被诊断患有癌症并接受姑息治疗的人对存在不确定性和确定性的意义：一种生活世界现象学研究。
Meanings of existential uncertainty and certainty for people diagnosed with cancer and receiving palliative treatment: a life-world phenomenological study.
机构信息
Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, Sweden, Box 457, Gothenburg SE- 405 30, Sweden ; Sahlgrenska University Hospital, Per Dubbsgatan, Gothenburg SE- 413 45, Sweden.
University of Gothenburg Centre for Person-Centred Care, Box 457, Gothenburg SE- 405 30, Sweden ; Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Stavanger 4036, Norway.
出版信息
BMC Palliat Care. 2014 Jun 11;13:28. doi: 10.1186/1472-684X-13-28. eCollection 2014.
BACKGROUND
Many people around the world are getting cancer and living longer with the disease. Thanks to improved treatment options in healthcare, patients diagnosed with advanced gastrointestinal cancer can increasingly live for longer. Living with cancer creates existential uncertainty, but what does this situation mean for the individual? The purpose of the study is to interpret meanings of existential uncertainty and certainty for people diagnosed with advanced gastrointestinal cancer and receiving palliative treatment.
METHODS
This study is part of a larger project in which 7 men and 7 women aged between 49 and 79 participated in a study of information and communication for people with advanced gastrointestinal cancer. A total of 66 interviews were conducted with participants who were followed up over time. The narrative interviews were transcribed verbatim and the texts were analysed in three steps: naive reading, structural analysis and interpreted whole by utilizing a phenomenological life-world approach.
RESULTS
THIS STUDY HAS IDENTIFIED DIFFERENT SPHERES IN WHICH PEOPLE DIAGNOSED WITH ADVANCED GASTROINTESTINAL CANCER VACILLATE BETWEEN EXISTENTIAL UNCERTAINTY AND CERTAINTY: bodily changes, everyday situations, companionship with others, healthcare situations and the natural environment. Existing in the move between existential uncertainty and certainty appears to change people's lives in a decisive manner. The interview transcripts reveal aspects that both create existential certainty and counteract uncertainty. They also reveal that participants appear to start reflecting on how the new and uncertain aspects of their lives will manifest themselves -a new experience that lays the foundation for development of knowledge, personal learning and growth.
CONCLUSIONS
People diagnosed with advanced gastrointestinal cancer and receiving palliative care expressed thoughts about personal learning initiated by the struggle of living with an uncertain future despite their efforts to live in the present. Their personal learning was experienced through a changed life for themselves and having to confront their own pending death and develop self-insight regarding finality of life. Healthcare professionals can try to support people receiving palliative treatment for cancer by diversifying avenues for their personal growth, thus helping them manage their existential uncertainty and gravitate towards greater existential certainty.
背景
世界各地有许多人患有癌症，并在与癌症共存的过程中活得更久。由于医疗保健中治疗选择的改善，被诊断患有晚期胃肠道癌症的患者可以越来越长寿。患有癌症会带来存在的不确定性，但这种情况对个人意味着什么？本研究的目的是解释接受姑息治疗的晚期胃肠道癌症患者对存在不确定性和确定性的意义。
方法
本研究是一个更大项目的一部分，其中 7 名年龄在 49 至 79 岁的男性和 7 名女性参与了一项针对晚期胃肠道癌症患者的信息和沟通研究。总共对参与者进行了 66 次随访访谈。对参与者进行了叙述性访谈，并逐字转录了访谈文本，并分三个步骤进行分析：直观阅读、结构分析和利用现象学生活世界方法对整体进行解释。
结果
本研究确定了患有晚期胃肠道癌症的人在存在不确定性和确定性之间摇摆的不同领域：身体变化、日常生活情况、与他人的陪伴、医疗保健情况和自然环境。在存在不确定性和确定性之间的转变中生存，似乎以决定性的方式改变了人们的生活。访谈记录揭示了既创造存在确定性又对抗不确定性的方面。它们还表明，参与者似乎开始思考他们生活中新的和不确定的方面将如何表现出来——这是一种新的体验，为知识、个人学习和成长奠定了基础。
结论
接受姑息治疗的晚期胃肠道癌症患者表达了对个人学习的思考，这种学习是由对不确定未来的生存斗争引发的，尽管他们努力活在当下。他们的个人学习是通过改变自己的生活来体验的，不得不面对自己即将到来的死亡，并对生命的终结有自我洞察。医疗保健专业人员可以通过为癌症姑息治疗患者提供多样化的个人成长途径来尝试支持他们，从而帮助他们管理存在的不确定性，并向更大的存在确定性倾斜。
Zotero 插件