Pieters Huibrie C
Author Affiliation: School of Nursing, University of California, Los Angeles.
Cancer Nurs. 2016 Jan-Feb;39(1):E20-8. doi: 10.1097/NCC.0000000000000248.
Cancer presents a severe adversity that calls on intrinsic strength factors such as resilience. Breast cancer is especially common among older women. Understanding the interaction between the mechanisms of resilience and the psychosocial impact of cancer requires consideration of developmental age.
This research explores resilience from the point of view of older women who recently completed treatment for early-stage breast cancer.
Constructivist grounded theory directed data collection and analysis of 31 personal, semistructured interviews with 18 women aged 70 to 94 years.
Faced with overcoming the adversity of a first cancer experience, participants rebounded and restored balance to their lives with a sense that they did the work of managing cancer with self-efficacy and autonomy. Resilience was evidenced as a multidimensional process containing a natural interaction of attributes. Self-reliance, optimism, and persevering were embedded in human interconnectedness.
The process of cancer survivorship was positioned in the larger picture of the joys and hardships of having lived a long life. The core self continued through these changing times, connecting the past, present, and anticipated future, as exemplified by "I'm still here." Regaining balance required tenacity, pragmatism, and dedication to do the work that needed to be done to treat cancer and move on with life.
Resilience is a valuable resource in strength-based approaches in healthcare. Practical examples for clinicians who follow a strength-based approach to promote adaptation for the continuing challenges of breast cancer survivorship among older women include acknowledging unique individual expressions of resilience. Gero-oncology is a salient field for multidisciplinary teams who seek to study resilience.
癌症是一种严重的逆境，需要内在的力量因素如适应力来应对。乳腺癌在老年女性中尤为常见。理解适应力机制与癌症心理社会影响之间的相互作用需要考虑发育年龄。
本研究从近期完成早期乳腺癌治疗的老年女性的角度探讨适应力。
建构主义扎根理论指导对18名年龄在70至94岁之间的女性进行31次个人半结构化访谈的数据收集和分析。
面对克服首次患癌经历的逆境，参与者恢复过来并重新找回生活的平衡，她们感觉自己凭借自我效能感和自主性应对了癌症。适应力被证明是一个包含多种属性自然相互作用的多维度过程。自力更生、乐观和坚持不懈融入了人际联系之中。
癌症幸存者的过程置于漫长人生的欢乐与艰辛这一更大背景之中。核心自我在这些变化的时期持续存在，连接着过去、现在和预期的未来，“我还在这里”就是例证。恢复平衡需要坚韧、务实和奉献精神，以完成治疗癌症及继续生活所需做的工作。
适应力是医疗保健中基于优势方法的宝贵资源。对于采用基于优势方法促进老年女性适应乳腺癌幸存者持续挑战的临床医生来说，实际例子包括认可适应力的独特个体表现。老年肿瘤学是多学科团队研究适应力的一个重要领域。
