护理学报 ›› 2021, Vol. 28 ›› Issue (1): 38-44.doi: 10.16460/j.issn1008-9969.2021.01.038
乳腺癌患者就医延迟原因质性研究的Meta整合
路莉静1, 孟爱凤1, 程芳1, 邾萍1, 智晓旭1, 汤琳2, 王鹏程2
- 1.江苏省肿瘤医院 江苏省肿瘤防治研究所 南京医科大学附属肿瘤医院 护理部,江苏 南京 210009;
2.南京中医药大学 护理学院,江苏 南京 210023
摘要： 目的 系统总结乳腺癌患者延迟就诊的原因,为早期筛查、预防及诊治提供依据及参考。方法 计算机检索Pubmed、Web of Science、EMbase、CINAHL、The Cochrane Library、中国知网、万方、维普及中国生物医学数据库,检索时间从建库至2020年1月,采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准对文献进行评价,并运用汇集性整合方法对结果进行整合。结果 共纳入19篇文献,提出36个研究结果,形成11个新的类属,得到4个整合的结果：信息的缺失与偏差;信仰与身心感知的差异;医疗资源与服务的制约;生活条件的限制。结论 乳腺癌患者的延迟就诊不仅影响了个人的生存期及生活质量,也给家庭及社会带来了负担。政府、医疗机构、社区及学校应重视对乳房健康知识的宣教,同时给已确诊患者心理社会支持,为患者创造良好的社会支持系统,并不断缩小城乡医疗差距,从而提高乳腺癌早期筛查率,促进及时就医,提高生活质量,减轻负担。
中图分类号:
- R473.71
| [1] 马丹丹,刘坤,齐晓伟.2018年全球癌症统计:乳腺癌发病和死亡人数统计[J].中华乳腺病杂志(电子版),2018,12(6):375. DOI:10.3877/cma.j.issn.1674-0807.2018.06.015. [2] Feng RM,Zong YN,Cao SM,et al.Current Cancer Situation in China:Good or Bad News from the 2018 Global Cancer Statistics[J].Cancer Commun (Lond),2019,39(1):22. DOI:10.1186/s40880-019-0368-6. [3] 朱思悦,桂莉.青年乳腺癌患者心理护理的研究进展[J].解放军护理杂志, 2017,34(23):58-60. DOI:10.3969/j.issn.1008-9993.2017.23.014. [4] 张雅琳,张静.有氧运动结合松弛疗法对乳腺癌化疗病人症状群和生活质量的影响[J].护理研究,2016,30(22):2764-2767. DOI:10.3969/j.issn.1009-6493.2016.22.019. [5] 朱一凡,陈芷谦,郭巧红,等.196例乳腺癌化疗患者尊严现状及影响因素分析[J].护理学报,2020,27(12):33-38. DOI:10.16460/j.issn1008-9969.2020. 12.033. [6] 朱冰洁,李佳倩,黄孟秋,等.154例乳腺癌化疗患者症状管理自我效能影响因素分析[J].护理学报,2019,26(18):42-46. DOI:10.16460/j.issn1008-9969.2019.18.042. [7] Bish A, Ramirez A,Burgess C, et al.Understanding Why Women Delay in Seeking Help for Breast Cancer Symptoms[J].J Psychosom Res,2005,58(4):321-326. DOI:10.1016/j.jpsychores.2004.10.007. [8] Macleod U,Mitchell ED,Burgess C,et al.Risk Factors for Delayed Presentation and Referral of Symptomatic Cancer:Evidence for Common Cancers[J].Br [J] Cancer.2009,101(3):S92-S101. DOI:10.1038/sj.bjc.6605398. [9] Smith LK,Pope C,Botha JL.Patients' Help-seeking Experiences and Delay in Cancer Presentation:A Qualitative Synthesis[J]. Lancet, 2005,366(9488):825-831. DOI:10.1016/S0140-6736(05)67030-4. [10] 杨雅岚,李青,张频,等.卡培他滨联合多西他赛或长春瑞滨治疗蒽环类耐药晚期乳腺癌患者的生活质量:3期临床研究[J].中华乳腺病杂志(电子版),2018,12(4):209-215. DOI:10.3877/cma.j.issn.1674-0807.2018.04.004. [11] 胡雁,郝玉芳.循证护理学[M].北京:人民卫生出版社,2018:157-164. [12] 李梦媛,田丽,吴婷,等.乳腺癌患者乳房重建心理体验质性研究的Meta整合[J].中华护理杂志,2019, 54(7):1091-1096. DOI:10.3761/j.issn.0254-1769.2019.07.027. [13] Soliman AA,Khouchani M,Renne EP.Sociocultural Barriers Related to Late-stage Presentation of Breast Cancer in Morocco[J].J Cancer Educ,2019,34(4):735-742. DOI:10.3761/j.issn.0254-1769.2019.07.027. [14] Gebremariam A, Addissie A,Worku A,et al.Perspectives of Patients,Family Members,and Health Care Providers on Late Diagnosis of Breast Cancer in Ethiopia:A Qualitative Study[J].PLoS One,2019, 14(8):e0220769. DOI:10.1371/journal.pone. 