AimsTo explore the experience and feelings associated with the endocrine therapy treatment trajectory in women with breast cancer and what affects medication taking behaviour.DesignQualitative systematic review.Data sourcesQualitative studies were extracted from PubMed, EMBASE, CINAHL, PsycINFO from inception of each database until February 2019.Review methodsThe systematic search method SPIDER (sample, phenomenon of interest, design, evaluation, research type) was used. Thematic synthesis of the qualitative data was used.ResultsA total of 478 were identified in the initial search. Only 17 articles met inclusion criteria and were included in this review. Five analytical themes and 17 descriptive subthemes were identified.ConclusionsThe systematic review highlights knowledge, balancing the scales, self‐efficacy and support influence medication taking behaviour to women with breast cancer.ImpactThe medication taking behaviour of breast cancer women can be classified into four types: acceptance/persistence, bearing/suffering, hesitation/adjustment, refusing/abandoning. The four types can switch from one to another. Medication taking behaviour is affected by knowledge, balancing the scales, self‐efficacy, and support. The medical institutions, communities, and families can gain knowledge of the treatment experiences of women to better understand medication taking behaviour and those at risk for non‐adherence. Women wanted different types and amounts of information. Healthcare providers should be aware of patient preferences and take targeted interventions to help them receive treatment.
Background/Objective: Chronic skin disease (CSD) often has physiological, psychological, and social impacts, which requires the patient to adjust to achieve psychosocial adaptation (PSA). As a standardized assessment instrument was lacking, we developed a PSA questionnaire for patients with CSD (PSAQ-CSD). Methods: According to the steps of questionnaire development, a systematic process of scoping review, qualitative research, content validity expert review, testing in a sample of 321 adults, item analysis, and classical test theory methods were applied. Results: Following item analysis and exploratory factor analyses, 18 items were eventually entered into the model of confirmatory factor analyses, with a cumulative contribution of 65.435%. Three subscales were developed: emotional, self-cognitive, and social dimensions. Item analysis, exploratory factor analyses, and content validity expert review narrowed the subscales to 8, 6, and 4 items, respectively. Conclusions: The 18-item PSAQ-CSD has been confirmed to have good internal consistency reliability and convergent and discriminant validity. It may be a useful tool to evaluate the PSA among patients with CSD and provide a basis for further research.
Objective: Despite the proven benefits of adjuvant endocrine therapy, adherence to oral endocrine therapy in breast cancer treatment is a substantial problem. The aim of this study was to assess adherence to adjuvant endocrine therapy by women in China for the first 5 years, and to identify its influencing factors. Methods: Stratified sampling method was adopted to select 1875 cases of breast cancer patients for cross-sectional telephone follow-up. Compliance to medications was assessed using the Morisky Medication Adherence Scale. Status of endocrine therapy was assessed using nine additional questions. Binomial regression was used when assessing the factors associated with persistence, multinomial regression models were used to assess factors associated with compliance. Results: Of 888 patients who started adjuvant endocrine therapy, 769(86.6%) persisted and 119 (13.4%) discontinued. 760 patients who completed Morisky Medication Adherence Scale, the compliance was 7.4% low, 42% medium, and 50.6% high. The type of medication, duration of medication and side effects had an impact both on persistence and compliance. Age, history of radiotherapy and caregivers only had an impact on persistence. Conclusions: Medication adherence was affected by many factors. Special attention and interventions should be given to women taking tamoxifen in the 2nd to 3rd year of medication, and aromatase inhibitors in the 1st to 2nd year. Further prospective design studies are needed to explore effective measures to improve medication adherence of women with breast cancer treated by endocrine therapy.
K E Y W O R D Sadherence, breast cancer, compliance, endocrine therapy, oncology, persistence
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