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回肠造口术患者生活中的心理挑战:一项诠释现象学分析。

The psychological challenges of living with an ileostomy: An interpretative phenomenological analysis.

作者信息

Smith Jonathan A, Spiers Johanna, Simpson Phillip, Nicholls Adam R

机构信息

Department of Psychological Sciences, Birkbeck, University of London.

Department of Sport, Health and Exercise Science, University of Hull.

出版信息

Health Psychol. 2017 Feb;36(2):143-151. doi: 10.1037/hea0000427. Epub 2016 Nov 10.

Abstract

OBJECTIVES

Ileostomy, in which the small intestine is redirected out of an abdominal wall so that waste is collected using a bag, is used to treat conditions including inflammatory bowel disease and colorectal cancer. This article reports an in-depth idiographic analysis of the experience of living with an ileostomy.

METHOD

Twenty-one participants took part in semistructured interviews about their lives and relationships. Those interviews were transcribed verbatim and analyzed using the experiential qualitative methodology interpretative phenomenological analysis.

RESULTS

Two superordinate themes arose from the data: ileostomy's intrapersonal impact and the impact of ileostomy on relationships with others. The authors found that ileostomy may destabilize the sense of self, disrupt body image, and alter experience of age and sexuality. Other participants were able to use their illness to positively reframe the self. Disclosure of ileostomy status was difficult for some. Intimate and friend relationships were often challenged by stoma status, whereas other family relationships were largely characterized as supportive.

CONCLUSIONS

Ileostomy may impact upon both intra- and interpersonal aspects of the lives of those who live with it, in both negative and positive ways. Consequently, the sense of self can appear challenged, and relationships with partners, family members and friendships could be causes of distress. On the other hand, some partners were supportive, and children were found to be sources of comfort. (PsycINFO Database Record

摘要

目的

回肠造口术是将小肠引出腹壁,以便用袋子收集排泄物,用于治疗包括炎症性肠病和结直肠癌在内的疾病。本文报告了一项对回肠造口术生活体验的深入个案分析。

方法

21名参与者参加了关于他们生活和人际关系的半结构化访谈。这些访谈被逐字记录,并使用经验性定性方法——解释现象学分析进行分析。

结果

数据中出现了两个上位主题:回肠造口术对个人的影响以及回肠造口术对与他人关系的影响。作者发现,回肠造口术可能会破坏自我意识、扰乱身体形象,并改变年龄和性取向的体验。其他参与者能够利用他们的疾病对自我进行积极的重新构建。对一些人来说,透露回肠造口术的情况很困难。亲密关系和朋友关系常常受到造口状况的挑战,而其他家庭关系在很大程度上则表现为支持性的。

结论

回肠造口术可能会以消极和积极的方式影响患者生活的个人和人际方面。因此,自我意识可能会受到挑战,与伴侣、家庭成员和朋友的关系可能会成为困扰的根源。另一方面,一些伴侣给予支持,孩子也被发现是安慰的来源。(PsycINFO数据库记录)

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