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‘Kiểm Soát Ung Thư’: Hiểu Lựa Chọn Của Phụ Nữ Về Phẫu Thuật Cắt Tuyến Vú
Tóm tắt
Tỷ lệ cắt bỏ vú một bên (UM) và cắt bỏ vú phòng ngừa hai bên (CPM) đối với ung thư vú giai đoạn sớm đơn thuần (ESBC) đã tăng lên kể từ năm 2003. Các nghiên cứu gần đây cho thấy sự gia tăng này có thể là do phụ nữ chọn lựa UM và CPM do nỗi sợ hãi. Chúng tôi đã thực hiện một nghiên cứu định tính sâu để xác định những yếu tố ảnh hưởng đến quyết định của phụ nữ khi chọn phẫu thuật mở rộng hơn. Các cuộc phỏng vấn bán cấu trúc đã được tiến hành với các bệnh nhân ung thư vú để khám phá trải nghiệm, quá trình ra quyết định và lựa chọn UM ± CPM trong điều trị ESBC. Lấy mẫu mục tiêu đã xác định những ứng viên phù hợp cho liệu pháp bảo tồn vú (BCT) đã thực hiện UM ± CPM. Các cuộc phỏng vấn được hướng dẫn theo phương pháp lý thuyết cơ sở, và phân tích so sánh liên tục đã xác định những khái niệm và chủ đề chính. Đã đạt được sự bão hòa dữ liệu sau 29 cuộc phỏng vấn. ‘Kiểm soát ung thư’ là chủ đề nổi bật. Nỗi sợ ung thư vú được thể hiện ngay từ khi chẩn đoán và vẫn tồn tại trong suốt quá trình ra quyết định. Những trải nghiệm cá nhân của gia đình hoặc bạn bè ‘sống với ung thư’ là nguồn thông tin có ảnh hưởng nhất trong quá trình ra quyết định. Nỗi sợ hãi đã dịch thành sự ước lượng quá mức về nguy cơ tái phát, ung thư vú đối bên (CBC) và tử vong. Mặc dù các bác sĩ phẫu thuật đã thảo luận về khả năng sống sót tương đương với BCT, nhưng các bệnh nhân UM ± CPM tin rằng việc chọn UM ± CPM sẽ giúp họ loại trừ tái phát, CBC và sống lâu hơn. Bằng cách chọn phẫu thuật mở rộng hơn, phụ nữ đang tích cực cố gắng kiểm soát kết quả ung thư vì phẫu thuật nhiều hơn được cho là mang lại khả năng sống sót cao hơn. Phụ nữ tìm kiếm UM và CPM để kiểm soát ung thư và quản lý nỗi sợ hãi của họ. Điều quan trọng là các bác sĩ phẫu thuật phải hiểu cách mà các trải nghiệm cá nhân hình thành sự lựa chọn của phụ nữ đối với UM ± CPM để hỗ trợ quá trình ra quyết định được thông tin.
Từ khóa
#ung thư vú #cắt bỏ vú #cắt bỏ vú phòng ngừa #quyết định điều trị #nỗi sợ hãiTài liệu tham khảo
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