Threader J, McCormack L
Research School of Psychology, Australian National University, Canberra, ACT, Australia.
Faculty of Science and IT, School of Psychology, University of Newcastle, Callaghan, NSW, Australia.
Eur J Cancer Care (Engl). 2016 Jan;25(1):157-69. doi: 10.1111/ecc.12320. Epub 2015 Apr 21.
Head and neck cancer is associated with multiple layers of distress including stigma. Stigma attraction or devalued social identity is twofold: (1) it is a cancer associated with lifestyle risk factors and (2) treatment often results in confronting facial disfigurement. Subjective interpretations from nine head and neck cancer patients were analysed using Interpretative Phenomenological Analysis. An overarching superordinate theme--Distress, Stigma and Psychological Growth--encompassed four subordinate themes. Two themes captured the expressed trauma and terror as a result of diagnosis and treatment, and two the redefining of self despite stigma through meaning making. Distress was interpreted as a catalyst for awakening new life interpretations and combined with social support to facilitate two distinct pathways of growth: (1) psychological growth without support; (2) psychological and relational growth with support. Previously unfelt empathetic understanding and altruism for others with cancer emerged from the impact of stigma on 'self'. Acceptance allowed a new sense of identity that recognised cancer-related traumatic distress as integral to growth for these participants. The present study offers a unique insight into cancer-related trauma and stigma and the potential to redefine a more accepting, empathic and altruistic 'self' for psychological growth. Implications are discussed.
头颈癌与包括耻辱感在内的多层痛苦相关。耻辱感的吸引或被贬低的社会身份有两方面：（1）它是一种与生活方式风险因素相关的癌症，（2）治疗往往会导致面部毁容。使用解释现象学分析方法分析了9名头颈癌患者的主观解读。一个总体的上级主题——痛苦、耻辱感与心理成长——包含了四个下级主题。两个主题捕捉到了诊断和治疗所带来的创伤和恐惧，另外两个主题则是尽管有耻辱感，但通过意义建构实现了自我重新定义。痛苦被解读为唤醒新生活解读的催化剂，并与社会支持相结合，促进了两种不同的成长途径：（1）无支持的心理成长；（2）有支持的心理和人际关系成长。耻辱感对“自我”的影响产生了以前未曾感受到的对其他癌症患者的同理心理解和利他主义。接纳带来了一种新的身份感，即认识到与癌症相关的创伤性痛苦对这些参与者的成长至关重要。本研究为与癌症相关的创伤和耻辱感以及为实现心理成长重新定义一个更具接纳性、同理心和利他主义的“自我 ”的潜力提供了独特的见解。并对其影响进行了讨论。
