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面对筛查中可能检测出的疾病——宫颈涂片病理检查结果异常的健康女性的经历

Facing possible illness detected through screening--experiences of healthy women with pathological cervical smears.

作者信息

Hounsgaard Lise, Petersen Lone Kjeld, Pedersen Birthe D

机构信息

Research Unit of Nursing, Faculty of Health Sciences, Institute of Clinical Research, University of Southern Denmark, J.B. Winsloews Vej 9, DK-Odense, Denmark.

出版信息

Eur J Oncol Nurs. 2007 Dec;11(5):417-23. doi: 10.1016/j.ejon.2007.04.005. Epub 2007 Jun 29.

DOI:10.1016/j.ejon.2007.04.005
PMID:17604694
Abstract

The aim of this study is to gain knowledge about women's perceptions of illness based on their abnormal PAP smears, following screening for cervical cancer. The study uses a phenomenological, hermeneutic approach inspired by Ricoeur's theory of interpretation. Twelve women, aged between 23 and 59 years, were consecutively selected and then followed by participant observation during their examinations and treatment in hospital. They were interviewed on entering the study, a week following their surgery, and 6 months later. The material collected was analysed through a dialectic process consisting of a face-value review of participant experiences (naive reading), structural analysis and, critical interpretation of what it means to be potentially ill. The women were unprepared to find that their screening results showed abnormal cells, indicative of incipient genital cancer. They were frustrated by the results as they had not experienced any symptoms and felt well, despite being diagnosed with a potential disease. Being diagnosed with abnormal cells caused the participants to feel anxious. Their anxiety had subsided 6 months after the cells had been removed. For those who did not require treatment, anxiety flared up with recurrent check-ups. The bio-medical differentiation between pre-stage and actual cancer provided no comfort to the participants, who continued to see themselves as having early stage cancer.

摘要

本研究的目的是了解女性在宫颈癌筛查后,基于异常巴氏涂片结果对疾病的认知。该研究采用了受利科诠释学理论启发的现象学诠释方法。连续选取了12名年龄在23岁至59岁之间的女性,然后在她们住院检查和治疗期间进行参与观察。在她们进入研究时、手术后一周以及6个月后对她们进行访谈。通过一个辩证过程对收集到的材料进行分析,该过程包括对参与者经历的表面价值审查(朴素阅读)、结构分析以及对潜在患病意味着什么的批判性诠释。这些女性没想到她们的筛查结果显示有异常细胞,这表明有早期生殖器癌。她们对结果感到沮丧,因为尽管被诊断出患有潜在疾病,但她们没有任何症状,感觉良好。被诊断出细胞异常使参与者感到焦虑。在细胞被切除6个月后,她们的焦虑情绪有所缓解。对于那些不需要治疗的人来说,反复检查会使焦虑情绪再次出现。癌前阶段和实际癌症之间的生物医学区分并没有给参与者带来安慰,她们仍然认为自己患有早期癌症。

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