0220769. [15] Bonsu AB, Ncama BP.Recognizing and Appraising Symptoms of Breast Cancer as a Reason for Delayed Presentation in Ghanaian Women:A Qualitative Study[J].PLoS One,2019,14(1):e0208773. DOI:10.1371/journal.pone.0208773. [16] Oshiro M,Kamizato M.Patients' Help-seeking Experiences and Delaying in Breast Cancer Diagnosis:A Qualitative Study[J].Jpn J Nurs Sci,2018, 15(1):67-76. DOI:10.1111/jjns.12173. [17] Martei YM, Vanderpuye V, Jones BA.Fear of Mastectomy Associated with Delayed Breast Cancer Presentation Among Ghanaian Women[J].Oncologist,2018, 23(12):1446-1452. DOI:10.1634/theoncologist.2017-0409. [18] Grosse Frie K,Samoura H,Diop S,et al.Why Do Women with Breast Cancer Get Diagnosed and Treated Late in Sub-Saharan Africa Perspectives from Women and Patients in Bamako,Mali[J].Breast Care (Basel),2018,13(1):39-43. DOI:10.1159/000481087. [19] Kohler RE, Gopal S, Miller AR,et al.A Framework for Improving Early Detection of Breast Cancer in Sub-Saharan Africa:A Qualitative Study of Help-seeking Behaviors Among Malawian Women[J]. Patient Educ Couns,2017,100(1):167-173. DOI:10.1016/j.pec.2016.08.012. [20] Meacham E,Orem J,Nakigudde G,et al.Exploring Stigma as a Barrier to Cancer Service Engagement with Breast Cancer Survivors in Kampala,Uganda[J]. Psychooncology, 2016,25(10):1206-1211. DOI:10.1002/pon.4215. [21] Elobaid Y, Aw TC, Lim JNW, et al.Breast Cancer PreMeacham E,Orem J,Nakigudde G,et al.Exploring Stigma as a Barrier to Cancer Service Engagement with Breast Cancer Survivors in Kampala,Uganda[J].Psychooncology,2016, 25(10):1206-1211. DOI:10.1002/pon.4215. [22] Pruitt L, Mumuni T,Raikhel E,et al.Social Barriers to Diagnosis and Treatment of Breast Cancer in Patients Presenting at a Teaching Hospital in Ibadan,Nigeria[J].Glob Public Health,2015,10(3):331-344. DOI:10.1080/17441692.2014.974649. [23] Lim JN, Potrata B,Simonella L,et al.Barriers to Early Presentation of Self-discovered Breast Cancer in Singapore and Malaysia:A Qualitative Multicentre Study[J].BMJ Open,2015,5(12):e009863. DOI:10.1136/bmjopen-2015-009863. [24] McEwan J,Underwood C, Corbex M.“Injustice! That is the Cause”:A Qualitative Study of the Social,Economic,and Structural Determinants of Late Diagnosis and Treatment of Breast Cancer in Egypt[J].Cancer Nurs,2014,376(6):468-475. DOI:10.1097/NCC.0000000000000118. [25] Khakbazan Z, Taghipour A,Roudsari RL,et al.Delayed Presentation of Self-discovered Breast Cancer Symptoms in Iranian Women:A Qualitative Study[J].Asian Pac J Cancer Prev,2014,15(21):9427-9432. DOI:10.7314/APJCP.2014.15.21.9427. [26] Rastad H, Khanjani N, Khandani BK.Causes of Delay in Seeking Treatment in Patients with Breast Cancer in Iran:A Qualitative Content Analysis Study[J]. Asian Pac J Cancer Prev,2012, 