Watching, waiting and uncertainty in prostate cancer
Watching, waiting and uncertainty in prostate cancer
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DOI：
10.1111/j.1365-2702.2005.01545.x
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发表时间：
2007-04-01
影响因子：
4.2
通讯作者：
Mishel, Merle H.
中科院分区：
文献类型：
--
作者：
Bailey, Donald E., Jr.;Wallace, Meredith;Mishel, Merle H.
瞄准。这项研究探索了患有前列腺癌的老年男性的问题和不确定性，他们经历了警惕的等待，以及他们使用的策略来管理他们的担忧。随着预期寿命的延长，患有前列腺癌的老年男性人数也增加了。近50%的新前列腺癌是在70岁以上的男性中诊断出来的。对于这些老年男性中的许多人来说，医疗保健的改善增加了他们患前列腺癌多年的可能性。因此，对于患有局限性前列腺癌的老年男性，观察等待被认为是一种合理的替代治疗方法。本研究采用定性、描述性设计。对10名接受前列腺癌观察等待治疗的男性的访谈结果用米谢尔重新概念化的疾病不确定性模型进行了分析。确定了不确定性域、危险评价域和机会评价域，每个域都得到了参与者的经验支持。该研究结果可用于扩展疾病中的不确定性模型，并为正在观察等待前列腺癌的男性开发干预措施。这些发现可能被用来加强目前对选择警惕等待作为前列腺癌治疗替代方案的男性的护理干预，包括患者教育和支持服务。未来的研究应该检查护士在管理不确定性方面的作用，特别是在病人教学和管理不确定性的干预措施的开发、实施和评估中。
Aim. This study explores the problems and uncertainties of older men, with prostate cancer, who have undergone watchful waiting and the strategies they use to manage their concerns.Background. With life expectancy rising, the number of older men with prostate cancer has increased. Nearly 50% of all new prostate cancers are diagnosed in men over 70 years old. For many of these older men, improvements in medical care have increased the likelihood of living for years with prostate cancer. Thus, watchful waiting has been proposed as a reasonable alternative to treatment for older men with localized prostate cancer.Methods. A qualitative, descriptive design was used for this study. The results from interviews with 10 men who were undergoing watchful waiting for prostate cancer were analysed using the Mishel's Reconceptualized Uncertainty in Illness model.Results. Domains of uncertainty, appraisal of danger and appraisal of opportunity were identified and each was supported by participant's experience.Conclusions. The results of the study may be used to expand the Uncertainty in Illness model and develop interventions for men undergoing watchful waiting for prostate cancer.Relevance to clinical practice. These findings may be used to enhance current nursing interventions for men electing for watchful waiting as an alternative to treatment for prostate cancer, including patient teaching and support services. Future study should examine the role of nurses in managing uncertainty, especially in patient teaching and in the development, implementation and evaluation of interventions to manage uncertainty.