Active surveillance in prostate cancer: a concept analysis
Active surveillance in prostate cancer: a concept analysis
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DOI：
10.1111/jocn.13111
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发表时间：
2016-04-01
影响因子：
4.2
通讯作者：
Horrill, Tara
中科院分区：
文献类型：
--
作者：
Horrill, Tara
目的报告对主动监测概念的分析。背景自从引入 PSA 筛查以来，前列腺癌变得更加普遍，然而，许多男性被诊断患有可能不需要治疗的低风险疾病。主动监测是一种治疗策略，用于在不需要立即治疗时避免治疗和相关不良反应。缺乏通用的定义。设计概念分析。数据来源使用主动监测一词检索了 1980 年至 2014 年间发表的文献，包括 CINAHL、PubMed、Scopus、Cochrane Library 和 Google Scholar 数据库。方法使用 Walker 和 Avant (2010) 的方法来分析主动监测的概念，特别是在前列腺癌的背景下。结果分析中出现的主动监测的关键属性包括：定期和有目的的监测、早期监测检测疾病进展并在必要时计划治疗干预。文献中使用多个术语来指代主动监视的概念。主动监测可能会带来不确定性，并促使男性改变生活方式并寻求更多有关前列腺癌的信息。结论主动监测尚未得到充分理解，并且概念仍然存在模糊性。主动监测和观察等待在文献和临床实践中可以互换使用，但实际上并不是指相同的策略。主动监测会给患者和家属带来很大的不确定性，这可能会成为选择其作为治疗策略的障碍，并且该领域的护理研究是有限的。与临床实践的相关性护士需要清楚地了解主动监测以及它与其他策略的区别，以减少概念的模糊性。护士必须意识到主动监测带来的不确定性，并且需要在这一领域继续进行护理研究。
AimTo report an analysis of the concept of active surveillance.BackgroundProstate cancer has become more prevalent since the introduction of PSA screening, however, many men are diagnosed with low-risk disease that may not require treatment. Active surveillance is a treatment strategy used to avoid treatment and related adverse effects when immediate treatment is not necessary. A universal definition is lacking.DesignConcept analysis.Data sourcesThe CINAHL, PubMed, Scopus, Cochrane Library and Google Scholar databases were searched for literature published between 1980 and 2014 using the term active surveillance.MethodsThe method of Walker and Avant (2010) was used to analyse the concept of active surveillance, specifically within the context of prostate cancer.ResultsKey attributes of active surveillance emerging from the analysis include: regular and purposeful monitoring, early detection of disease progression and planned curative intervention if necessary. Multiple terms are used in the literature to refer to the concept of active surveillance. Active surveillance can cause uncertainty, and prompt men to make lifestyle changes and seek more information on prostate cancer.ConclusionActive surveillance is not well understood, and ambiguity remains around the concept. Active surveillance and watchful waiting are used interchangeably in the literature and in clinical practice, but in fact do not refer to the same strategy. Active surveillance can generate significant uncertainty for the patient and family, which may be a barrier to choosing it as a treatment strategy and nursing research in this area is limited.Relevance to clinical practiceNurses need a clear understanding of active surveillance and how it differs from other strategies in order to reduce ambiguity around the concept. Nurses must be aware of the uncertainty accompanying active surveillance, and a need exists for continued nursing research in this area.