Isaksson Joakim, Salander Pär, Lilliehorn Sara, Laurell Göran
Department of Social Work, Umeå University, 901 87, Umeå, Sweden.
Department of Social Work, Umeå University, 901 87, Umeå, Sweden; Department of Radiation Sciences - Oncology, Umeå University, 901 87, Umeå, Sweden.
Soc Sci Med. 2016 Apr;154:54-61. doi: 10.1016/j.socscimed.2016.02.031. Epub 2016 Feb 20.
There are many studies available describing how patients are affected by head and neck cancer (HNC) and its treatment. Usually these studies are quantitative and focus on assessing patients' quality of life or distress post-treatment. These studies are important, but they are of limited value if we are interested in understanding more about HNC in an everyday life context.
The purpose was to determine how life was lived and valued during and after treatment for HNC and to detect different transitions in returning to everyday life.
During 2009-2012, 56 patients with HNC were consecutively included, and interviewed at 6, 12, and 24 months post-treatment about how they lived their lives. All patients received primary treatment at a tertiary referral university hospital in Sweden.
Four different trajectories and transitions emerged. The first group (n = 15) evaluated their illness experience as a past parenthesis in their life suggesting that they had psychologically left the illness behind. In the second group (n = 9), the impact of the disease seemed to be diluted by other strains in their life, and although these patients to some extent were still hampered by side effects, they regarded them as 'no big deal'. The cancer really made a difference in the third group (n = 12) in both positive and negative ways and seemed to reflect a balance between such effects. In the fourth group (n = 20), the physical and/or psychological problems predominated and the patients' lives had changed for the worse.
The narratives showed that being afflicted by HNC has different impacts depending on how the patients live their lives - it is a matter of individual transition in an everyday life context. This idiosyncrasy challenges the meaningfulness of screening efforts to identify vulnerable groups for psychosocial intervention.
有许多研究描述了头颈癌（HNC）患者及其治疗所受到的影响。通常这些研究是定量的，侧重于评估患者治疗后的生活质量或痛苦程度。这些研究很重要，但如果我们想在日常生活背景下更深入地了解头颈癌，其价值就有限了。
旨在确定头颈癌患者在治疗期间及治疗后如何生活以及如何看待生活，并检测回归日常生活过程中的不同转变。
在2009年至2012年期间，连续纳入了56名头颈癌患者，并在治疗后6个月、12个月和24个月对他们的生活方式进行了访谈。所有患者均在瑞典一家三级转诊大学医院接受了初步治疗。
出现了四种不同的轨迹和转变。第一组（n = 15）将他们的疾病经历视为生活中过去的一段插曲，这表明他们在心理上已经摆脱了疾病。第二组（n = 9）中，疾病的影响似乎被生活中的其他压力所冲淡，尽管这些患者在一定程度上仍受到副作用的困扰，但他们认为这些副作用“没什么大不了的”。癌症在第三组（n = 12）中产生了积极和消极两方面的显著影响，似乎体现了这些影响之间的平衡。在第四组（n = 20）中，身体和/或心理问题占主导，患者的生活变得更糟。
这些叙述表明，患头颈癌的影响因患者的生活方式而异——这是日常生活背景下个体转变的问题。这种特质对识别心理社会干预弱势群体的筛查工作的意义提出了挑战。
