St Catherine's Hospice, Crawley, UK.
J Adv Nurs. 2012 May;68(5):1134-44. doi: 10.1111/j.1365-2648.2011.05820.x. Epub 2011 Sep 5.
This paper reports a study to develop a grounded theory to explain the experience of recovery following surgery for colorectal cancer.
Studies have adopted a biomedical framework to measure quality of life and symptom distress following surgery for colorectal cancer. These studies suggest that symptoms of pain, insomnia and fatigue, may persist for many months following treatment. Fewer studies have considered the individual's experiences and perspective of the emotional, social and cultural aspects of recovery.
A longitudinal study using grounded theory was conducted with 12 individuals, who had received surgery for colorectal cancer. Semi-structured interviews were conducted at four time points over 1 year following surgery, between 2007 and 2009. Grounded theory analysis was undertaken using Strauss and Corbin's framework.
Recovery is described in three phases: disrupting the self; repairing the self; restoring the self. The core category is Restoring a sense of wellness; fostered through awareness and enjoyment of the physical, emotional, spiritual and social aspects of life. A sense of wellness exists as a duality with a sense of illness, where both perspectives may co-exist but one usually takes precedence. A sense of illness pervades when the individual is preoccupied with illness and the illness continues to disrupt their daily life.
Recovery takes time and energy, particularly when the individual is at home and in relative isolation from health professionals. Opportunities exist for nurses to provide information and support to facilitate the individual in their progress towards achieving a sense of wellness.
本文报告了一项旨在发展扎根理论的研究,以解释结直肠癌手术后康复的体验。
研究采用生物医学框架来衡量结直肠癌手术后的生活质量和症状困扰。这些研究表明,疼痛、失眠和疲劳等症状可能在治疗后持续数月。较少的研究考虑了个体在情感、社会和文化方面的康复的个人经历和观点。
2007 年至 2009 年期间,采用纵向研究方法,对 12 名接受结直肠癌手术的患者进行了研究。在手术后 1 年内的 4 个时间点进行了半结构化访谈。使用 Strauss 和 Corbin 的框架进行扎根理论分析。
康复分为三个阶段:破坏自我;修复自我;恢复自我。核心类别是恢复健康感;通过对身体、情感、精神和社会生活各个方面的认识和享受来促进。健康感是一种与疾病感并存的二元性,两者可能同时存在,但通常有一种占主导地位。当个体专注于疾病并且疾病继续扰乱他们的日常生活时,疾病感就会弥漫。
康复需要时间和精力,尤其是当个体在家中并且与卫生专业人员相对隔离时。护士有机会提供信息和支持,以促进个体朝着实现健康感的方向前进。