Institute of Public Health, University of Southern Denmark, Denmark.
Acta Oncol. 2011 Feb;50(2):259-64. doi: 10.3109/0284186X.2010.529460.
Today more and more people survive cancer. Cancer survivors need help to recover both from the cancer and the treatment. Rehabilitative interventions have been set up to meet their needs. However, there are studies that report no major effects following careful, targeted intervention. Furthermore, it seems difficult to define whether an effect is caused by the intervention or whether it is due to contextual parameters such as human interactions, the organisation, the staff, the physical surroundings or the general atmosphere. The present study examines the influence of three contextual parameters in rehabilitation courses for cancer survivors in Denmark.
The study was based on an ethnographic fieldwork with participant observation at nine week-long courses, on in-depth interviews and on written sources. Fieldwork is well-suited for studying interventions in context, such as social interactions between people and their physical, material and institutional surroundings. The analysis is based on Duranti's and Goodwin's theoretical approach to context.
The findings are categorised into three contextual parameters. The setting, including its aesthetic value, its physical surroundings and the scheduling of the courses. The behavioural environment, which comprised work commitment and the care provided by the staff. The language environment insofar as it facilitated a sense of community.
The results demonstrate the influence of contextual parameters not formalised in the intervention programme. Contexts affect the outcome of an intervention because they frame and inform the teaching, communication and various forms of social gathering. The study suggests that the effects of the intervention as measured by quantitative studies cannot be properly interpreted without taking into account the context within which the intervention is embedded.
如今，越来越多的癌症患者幸存下来。癌症幸存者需要帮助以从癌症和治疗中恢复。为此已经设立了康复干预措施来满足他们的需求。然而，有研究报告称，在经过精心、有针对性的干预后，并没有产生重大效果。此外，似乎很难确定效果是由干预引起的，还是由人类互动、组织、员工、物理环境或整体氛围等背景参数引起的。本研究考察了丹麦癌症幸存者康复课程中三个背景参数的影响。
该研究基于一项民族志实地工作，对九个为期一周的课程进行了参与式观察、深入访谈和书面资料研究。实地工作非常适合研究干预措施的背景，例如人与人之间的社会互动以及他们的物理、物质和制度环境。分析基于 Duranti 和 Goodwin 的语境理论方法。
研究结果分为三个语境参数。包括美学价值、物理环境和课程安排在内的环境设置。工作投入和员工提供的护理组成的行为环境。以及语言环境，因为它促进了社区感。
研究结果表明，背景参数对未在干预计划中正式确定的干预措施产生影响。背景会影响干预的结果，因为它们构成并告知教学、沟通和各种形式的社交聚会。该研究表明，在不考虑干预措施所嵌入的背景的情况下，通过定量研究测量的干预效果不能得到正确解释。
