Patients' Perceptions at Diagnosis: Lung Cancer Discovery and Provider Relationships.
Patients' Perceptions at Diagnosis: Lung Cancer Discovery and Provider Relationships.
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DOI：
10.1097/ncc.0000000000001050
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发表时间：
2022-09-01
期刊：
影响因子：
2.6
通讯作者：
Dickerson, Suzanne S.
中科院分区：
文献类型：
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作者：
Somayaji, Darryl;Mohedat, Heba;Dean, Grace E.;Dickerson, Suzanne S.
在美国，大多数肺癌病例在晚期被诊断出来，限制了治疗选择并影响生存。这项研究展示了患者对影响肺癌诊断因素复杂性的看法。对肺癌风险、症状、吸烟行为、家族史和环境因素的认识可以导致预防和早期发现措施。在早期研究的背景下，探讨肺癌患者对肺癌意识的看法，以了解NSCLC成人的睡眠-觉醒障碍。采用内容分析法对26例肺癌患者的原始去身份化纵向访谈数据进行分析。在最初的26名受试者中，16名受试者被纳入本次二次数据分析。参与者主要是女性（n=10），白人（n=13），年龄在49-83岁之间。一半的样本被诊断为IV期肺癌，大部分样本正在接受化疗（n=10）。确定了两个关键主题：肺癌的发现和医患关系。最初症状不明确，缺乏知识和筛查，以及害怕诊断而推迟就医。患者与医生的关系受到吸烟相关的耻辱，信息共享不足，缺乏协调，整体护理的阻碍。积极的沟通策略在患者和提供者之间至关重要，以满足患者的具体需求。提高肺癌意识的教育干预可以改善预防和筛查行动，改善及时的医疗干预，降低发病率和死亡率。
In the United States, most lung cancer cases are diagnosed at advanced stages, limiting treatment options and impacting survival. This study presents patients’ perspectives on the complexity of factors influencing a lung cancer diagnosis. Lung cancer awareness regarding risks, symptoms, smoking behaviors, family history, and environmental factors can lead to preventative and early detection measures. To explore lung cancer patient perspectives on lung cancer awareness within the context of an earlier study to understand sleep-wake disturbances in adults with NSCLC. A content analysis was used to analyze the original de-identified longitudinal interview data collected from 26 patients diagnosed with lung cancer. Of the original 26 participants, 16 participants were included in this secondary data analysis. The participants were primarily females (n=10), Caucasians (n=13) with ages ranging between 49–83 years. Half of the sample was diagnosed with stage IV lung cancer and a majority of the sample was on chemotherapy (n=10). Two key themes were identified: the lung cancer discovery, and the patient-physician relationship. Unspecific initial symptoms, lack of knowledge and screening, as well as fear of the diagnosis delayed seeking medical care. Patient-physician relationships were hindered by smoking-associated stigma, inadequate sharing of information, and lack of coordinated, holistic care. Positive communication strategies are critical between patients and providers to meet patients’ specific needs. Educational interventions that enhance lung cancer awareness may improve prevention and screening actions, improve timely healthcare intervention, and reduce incidence and mortality.