Lin He, Min Wen, Bo Tao, Shanwen Sun, Hao Huang, Xiaofeng Wang, Hui Xu
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Systematic searches were conducted in nine databases, including six English-language databases (PsycINFO, PubMed, CINAHL, Cochrane Library, Embase, and Web of Science) and three Chinese-language databases (SinoMed, CNKI, and Weipu), with searches covering the period from database inception to May 2024. The PICoS (Population, Interest of phenomena, Context, Study design) search strategy was applied to include the required qualitative studies.</p><p><strong>Results: </strong>A total of 1758 studies were screened, and 19 qualitative studies were ultimately included, comprising 584 female patients receiving endocrine therapy. Identified five main themes: (1) antecedent factors influence symptom perception and adaptation; (2) outcomes of symptom experiences; (3) the complexity and diversity of symptoms; (4) selection of coping strategies; (5) symptom management needs. 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引用次数: 0
摘要
目的：内分泌治疗是提高激素受体阳性乳腺癌患者无病生存和总生存的必要治疗手段。然而，与内分泌治疗相关的症状严重影响患者的生活质量和药物依从性。本研究系统回顾了内分泌治疗过程中患者的症状经历和应对策略的研究，为症状管理策略提供参考。方法：本研究采用专题综合定性研究，包括患者内分泌治疗相关症状的经历及应对策略。系统检索了9个数据库，包括6个英文数据库（PsycINFO、PubMed、CINAHL、Cochrane Library、Embase和Web of Science）和3个中文数据库（SinoMed、CNKI和weiipu），检索时间从数据库建立到2024年5月。采用PICoS（人口、现象兴趣、背景、研究设计）搜索策略纳入所需的定性研究。结果：共筛选1758项研究，最终纳入19项定性研究，共纳入584例接受内分泌治疗的女性患者。确定了五个主要主题：(1)前因因素影响症状感知和适应；(2)症状体验结果；(3)症状的复杂性和多样性；(4)应对策略选择；(5)症状管理需求。揭示前因因素对症状感知和适应的影响，为内分泌治疗相关症状的管理提供建议，并指出本研究的临床意义和局限性。结论：信息可及性和个体差异影响症状感知，生理变化、经历、心理状态和信息影响症状适应。症状出现后，患者经常面临痛苦和日常生活/工作限制。症状管理的一个主要挑战是缺乏一个系统的方法来解释症状的复杂性和动态性。此外，患者的信息需求未得到满足，缺乏专业支持。试验注册：本系统评价已在PROSPERO注册（CRD:42023444435）。
Experience and Coping Strategies of Endocrine Therapy-Related Symptoms in Breast Cancer Patients: A Systematic Review and Qualitative Meta-Synthesis.
Objective: Endocrine therapy is an essential treatment to improve disease-free and overall survival in patients with hormone receptor-positive breast cancer. However, symptoms associated with endocrine therapy severely affect patients' quality of life and medication adherence. To inform symptom management strategies, this study systematically reviews research on patients' symptom experiences and coping strategies during endocrine therapy.
Methods: This study conducted a thematic synthesis of qualitative research, including patients' experiences with endocrine therapy-related symptoms and the coping strategies they employ. Systematic searches were conducted in nine databases, including six English-language databases (PsycINFO, PubMed, CINAHL, Cochrane Library, Embase, and Web of Science) and three Chinese-language databases (SinoMed, CNKI, and Weipu), with searches covering the period from database inception to May 2024. The PICoS (Population, Interest of phenomena, Context, Study design) search strategy was applied to include the required qualitative studies.
Results: A total of 1758 studies were screened, and 19 qualitative studies were ultimately included, comprising 584 female patients receiving endocrine therapy. Identified five main themes: (1) antecedent factors influence symptom perception and adaptation; (2) outcomes of symptom experiences; (3) the complexity and diversity of symptoms; (4) selection of coping strategies; (5) symptom management needs. Reveals the impact of antecedent factors on symptom perception and adaptation, provides recommendations for managing endocrine therapy-related symptoms, and indicate the clinical significance and limitations of the research.
Conclusions: Findings indicate that information accessibility and individual differences influence symptom perception, while physiological changes, experiences, psychological states, and information affect symptom adaptation. After symptom onset, patients often face distress and daily life/work limitations. A major challenge in symptom management is the lack of a systematic approach that accounts for symptom complexity and dynamics. Additionally, patients' informational needs are unmet, and professional support is lacking.
Trial registration: This systematic review has been registered on PROSPERO (CRD:42023444435).
期刊介绍：
Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology.
This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues.
Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.
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