Department of Human Development, Virginia Tech, Blacksburg.
Center for Gerontology and The Institute for Society, Culture and Environment, Virginia Tech, Blacksburg.
Gerontologist. 2014 Dec;54(6):1024-34. doi: 10.1093/geront/gnt095. Epub 2013 Aug 29.
The purpose of this study was to explore how older women in rural Appalachia with gynecological cancer construct and interpret their experience with cancer.
Grounded in social constructionist theory, semistructured in-depth interviews were conducted with 20 women, aged 51-82, who had been treated for gynecological cancer. Transcripts were analyzed using the constant comparative method.
Although women narrated their experience along a common trajectory from symptoms to diagnosis to treatment, four distinct patterns of posttreatment perceptions were described: (a) positive: women believed they were cancer survivors, (b) cautious: women saw themselves as survivors but not risk free, (c) distanced: women viewed themselves as cured and equated survivor with victim, and (d) resigned: women refused more treatment. All of the women acknowledged an inner strength in how they experienced cancer, requiring a more nuanced framework for understanding how negative and positive feelings coexist with faith in a higher power and the capacity to endure a devastating threat to life and health.
The findings expand the concept of survivor identity, suggesting that the women's perception that they had met life's challenges with fortitude and inner strength may have more resonance in later life than the concept of survivorship. Family members and medical and public health professionals need to support older women's individual response to cancer recovery and acknowledge their complicated reactions to a cancer diagnosis and prognosis.
本研究旨在探讨农村阿巴拉契亚地区患有妇科癌症的老年女性如何构建和解释她们的癌症经历。
本研究基于社会建构主义理论，对 20 名年龄在 51-82 岁之间、接受过妇科癌症治疗的女性进行了半结构化深度访谈。使用恒定性比较法对转录本进行分析。
尽管女性沿着从症状到诊断到治疗的共同轨迹叙述她们的经历，但描述了四种不同的治疗后认知模式：（a）积极：女性认为自己是癌症幸存者，（b）谨慎：女性认为自己是幸存者，但仍有风险，（c）疏远：女性将自己视为治愈者，并将幸存者等同于受害者，（d）听天由命：女性拒绝接受更多治疗。所有女性都承认她们在经历癌症时具有内在力量，这需要更细致的框架来理解负面和积极的感受如何与对更高权力的信仰以及承受对生命和健康的毁灭性威胁的能力共存。
研究结果扩展了幸存者身份的概念，表明女性认为自己以坚韧和内在力量应对生活挑战的认知，可能比生存概念更能在晚年产生共鸣。家庭成员以及医疗和公共卫生专业人员需要支持老年女性对癌症康复的个体反应，并承认她们对癌症诊断和预后的复杂反应。
