背景:许多符合保乳治疗(BCT)条件的女性选择单侧乳房切除术(UM),有或没有对侧预防性乳房切除术(CPM),并表示希望“安心”。“这项研究旨在描述如何定义和衡量心灵平静,以及它与手术选择的关系。
方法:到2023年10月8日,共检索9个数据库中的相关文章,并从符合纳入标准的文章中提取数据。
结果:20项研究符合纳入标准。大多数是前瞻性队列研究(65%,13/20).在大多数研究中(72%,13/18),非西班牙裔白人/高加索女性占研究样本的80%或更多。几乎一半的研究在其出版物中使用了“安心”一词(45%,9/20),很少有直接定义的结构(15%,3/20)。相反,表示缺乏内心平静的词语很常见,具体来说,“焦虑”(85%,17/20),“恐惧”(75%,15/20),和“关注”(75%,15/20)。大多数研究(90%,18/20)使用经过验证的焦虑问卷间接测量了内心的平静,恐惧,担心,苦恼,或关注,在多个术后时间点给药(55%,11/20).大多数研究(95%,18/19)报告了至少一个具有统计学意义的结果,表明BCT之间的内心平静没有差异,嗯,和/或CPM在他们最近的评估时间。
结论:安心很大程度上是围绕着暗示其缺失的概念,即,焦虑,恐惧,和关注。现有文献表明,在接受BCT的平均风险女性中,内心的平静没有差异。嗯,或CPM。共同的手术决定应强调CPM和乳房保护之间至少可比的情感和/或社会心理健康。
BACKGROUND: Many women eligible for breast conservation therapy (BCT) elect unilateral mastectomy (UM) with or without contralateral prophylactic mastectomy (CPM) and cite a desire for \"peace of mind.\" This study aimed to characterize how peace of mind is defined and measured and how it relates to surgical choice.
METHODS: Nine databases were searched for relevant articles through 8 October 2023, and data were extracted from articles meeting the inclusion criteria.
RESULTS: The inclusion criteria were met by 20 studies. Most were prospective cohort studies (65%, 13/20). In the majority of the studies (72%, 13/18), Non-Hispanic white/Caucasian women comprised 80 % or more of the study\'s sample. Almost half of the studies used the phrase \"peace of mind\" in their publication (45%, 9/20), and few directly defined the construct (15%, 3/20). Instead, words representing an absence of peace of mind were common, specifically, \"anxiety\" (85%, 17/20), \"fear\" (75%, 15/20), and \"concern\" (75%, 15/20). Most of the studies (90%, 18/20) measured peace of mind indirectly using questionnaires validated for anxiety, fear, worry, distress, or concern, which were administered at multiple postoperative time points (55%, 11/20). Most of the studies (95%, 18/19) reported at least one statistically significant result showing no difference in peace of mind between BCT, UM, and/or CPM at their latest time of assessment.
CONCLUSIONS: Peace of mind is largely framed around concepts that suggest its absence, namely, anxiety, fear, and concern. Existing literature suggests that peace of mind does not differ among average-risk women undergoing BCT, UM, or CPM. Shared surgical decisions should emphasize at least comparable emotional and/or psychosocial well-being between CPM and breast conservation.