现出的三个主题。它们分别是发现问题、对诊断的反应以及信息。大多数女性在得知自己被诊断为DCIS时，出人意料地表现得平静且接受，这可能是因为她们之前没有疾病迹象，只是在常规筛查后被召回做进一步检查。她们感觉良好，没有理由认为预后不佳。也有可能她们的反应受到当时一场电视健康教育活动的影响，该活动对早期发现乳腺癌的益处描绘得非常乐观。据这些女性报告，信息提供似乎不足。她们中没有人知道自己患的是非浸润性疾病，一个人认为自己的病是良性的，另一个人则认为自己的病“难以捉摸”。本文结合有关信息提供以及护士在这方面作用的文献对研究结果进行了讨论，并提出了进一步研究的建议，以便系统地比较女性对浸润性和非浸润性乳腺癌的反应，从而使护士能够意识到她们可能存在的不同需求并做出适当回应。
