乳腺癌患者身体意象体验质性研究的Meta整合

doi:10.3761/j.issn.0254-1769.2025.014.020

摘要/Abstract

摘要：

目的系统整合乳腺癌患者身体意象体验的质性研究，旨在为临床制订相应干预方案提供参考。方法系统检索PubMed、Web of Science、Cochrane Library、CINAHL、PsycINFO、中国知网、万方数据库、维普数据库、中国生物医学文献数据库中关于乳腺癌患者身体意象体验的质性研究，检索时限为建库至2024年7月，根据澳大利亚乔安娜布里格斯研究所循证卫生保健中心的2016版质性研究真实性评价工具评价文献质量，采用汇集性整合方法进行结果整合。结果共纳入14篇文献，提炼出36个研究结果，归纳为7个新类别，得出3个整合结果：身体意象改变的负面影响、患者的自我调适与成长、患者对外界支持的需求。结论乳腺癌患者存在多重身体意象困扰，医护人员应关注患者心理状态，做好健康宣教，提升社会理解与支持，提供针对性的专业指导，促进患者心理适应，满足患者情感需求，建立多元支持系统，改善患者的身体意象和生活质量。

关键词: 乳腺癌, 身体意象, 质性研究, Meta整合, 循证护理学

Abstract:

Objective To systematically integrate the qualitative studies on body image experience in breast cancer patients，in order to provide references for the clinical formulation of corresponding intervention programs. Methods Systematical search was conducted for qualitative studies on the body image experiences of breast cancer patients in databases including PubMed，Web of Science，Cochrane Library，CINAHL，PsycINFO，CNKI，WanFang Database，VIP and CBM. The search period was from the establishment of the database to July 2024. The quality of the literature was evaluated using the 2016 edition of the qualitative research appraisal tool from the Evidence-Based Health Care Center of the Joanna Briggs Research Institute in Australia，and the results were integrated using the pooled integration method. Results A total of 14 pieces of the literature were included，and 36 research results were extracted and summarized into 7 new categories. Totally 3 integrated results were obtained，namely the negative impact of changes in body image，patients’ self-adjustment and growth，and patients’ need for external support. Conclusion Breast cancer patients are plagued by multiple body images. Medical staff should pay attention to the psychological state of patients，do a good job in health education，improve the understanding and support of the society，provide targeted professional guidance，promote the psychological adaptation of patients，meet the emotional needs of patients，establish multiple support systems，and improve the body image and quality of life of patients.

Key words: Breast Neoplasms, Body Image, Qualitative Research, Meta-Synthesis, Evidence-Based Nursing

杨舒, 林伊慧, 韩知浩, 唐林霞, 裘云霞, 马小琴. 乳腺癌患者身体意象体验质性研究的Meta整合[J]. 中华护理杂志, 2025, 60(14): 1786-1792.

YANG Shu, LIN Yihui, HAN Zhihao, TANG Linxia, QIU Yunxia, MA Xiaoqin. Meta-integration of qualitative studies on body image experience in breast cancer patients[J]. Chinese Journal of Nursing, 2025, 60(14): 1786-1792.

