Lucas Matthew S, Barakat Lamia P, Jones Nora L, Ulrich Connie M, Deatrick Janet A
Narrat Inq Bioeth. 2014 Winter;4(3):233-51. doi: 10.1353/nib.2014.0068.
Survivors of childhood brain tumors face many obstacles to living independently as adults. Causes for lack of independence are multifactorial and generally are investigated in terms of physical, cognitive, and psychosocial treatment-related sequelae. Little is known, however, about the role of expectation for survivors' function. From a mixed-methods study including qualitative interviews and quantitative measures from 40 caregiver-survivor dyads, we compared the data within and across dyads, identifying four distinct narrative profiles: (A) convergent expectations about an optimistic future, (B) convergent expectations about a less optimistic future, (C) non-convergent expectations about a less optimistic future, and (D) non-convergent expectations about an unclear future. Dyads both do well and/or struggle in systematically different manners in each profile. These profiles may inform the design of interventions to be tested in future research and help clinicians to assist families in defining, (re-)negotiating, and reaching their expectations of function and independence.
儿童脑肿瘤幸存者成年后在独立生活上面临诸多障碍。缺乏独立性的原因是多方面的,通常从身体、认知和心理社会治疗相关后遗症的角度进行调查。然而,对于幸存者功能期望的作用却知之甚少。在一项包括定性访谈和对40对照顾者-幸存者二元组进行定量测量的混合方法研究中,我们比较了二元组内部和之间的数据,识别出四种不同的叙事模式:(A) 对乐观未来的趋同期望,(B) 对不太乐观未来的趋同期望,(C) 对不太乐观未来的非趋同期望,以及 (D) 对不明确未来的非趋同期望。在每种模式中,二元组在系统上以不同的方式表现良好和/或挣扎。这些模式可为未来研究中有待测试的干预措施设计提供参考,并帮助临床医生协助家庭界定、(重新)协商并达成他们对功能和独立性的期望。