摘要
目的探讨可行保乳手术的乳腺癌患者选择放弃保乳转行单乳切除的心理及影响因素。方法采用目的抽样法,选取2019年9月—2020年2月山西白求恩医院乳腺外科收治的18例有保乳指征最终选择单乳切除的乳腺癌患者作为研究对象。采用质性研究的方法,对其进行半结构式深入访谈,并进行资料整理与分析。结果从患者因素、家庭因素、医护人员因素及社会因素4个层面归纳出8个影响决策的主题,即患者呈现经济压力、疲于应对、认知偏差、预期性悲伤;家属隐瞒病情与患者决策参与缺失;医护人员宣教不足;网络信息有待商榷,同伴体验错误导向。结论乳腺癌患者手术方式的决策受多方因素的影响。医护人员应以现有因素为切入点,构建干预措施,促进患者参与临床决策。
Objective To explore the psychology and influencing factors of decision-making for giving up breast-conserving and choosing unilateral mastectomy among breast cancer patients with feasible breast-conserving surgery.Methods From September 2019 to February 2020,we selected 18 breast cancer patients with breast-conserving indications and finally choosing unilateral mastectomy in Breast Surgery at Shanxi Bethune Hospital as the study objects by purposive sampling.The qualitative research was used to carry out semi-structured in-depth interview,and the data was organized and analyzed.Results From four aspects,the patient factor,family factor,medical and nursing staff factor as well as social factor,a total of 8 themes that affected decision-making were summarized,including that patients were under financial pressure,fatigue,and had cognition bias and expected sadness;family members concealed the condition,and lack of family members and patients participation in decision-making;inadequate health education by medical and nursing staff;network information needed to be discussed,and misdirection of peer experience.Conclusions Decision-making for surgical methods of breast cancer patients is influenced by many factors.Medical and nursing staff should use the existing factors as an entry point to construct intervention measures so as to promote patient participation in clinical decision-making.
作者
栗敏
陈琳
韩晶晶
王临英
Li Min;Chen Lin;Han Jingjing;Wang Linying(Department of Breast Surgery,Shanxi Bethune Hospital&Shanxi Academy of Medical Sciences,Taiyuan 030032,China)
出处
《中华现代护理杂志》
2020年第20期2736-2740,共5页
Chinese Journal of Modern Nursing
基金
山西省卫生计生委科研课题(2017007)。
关键词
乳腺肿瘤
保乳手术
单乳切除
决策经历
影响因素
Breast neoplasms
Breast conservation surgery
Unilateral mastectomy
Decision-making experience
Influencing factors
