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  • 學位論文

探討育齡期乳癌婦女接受生殖保留術之經驗歷程

To exploring the experience of receiving fertility preservation among reproductive aged breast cancer women

指導教授 : 楊雅玲
本文將於2025/03/12開放下載。若您希望在開放下載時收到通知,可將文章加入收藏

摘要


乳癌檢測和治療的進步,第零至二期乳癌患者的5年存活率可高達89%以上。當面對癌症診斷的衝擊,又因癌症治療誘發了卵巢功能早衰和引起不孕,讓他們再次面臨生殖保留治療的決策,對育齡期乳癌婦女與其家人不外乎是再度的打擊。基於對生育的渴望,她們承擔著復發或延遲治療的風險,選擇生殖保留治療來捍衛自身的生育能力,治療過程中會有什麼樣的感受和經驗,治療後如何評價治療結果,這中間的心境轉折仍不清楚,故本研究目的是探討育齡期乳癌婦女接受生殖保留術的抉擇和治療歷程之經驗感受與評價,以了解她們接受生殖保留術的動機、感受經驗,和照護需求。 本研究以前瞻性研究設計並以質性訪談的方式以了解接受生殖保留術的育齡期乳癌個案的生命歷程,研究情境為台北市某醫學中心。研究對象採立意取樣方式,研究者透過三次半結構性一對一深度訪談方式蒐集資料,共收集8位乳癌個案 (3位採冷凍胚胎保存及5位冷凍卵母細胞保存),以內容分析法進行資料的分析,呈現育齡期的乳癌個案接受生殖保留術歷程真實的經驗與感受。 本研究結果發現育齡期的乳癌個案接受生殖保留術歷程的主觀經驗歸納出,一個核心主題和三個次主題。核心主題:人生逆境,圓滿自我;三個次主題:(一)抉擇期:自我性命與使命間拉鋸;(二)治療期:檢視風險並轉移生活重心;(三)治療後期:懷抱希望面對乳癌治療。生殖保留術的照護需求:(一)抉擇期:專屬癌症病患的生殖保留術衛教資訊;(二) 治療期:全面瞭解治療的現況;(三)治療後期:懷瞭解冷凍胚胎/卵泡的品質。 育齡期的乳癌患者在接受生殖保留術歷程中,身心靈都面臨重重的考驗和挑戰,需要專業醫療人員了解其內心的衝突與不安,且提供正確的生殖保留術相關資訊,以及持續地關懷、支持鼓勵,方能協助她們渡過此危機,以提昇癌症治療後的生活品質。

並列摘要


With improvements in breast cancer detection and cancer treatment, the 5-year survival rate of patients with stage 0–II breast cancer can reach as high as 89%. When these patients face cancer diagnosis- and cancer treatment-induced premature ovarian insufficiency and infertility, they also face the decision of reproductive retention treatment, which is another setback to women of reproductive age and their families. Owing to their desire to give birth, they have a risk of disease recurrence or treatment delay, and they select fertility preservation to maintain their fertility. The feelings and experiences of patients during treatment and their evaluation of treatment results remain unclear. The purpose of this study was to explore the feelings of patients and evaluate their experiences of fertility preservation and the treatment process among women of reproductive age who choose to undergo fertility preservation in order to understand their motives, feelings, and care needs regarding fertility-preserving interventions. This study had a prospective design, and it involved a qualitative interview to understand the life course of breast cancer women. The study included breast cancer patients of reproductive age undergoing fertility-preserving interventions at a medical center in Taipei City. The researchers collected information through three semi-structured, in-depth, one-on-one interviews with eight patients having breast cancer (three undergoing embryo cryopreservation and five undergoing oocyte cryopreservation). The data were analyzed by content analysis to show the true experiences and feelings of the fertility-preservation process among these patients of reproductive age. This study found that the subjective experiences of the fertility-preservation process among breast cancer patients of reproductive age can be summarized as one core theme and three sub-themes. The core theme was “completing oneself through adversity in life.” The three sub-themes were as follows: (i) choice period, tug between your own life and your destiny; (ii) treatment period, a review of risk and shift in life focus; and (iii) late treatment stage, embrace hope and face breast cancer treatment. The care needs for reproductive preservation were as follows: (i) choice period, exclusive health education information on reproductive preservation for cancer patients; (ii) treatment period, comprehensive understanding of the current status of treatment; and (iii) late treatment stage, understanding of embryo/oocyte cryopreservation quality. Breast cancer patients of reproductive age face many physical and mental challenges and trials during the fertility-preservation process. Professional medical personnel are required to understand the patients’ inner conflicts and anxieties, and provide proper information related to fertility preservation, in addition to continuous care, support, and encouragement to help them overcome the crisis and to improve their quality of life after cancer treatment.

參考文獻


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