Mosher Catherine E, Adams Rebecca N, Helft Paul R, O'Neil Bert H, Shahda Safi, Rattray Nicholas A, Champion Victoria L
a Department of Psychology , Indiana University-Purdue University Indianapolis , Indianapolis , IN , USA.
b Department of Pediatrics , Stanford University School of Medicine , Palo Alto , CA , USA.
Psychol Health. 2017 Jan;32(1):94-109. doi: 10.1080/08870446.2016.1247839. Epub 2016 Oct 24.
This study assessed positive changes in patients with advanced colorectal cancer and their family caregivers following diagnosis. We compared self-reported positive changes within patient-caregiver dyads as well as self-reports and patient reports of positive changes in caregivers.
Individual, semi-structured qualitative interviews were conducted with 23 patients with advanced colorectal cancer and 23 caregivers. A theoretical thematic analysis of interview transcripts was framed by posttraumatic growth theory.
Patients and caregivers described five positive changes: closer relationships with others, greater appreciation of life, clarifying life priorities, increased faith, and more empathy for others. Additionally, only caregivers reported better health habits following the cancer diagnosis, and a minority of patients and caregivers reported no positive changes. In about half of cases, patients reported at least one positive change that was identical to that of their caregiver. However, in most cases, patient and caregiver reports of the caregiver's positive change were discrepant.
Findings suggest that positive changes are a shared experience for many patient-caregiver dyads and obtaining both patient and caregiver reports of caregiver positive changes provides a more comprehensive understanding of their experience. Interventions may capitalise on positive changes to promote meaningful living in the context of advanced cancer.
本研究评估了晚期结直肠癌患者及其家庭照顾者在确诊后的积极变化。我们比较了患者-照顾者二元组内自我报告的积极变化以及照顾者积极变化的自我报告与患者报告。
对23例晚期结直肠癌患者和23名照顾者进行了个体、半结构化定性访谈。访谈记录的理论主题分析以创伤后成长理论为框架。
患者和照顾者描述了五个积极变化：与他人关系更亲密、对生活的感激之情增强、明确生活优先事项、信仰增加以及对他人更有同理心。此外，只有照顾者报告在癌症诊断后有更好的健康习惯，少数患者和照顾者报告没有积极变化。在大约一半的案例中，患者报告至少有一项与照顾者相同的积极变化。然而，在大多数情况下，患者和照顾者对照顾者积极变化的报告存在差异。
研究结果表明，积极变化是许多患者-照顾者二元组的共同经历，获取患者和照顾者对照顾者积极变化的报告能更全面地了解他们的经历。干预措施可以利用积极变化来促进晚期癌症患者有意义的生活。
