基于认知性访谈的年轻乳腺癌患者生育力保存决策辅助工具的文化调试  

The cultural adaptation of decision aid tool for fertility preservation in young breast cancer patients based on cognitive interview

作　　者：安培[1] 王慧[1] 丁焱[1] 吴克瑾[1] AN Pei;WANG Hui;DING Yan;WU Kejin(Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200011,China)

机构地区：[1]复旦大学附属妇产科医院,上海200011

出　　处：《护士进修杂志》2025年第3期243-248,共6页Journal of Nurses Training

基　　金：上海申康医院发展中心临床诊疗技术示范应用的规范化管理研究项目(编号:SHDC22020209);复旦大学复星护理科研基金(编号:FNF202012)。

摘　　要：目的汉化英文版年轻乳腺癌患者生育力保存决策辅助工具,运用认知性访谈探查目标人群对中文版工具的认知和理解,并对工具进行修订。方法采用目的抽样法,2022年6—10月选取在上海市某三级甲等妇产专科医院治疗、有生育力保存决策经历的年轻乳腺癌患者22名,进行2轮认知性访谈,了解受访者对汉化后中文版乳腺癌患者生育力保存决策辅助工具内容的理解,综合受访者反馈及专家团队意见对存在歧义的内容进行修订。运用自行设计的决策工具接受度调查问卷,调查10例有生育力保存需求的乳腺癌患者对修订后工具的接受度。结果通过内容分析法共提炼出了4个主题:信息内容、信息理解、文化适应、对工具的总体感受。根据第1轮认知性访谈结果,对4条有歧义、概念模糊的信息内容进行修订,新增乳腺癌预后、案例分享2个主题的内容。第2轮认知性访谈结果显示,受访者均能够能正确理解工具内容。最终确定决策工具内容包括5个版块(背景信息、乳腺癌治疗前后的生育选择、决策利弊与偏好练习、决策指引、术语目录及参考文献),涵盖22个主题。绝大部分患者对该工具的接受度较高。结论认知性访谈是一种前测方法,有助于决策辅助工具适应不同文化背景,提高目标人群对工具内容的理解和接受度,为后期工具用于有效性检验奠定基础。Objective To convert the English version of the fertility preservation decision aid for young breast cancer patients into Chinese,and to apply cognitive interviews to explore target population's cognition and understanding of the translation version tool,and undertake modifications.Methods Purposive sampling was used to select 22 young breast cancer patients with decision-making experience of fertility preservation in a tertiary Grade A Obstetrics and Gynecology Hospital of Fudan University in Shanghai from June to October 2022,and 2 rounds of cognitive interviews were conducted to explore the respondents'understanding of the content of the Chinese version of the fertility preservation decision aid tool for breast cancer patients,and the items with ambiguities were revised according to the feedback of the respondents and the opinions from a panel of experts.A self-designed acceptance questionaire for decision-making tools was used to investigate the acceptance of the revised tools among 10 breast cancer patients with fertility preservation needs.Results Through content analysis,4 main themes were found as follows:Information content,information understanding,cultural adaptation,and overall impressions of the tool.According to the results of the first round of interviews,4 items of information with ambiguity and vague concept were modified,and 2 new topics contents of breast cancer prognosis and case sharing were added.The second round of cognitive interviews confirmed that respondents could accurately understand the tool's content.The final decision aid comprised 5 sections(background information,fertility options before and after breast cancer treatment,decision guidelines and preferences exercise,glossary of terms,and references)covering 22 topics.The vast majority of patients had a high acceptance of this tool.Conclusion Cognitive interviewing is a useful pre-testing method in enhancing the adaptability of decision aids tool to different cultural contexts,and improving the target population's understanding and

关 键 词：认知性访谈 乳腺癌患者 生育力保存 决策辅助工具 文化调试 

分 类 号：R473.73[医药卫生—护理学]