Quality of life and care needs in women with estrogen positive metastatic breast cancer: a qualitative study
Quality of life and care needs in women with estrogen positive metastatic breast cancer: a qualitative study
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DOI：
10.1080/0284186x.2017.1406141
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发表时间：
2018-01-01
期刊：
影响因子：
3.1
通讯作者：
Ejlertsen, Bent
中科院分区：
文献类型：
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作者：
Mortensen, Gitte Lee;Madsen, Ivan Bredbjerg;Ejlertsen, Bent
背景资料：近年来，转移性乳腺癌（MBC）的预后随着适用于更广泛患者的更有效疗法而得到改善。因此，对许多患者来说，MBC诊断启动了长期的疾病和治疗过程。本定性研究旨在探讨长期健康相关的生活质量（HRQoL）和支持需求MBC患者的所有年龄段在Danishcontext.Material和方法：18 MBC患者参加了五个定性焦点小组访谈，使用内容分析和建构主义的方法进行了分析。参与者描述了MBC如何严重降低他们的身体和心理社会功能，并需要不断适应他们的生活质量（QoL）标准与他们不断变化的生活状况和疾病进展有关。总的来说，他们觉得在医学上得到了很好的治疗，但缺乏多学科的护理方法，特别是包括心理支持，但也包括手动物理治疗，卫生保健协调和社会咨询。与会者呼吁由相同的卫生保健专业人员提供连续性护理，因为这有助于在计划治疗和控制方面的沟通和灵活性。他们要求减少宝贵的时间花在治疗上，使他们能够专注于他们最有意义的关系和activities.Conclusion：与MBC的诊断，治疗的重点从疾病根除开关延长生存，减轻症状，提高生活质量。对于患者来说，MBC标志着期望从数量到生活质量的转变，以及对其生活质量标准的永久调整。为了维持患者的HRQoL，重要的是沿着延长生命治疗的改善，综合护理也支持他们的主要心理社会需求。这些患者需要支持，以维持正常和角色功能，使他们能够专注于生活，而不仅仅是生存，通过这一长期的疾病阶段。
Background: In recent years, the prognosis of metastatic breast cancer (MBC) has improved with more effective therapies applicable to a wider range of patients. To many patients, a MBC diagnosis thus initiates a prolonged course of illness and treatment. This qualitative study aimed to explore the long-term health-related quality of life (HRQoL) and support needs in MBC patients of all ages in the Danish context.Material and methods: Eighteen MBC patients participated in five qualitative focus group interviews that were analyzed using content analysis and a constructivist approach.Results: The participants described how MBC severely reduced their physical and psychosocial functioning and required a constant adaptation of their quality of life (QoL) standards in relation to their changing life situation and disease progression. Overall, they felt medically well-treated but lacked a multidisciplinary approach to care including psychological support, in particular, but also manual physiotherapy, health care coordination and social counseling. The participants called for continuity of care with the same health care professionals as this facilitated communication and flexibility in planning treatment and controls. They requested a reduction of precious time spend on treatment to enable them to focus on their most meaningful relations and activities.Conclusion: With the MBC diagnosis, the focus of treatment switches from disease eradication to prolonging survival, alleviating symptoms and improving QoL. To patients, MBC marks a shift in expectations from quantity to quality of life and a perpetual adaptation of their QoL standards. To sustain patients' HRQoL, it is important that along with improvements in life-prolonging treatment, comprehensive care also supports their main psycho-social needs. These patients needed support in maintaining normality and role functioning enabling them to focus on living, not merely surviving, through this prolonged disease phase.