Early-stage breast cancer menopausal symptom experience and management: exploring medical oncology clinic visit conversations through qualitative analysis.
Early-stage breast cancer menopausal symptom experience and management: exploring medical oncology clinic visit conversations through qualitative analysis.
复制标题
早期乳腺癌绝经期症状体验与管理：通过定性分析探索肿瘤内科门诊就诊对话。
DOI：
10.1007/s00520-022-07446-z
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Rosenzweig,MargaretQ
中科院分区：
文献类型：
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作者：
Limbacher,SarahA;Mazanec,SusanR;Frame,JenniferM;Connolly,MaryC;Park,Sumin;Rosenzweig,MargaretQ
目的：接受乳腺癌化疗的妇女经历的更年期症状在表现和对生活质量的影响方面各不相同。每个化疗周期前的临床访问提供了一个重要的机会，让患者与他们的肿瘤医疗保健提供者就这些症状进行对话，并确定自我管理的策略。本研究的目的是描述在乳腺癌治疗的背景下，患者和提供者在更年期症状经历和管理方面的相互作用。方法对61例乳腺癌化疗妇女临床就诊记录进行专题分析。转录本的选择基于对绝经期症状的讨论。结果主题被分为三种不同的类别：患者、临床医生和二元主题。总体主题是临床访问的目标不一致，这反映在以下主题：意外和没有准备；苦恼的，被扰乱的；临床不敏感;错失了管理和同理心的机会；幽默和口语的运用。总的来说，妇女对更年期症状的经历没有准备，临床医生通常没有提供管理，干预或移情反应。结论临床访视时应对绝经期症状进行更准确的评估和沟通。可能的干预措施包括更全面的评估，促进临床医生对更年期症状的关注和反应的算法，以及对症状的治疗。
PurposeWomen being treated with chemotherapy for breast cancer experience menopausal symptoms that vary in presentation and impact on quality of life. The clinical visit before each chemotherapy cycle provides an important opportunity to allow patients to dialogue with their medical oncology healthcare providers about these symptoms and identify strategies for self-management. The objective of this study was to characterize patient and provider interactions regarding the menopausal symptom experience and management in the context of breast cancer treatment.MethodsThematic analysis was employed to analyze 61 transcripts from clinical encounters of women receiving chemotherapy treatment for breast cancer. Transcripts were chosen based on their inclusion of menopausal symptom discussion.ResultsThemes were separated into three distinct categories: patient, clinician, and dyadic themes. The overarching theme was goal discordance in the clinical visit, which was reflected in the following themes: unexpected and unprepared; distressed, disrupted and disturbed; clinical insensitivity; missed opportunity for management and empathy; and use of humor and colloquial language. Overall, women were unprepared for the menopausal symptom experience, and clinicians did not often provide management, interventions, or empathetic responses.ConclusionThere is a need to develop more astute assessment and communication regarding menopausal symptoms during the clinical visit. Possible interventions include a more holistic assessment, algorithms to facilitate the clinician’s attention and response to menopausal symptoms, and treatment of symptoms.