13(9):4511-4515. DOI:10.7314/APJCP.2012.13.9.4511. [27] Norsa'adah B,Rahmah MA,Rampal KG,et al.Understanding Barriers to Malaysian Women with Breast Cancer Seeking Help[J].Asian Pac J Cancer Prev, 2012, 13(8):3723-3730. DOI:10.7314/APJCP.2012.13.8.3723. [28] Taib NA,Yip CH,Low WY.Recognising Symptoms of Breast Cancer as A Reason for Delayed Presentation in Asian Women--the Psycho-socio-cultural Model for Breast Symptom Appraisal:Opportunities for Intervention[J].Asian Pac J Cancer Prev,2011, 12(6):1601-1608. DOI:10.1097/01.cad.0000390767.85658.83. [29] Lam WW, Tsuchiya M, Chan M,et al.Help-seeking Patterns in Chinese Women with Symptoms of Breast Disease:A Qualitative Study[J].J Public Health (Oxf),2009, 31(1):59-68. DOI:10.1093/pubmed/fdn088. [30] Burgess C, Hunter MS, Ramirez AJ.A Qualitative Study of Delay among Women Reporting Symptoms of Breast Cancer[J].Br J Gen Pract, 2001,51(473):967-971. DOI:10.3109/07853890109002108. [31] 江端英,高丽梅,侯香传,等.中晚期乳腺癌病人就医延迟原因的质性研究[J].护理研究,2013,27(29):3229-3230. DOI:10.3969/j.issn.1009-6493.2013.29.013. [32] 吕艳,张伊娜,马红梅.杭州市医学与非医学专业女大学生乳房保健知识、态度、行为调查[J].中国高等医学教育,2019(4):41-42. DOI:10.3969/j.issn.1002-1701.2019.04.021. [33] 雷雨蒙,王钦,易玲娜,等.武汉市社区适龄女性乳腺癌认知度与乳腺自检现状调查[J].公共卫生与预防医学,2019,30(3):103-106. DOI:10.3969/j.issn.1006-2483.2019.03.024. [34] 王玮婧,张国军.基于POCT的“流动乡村医疗车”医疗服务新模式初探[J].首都食品与医药,2018,25(1):50-52. [35] 张焜琨,崔文彬,高春辉,等.公立医院开展“互联网+”医疗服务定价研究[J].中国医院, 2020, 24(3):7-9. DOI:10.19660/j.issn.1671-0592.2020.03.03. |
| [1] | 贾莉莉, 张国增, 越丽霞, 朱康宁, 王志霞, 王飞杰. 临时性肠造口患者还纳术后居家生活体验的质性研究[J]. 护理学报, 2021, 28(2): 1-4. |
| [2] | 王惠, 仝旭, 李玲. 慢性心力衰竭患者自我管理体验质性研究的Meta整合[J]. 护理学报, 2021, 28(2): 31-36. |
| [3] | 刘庆伟, 邵美华, 赵亚玲, 尹霄朦, 姜园园, 朱秀丽. 间质性肺疾病患者健康信息获取行为的描述性质性研究[J]. 护理学报, 2021, 28(2): 47-51. |
| [4] | 江丽玲, 詹梦梅, 黄秋霞, 李立群, 张淑, 龚晶晶, 王建宁. 乳腺癌患者性生活体验质性研究的Meta整合[J]. 护理学报, 2021, 28(1): 33-37. |
| [5] | 黄莉莉, 卜梦茹, 翟惠敏, 王映. 护理人文关怀实践困境的质性研究[J]. 护理学报, 2021, 28(1): 69-72. |
| [6] | 刘丽萍, 吴艳妮, 从维莲, 胡明钰, 李晓霞, 周春兰. 癌症患者化疗期自我护理体验质性研究的系统评价[J]. 护理学报, 2020, 27(7): 1-6. |
| [7] | 尹霄朦, 胡波, 王薇, 姜园园, 莘秀芳, 朱秀丽. 基于角色理论医学硕士研究生对导师角色期望的质性研究[J]. 护理学报, 2020, 27(5): 1-5. |
| [8] | 张新, 崔菡斐, 董凤齐, 郑瑞双. 护理学硕士学历护士临床工作体验的Meta整合[J]. 护理学报, 2020, 27(4): 25-31. |
| [9] | 张丹妮, 朱慧, 谢传艺, 陈肖敏. 乳腺癌患者配偶照顾体验质性研究的Meta整合[J]. 护理学报, 2020, 27(4): 32-36. |
| [10] | 王佳, 郝飞, 周慧敏. 叠加敷料粘贴法对乳腺癌患者PICC置管部位接触性皮炎的效果观察[J]. 护理学报, 2020, 27(4): 63-66. |
| [11] | 李文玉, 涂文怡, 郑静, 黄小芳, 刘庆华, 徐小群. 样本量对质性研究主题与现象诠释的影响研究[J]. 护理学报, 2020, 27(3): 62-65. |
| [12] | 高珊, 黄慧敏, 张芳, 何宗斌, 刘亚珍, 申海燕. 前列腺增生患者自我管理需求及影响因素的质性研究[J]. 护理学报, 2020, 27(24): 52-56. |
| [13] | 陈丽玲, 周春兰, 吴艳妮, 赵慧慧. 临床护士参与循证实践培训体验的质性研究[J]. 护理学报, 2020, 27(23): 49-52. |
| [14] | 史博慧, 吕爱莉, 王恋, 郭萍利, 马晓霞, 齐晶. 乳腺癌术后上肢淋巴水肿预防策略的证据总结[J]. 护理学报, 2020, 27(22): 32-38. |
| [15] | 张世西, 何月月, 尹安春, 黄秀美, 刘思雨. 帕金森病患者照顾者照护体验质性研究的Meta整合[J]. 护理学报, 2020, 27(22): 45-51. |
|