图/表 2

参考文献 33

[1]	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3):209-249.
[2]	Afshar-Bakshloo M, Albers S, Richter C, et al. How breast can-cer therapies impact body image-real-world data from a pros-pective cohort study collecting patient-reported outcomes[J]. BMC Cancer, 2023, 23(1):705. DOI PMID
[3]	Grogan S. Body image:understanding body dissatisfaction in men,women, and children[M]. 4th ed. London:Routledge,2021:1-6.
[4]	An JH, Zhou KN, Li MJ, et al. Assessing the relationship bet-ween body image and quality of life among rural and urban breast cancer survivors in China[J]. BMC Womens Health, 2022, 22(1):61.
[5]	Pereira MG, Ribeiro C, Ferreira G, et al. The indirect effect of body image on distress in women with breast cancer under-going chemotherapy[J]. Health Psychol Rep, 2021, 10(1):47-57.
[6]	崔娟, 王杰敏, 杨科, 等. 互联网时代下乳腺癌术后患者自我身体形象认识及性体验的质性研究[J]. 中华现代护理杂志, 2021, 27(18):2381-2386.
	Cui J, Wang JM, Yang K, et al. Qualitative research on self-body image and sexual experience of breast cancer patients after surgery in the Internet era[J]. Chin J Mod Nurs, 2021, 27(18):2381-2386.
[7]	刘季婷. 乳腺癌女性患者的体像研究:以上海市为例[D]. 上海: 上海师范大学, 2019.
	Liu JT. Study on body image of female patients with breast cancer:taking Shanghai as an example[D]. Shanghai: Shanghai Normal University, 2019.
[8]	胡雁, 郝玉芳. 循证护理学[M]. 2版. 北京: 人民卫生出版社,2018:159-164.
	Hu Y, Hao YF. Evidence-based nursing[M]. 2nd ed. Beijing: People’s Medical Publishing House,2018:159-164.
[9]	Sukartini T, Permata Sari YI. Women with breast cancer living with one breast after a mastectomy[J]. Cent Eur J Nurs Midw, 2021, 12(2):366-375.
[10]	Koçan S, Gürsoy A. Body image of women with breast cancer after mastectomy:a qualitative research[J]. J Breast Health, 2016, 12(4):145-150.
[11]	Chuang LY, Hsu YY, Yin SY, et al. Staring at my body:the experience of body reconstruction in breast cancer long-term survivors[J]. Cancer Nurs, 2018, 41(3):E56-E61.
[12]	Buki LP, Reich M, Lehardy EN. “Our organs have a purpose”:body image acceptance in Latina breast cancer survivors[J]. Psychooncology, 2016, 25(11):1337-1342.
[13]	Lundberg PC, Phoosuwan N. Life situations of Swedish women after mastectomy due to breast cancer:a qualitative study[J]. Eur J Oncol Nurs, 2022,57:102116.
[14]	Alhusban RY. Changed body image as perceived by Jordanian women undergoing breast cancer treatment[J]. Asian Pac J Can-cer Prev, 2019, 20(3):767-773.
[15]	Hasan S, Chew KS, Balang RV, et al. Beyond the scars:a qua-litative study on the experiences of mastectomy among young women with breast cancer in a country with crisis[J]. BMC Wo-mens Health, 2023, 23(1):596.
[16]	Brunet J, Sabiston CM, Burke S. Surviving breast cancer:women’s experiences with their changed bodies[J]. Body Image, 2013, 10(3):344-351.
[17]	Brunet J, Price J, Harris C. Body image in women diagnosed with breast cancer:a grounded theory study[J]. Body Image, 2022, 41:417-431.
[18]	Piot-Ziegler C, Sassi ML, Raffoul W, et al. Mastectomy,body deconstruction,and impact on identity:a qualitative study[J]. Br J Health Psychol, 2010, 15(Pt 3):479-510. DOI PMID
[19]	Sebri V, Durosini I, Mazzoni D, et al. The body after cancer:a qualitative study on breast cancer survivors’ body representa-tion[J]. Int J Environ Res Public Health, 2022, 19(19):12515.
[20]	Grogan S, Mechan J. Body image after mastectomy:a thematic analysis of younger women’s written accounts[J]. J Health Psy-chol, 2017, 22(11):1480-1490.
[21]	Tahir K, Khan N. Mediating role of body image between se-xual functioning and marital intimacy in Pakistani women with breast cancer[J]. Psychooncology, 2021, 30(2):260-266.
[22]	张维霞, 李祥萍, 公连花. 乳腺癌乳房切除病人负面身体自我、负面评价恐惧、外表完美主义与社交外表焦虑的关系分析[J]. 护理研究, 2022, 36(3):511-516.
	Zhang WX, Li XP, Gong LH. Analysis of the relationship between negative physical self,negative evaluation,physical appearance perfectionism and social appearance anxiety in patients with breast cancer mastectomy[J]. Chin Nurs Res, 2022, 36(3):511-516.
[23]	Shaw SL, Green JW. Cognitive behavioral theories[M]//Capuzzi D,Stauffer MD. Alexandria,VA:American Counseling Associa-tion,2022:193-216.
[24]	Runowicz CD, Leach CR, Henry NL, et al. American cancer society/American society of clinical oncology breast cancer sur-vivorship care guideline[J]. CA Cancer J Clin, 2016, 66(1):43-73.
[25]	高文娟, 张倩, 韩静. 乳腺癌患者夫妻亲密关系质性研究的Meta整合[J]. 中华护理杂志, 2024, 59(5):618-626. DOI
	Gao WJ, Zhang Q, Han J. Meta-integration of qualitative resear-ch on couple intimacy in breast cancer patients[J]. Chin J Nurs, 2024, 59(5):618-626.
[26]	姚树桥, 杨艳杰. 医学心理学[M]. 7版. 北京: 人民卫生出版社,2018:96-112.
	Yao SQ, Yang YJ. Medical psychology[M]. 7th ed. Beijing: People’s Medical Publishing House,2018:96-112.
[27]	Gutiérrez-Hermoso L, Velasco-Furlong L, Sánchez-Román S, et al. The importance of alexithymia in post-surgery. Differences on body image and psychological adjustment in breast cancer patients[J]. Front Psychol, 2020,11:604004.
[28]	冯琦凡, 涂发妹, 吴季敏, 等. 烧伤患者身体意象体验质性研究的Meta整合[J]. 中华护理杂志, 2024, 59(3):362-370. DOI
	Feng QF, Tu FM, Wu JM, et al. The experience of body image experience in burn patients:a meta-synthesis of qua-litative studies[J]. Chin J Nurs, 2024, 59(3):362-370.
[29]	黄思思, 严梅. 乳腺癌单乳切除术后病人身体意象障碍研究进展[J]. 循证护理, 2024, 10(5):815-820.
	Huang SS, Yan M. Research progress on body image disorder in patients with breast cancer after single mastectomy[J]. Chin Evid Based Nurs, 2024, 10(5):815-820.
[30]	Toole AM, LoParo D, Craighead LW. Self-compassion and dis-sonance-based interventions for body image distress in young adult women[J]. Body Image, 2021,38:191-200.
[31]	Wells KJ, Drizin JH, Ustjanauskas AE, et al. The psychosocial needs of underserved breast cancer survivors and perspectives of their clinicians and support providers[J]. Support Care Cancer, 2022, 30(1):105-116.
[32]	吴媛, 张玉玺, 王楠楠, 等. 乳腺癌患者参与同伴支持体验质性研究的Meta整合[J]. 中华护理杂志, 2023, 58(7):800-808. DOI
	Wu Y, Zhang YX, Wang NN, et al. Meta-synthesis of quali-tative research on the experience of peer support for breast cancer patients[J]. Chin J Nurs, 2023, 58(7):800-808.
[33]	郭苗苗, 严婷婷, 许丹丹, 等. 乳腺癌患者全病程管理信息系统的开发与应用研究[J]. 中华护理杂志, 2024, 59(8):901-908. DOI
	Guo MM, Yan TT, Xu DD, et al. Development and application of a whole course management information system for breast cancer[J]. Chin J Nurs, 2024, 59(8):901-908. DOI