乳癌婦女，接受前導性化學治療歷程之經驗與因應

The Experience and Coping Process of Women With Breast Cancer Undergoing Neoadjuvant Chemotherapy

背景：前導性化學治療常被運用於部分乳房切除手術之前，用以縮小腫瘤體積提高乳房保存機會，但是與乳癌婦女接受前導性化學治療歷程與因應的研究仍然較少。 目的：探討乳癌婦女於前導性化學治療歷程之經驗與因應。 方法：以紮根理論方法論作為探究之途徑，採立意取樣，使用半結構訪談指引進行深度訪談。資料分析涵蓋開放譯碼、主軸譯碼與選擇譯碼。 結果：共15位初診斷乳癌婦女參與，研究浮現之核心範疇為「擺盪於腫瘤大小之間」，包含三個範疇為：難以抗衡化療的身體反應；角色履行缺席；忐忑不安的節奏。婦女的策略行動有調身、調心、隱藏、家庭勞務調整與社交生活轉向。 結論／實務應用：婦女在前導性化學治療期間身體與心理皆承擔巨大的壓力，療程中腫瘤反應評估是重要時間點，醫療人員除了關照婦女的身體變化也應注意她們心理的負擔，提供必要的情緒支持與治療訊息以降低婦女的壓力。

Background: Neoadjuvant chemotherapy is commonly performed to reduce the size of tumors before partial mastectomy to improve the rate of breast-conservation. Few studies have been conducted to assess the neoadjuvant chemotherapy experience of women diagnosed with breast cancer and their responses to it. Purpose: To explore the experience of women diagnosed with breast cancer who received neoadjuvant chemotherapy and their responses to it. Methods: The grounded theory was adopted as the methodology. Participants were recruited using purposive sampling. The data were collected using semi-structured, in-depth interviews and analyzed using open, axial, and selective coding. Results: A total of 15 women newly diagnosed with breast cancer participated in this study, with information showing that the core category oscillated between the sizes of the tumor. The three categories included difficulty in coping with the physical response to chemotherapy, absence of role fulfillment, and uneasy emotions. The coping strategies used by the participants included: body and mind adjustment, hiding, family labor adjustment, and changing the pace of social life. Conclusions/Implications for Practice: The participants experienced tremendous physical and psychological stress during their neoadjuvant chemotherapy, in which tumor response assessment served as a critical time point. Medical professionals, in addition to noting changes in women’s physiological response, must pay attention to their psychological burden and provide emotional support and treatment information as needed.