目的 基于生态系统理论深入了解育龄期乳腺癌患者婚姻生活体验的现状,并为临床育龄期乳腺癌患者婚姻支持提供依据。方法 采用目的抽样方法,于2024年10月1日-12月1日对15例已婚乳腺癌患者进行深度访谈。采用定向内容分析法和NVivo软件对访谈数据进行分析和整理。结果 从访谈数据中总结出3个主题和12个子主题：婚姻焦虑（体象焦虑激活、自责愧疚加剧、自我反思回溯、消极逃避倾向）;夫妻互动（情感依赖加重、情感支持充分、照护支持有效供给、夫妻疏离加深）;家庭变革（角色冲突加剧、子女健康忧虑、生活负担加重、韧性调适激活）。本研究发现,低收入背景患者的经济压力与角色冲突尤为凸显。结论 本研究创新性地揭示了低收入育龄期乳腺癌患者婚姻生活体验的多层次性及互动性：微观层面的焦虑情绪是核心困扰;中观层面配偶支持是维系婚姻质量的关键缓冲;宏观层面经济压力与家庭角色失衡是普遍且沉重的负担来源。这提示临床工作者需系统识别不同层次的问题,特别关注低收入患者的经济与角色困境,提供整合心理疏导、夫妻沟通促进及家庭资源链接的多层次、个性化婚姻支持方案,以改善其整体婚姻生活质量。
Abstract
Objective To gain an in-depth understanding of the current status of marital life experience of breast cancer patients at reproductive age based on ecosystem theory, and to provide reference for clinical support of breast cancer patients at reproductive age in a targeted manner. Methods Purposive sampling was used to select 15 married breast cancer patients from October 1 to December 1, 2024 to conduct in-depth interviews. Directed content analysis and NVivo software were used to analyze the interview data. Results Three themes and 12 sub-themes were summarized: marital anxiety (somatic anxiety activation, increased self-blame and guilt, self-reflective retrospection, and negative avoidance tendencies); couple interaction (increased emotional dependence, adequate emotional support, effective provision of caregiving support, and deepened marital estrangement); and family change (increased role conflict, children's health concerns, increased burden of living, and activation of resilience adjustment). Financial stress and role conflict were particularly prominent for patients with low-income. Conclusion This study innovatively reveals the multilevel and interactive nature of marital life experiences of low-income breast cancer patients at reproductive age. Anxiety emerges as the core distress (micro level); spousal support serves as the critical buffer for marital quality maintenance (meso level), and financial strain and family role imbalance constitutes pervasive and burdensome stressors (macro level). This suggests that clinical staff need to identify problems at different levels, with particular attention to the socioeconomic and role dilemmas faced by low-income patients. An integrated, tiered marital support program should be implemented, incorporating psychological counseling, spousal communication facilitation, and family resource linkage to improve patients’ overall marital quality of life.
关键词
乳腺癌 /
育龄期 /
已婚 /
婚姻生活 /
生态系统理论 /
质性研究
Key words
breast cancer /
reproductive age /
married /
martial life /
ecosystem theory /
qualitative research
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基金
湖南省自然科学基金（2025JJ80854）; 湖南省卫生健康高层次人才支持计划（20240304039）
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