Institute of Public Health, Research Unit Health, Man and Society, University of Southern Denmark, Odense, Denmark.
Palliat Support Care. 2009 Dec;7(4):469-79. doi: 10.1017/S1478951509990472.
This study aims to explore and understand how people with advanced cancer create meaning and handle everyday life through activity.
A purposive sample of seven participants was recruited from a larger study. Data were collected through qualitative interviews and participant observations conducted in the participants' home environments while they were engaged in activities to which they assigned particular value. Interpretive analysis was conducted using narrative theory and relevant literature.
The study shows how people in conditions of advanced cancer fashion narratives useful for handling everyday life with advanced cancer. A meta-narrative of "saying goodbye in a good way" provided an overall structure for the participants as they attempted to create desired narratives negotiated in context of the individuals' sociocultural life and in the proximity of death. A narrative of "being healthy although ill" provided an arena for exploring the contrast between simultaneously feeling well and severely ill. Further emplotment of activities in "routines and continuity" was identified as a means to provide a safe, familiar framework stimulating participants' everyday agency. "My little Mecca" was identified as a narrative reflecting the activity of life-confirming experiences and taking time out.
The identified narratives performed and told in daily life may guide the development of palliative care services to support people with advanced cancer in creating meaning in the remains of their lives.
本研究旨在探索和了解晚期癌症患者如何通过活动创造意义和应对日常生活。
从一项更大的研究中，通过有目的的抽样，招募了 7 名参与者。通过在参与者的家庭环境中进行的定性访谈和参与者观察，收集了数据，这些活动是参与者赋予特定价值的活动。采用叙事理论和相关文献进行解释性分析。
该研究展示了晚期癌症患者如何塑造有用的叙事，以应对晚期癌症的日常生活。一个“以好的方式说再见”的元叙事为参与者提供了一个总体结构，因为他们试图在个体的社会文化生活背景下，在接近死亡的情况下，创造出经过协商的理想叙事。一种“虽然生病但健康”的叙述提供了一个探索同时感觉良好和严重生病之间对比的舞台。进一步将活动“常规和连续性”进行情节化，被确定为提供安全、熟悉的框架，激发参与者日常能动性的一种手段。“我的小麦加”被确定为一种反映生活确认体验和腾出时间的叙事。
在日常生活中表演和讲述的这些确定的叙事可能指导姑息治疗服务的发展，以支持晚期癌症患者在他们生命的剩余时间里创造意义。
