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通过叙事终结寻求确定性:处于阈限状态的男性前列腺癌治疗故事

Seeking certainty through narrative closure: men's stories of prostate cancer treatments in a state of liminality.

作者信息

Pietilä Ilkka, Jurva Raisa, Ojala Hanna, Tammela Teuvo

机构信息

Faculty of Social Sciences, University of Tampere, Tampere, Finland.

Gerontology Research Center, University of Tampere, Tampere, Finland.

出版信息

Sociol Health Illn. 2018 May;40(4):639-653. doi: 10.1111/1467-9566.12671. Epub 2018 Feb 11.

Abstract

Radical treatments of prostate cancer often lead to a pervasive liminal state that is characterised by multiple uncertainties that relate both to a possible recurrence of cancer and recovery from side effects, such as erectile and urinary dysfunctions. Liminality can make it difficult for cancer patients to narrate their experiences, as their stories lack a definite ending. After interviews with 22 Finnish men who had undergone radical prostatectomy, we analysed how men produce closure in their illness narratives. Focusing on the timelines of control visits or their anticipated recovery from side effects, these interviewees sought provisional certainty within a seemingly chaotic future. By locating erectile dysfunction in the wider context of a life-course and interpreting their fading sexuality as a 'natural' consequence of ageing, these men were adjusting to their post-operative lives. Our study further shows that the inability to adjust personal experiences to positive culturally available storylines that provide a chance for the narrative reconstruction of life, can cause materialised negative consequences, such as relationship breakdowns.

摘要

前列腺癌的根治性治疗常常导致一种普遍存在的临界状态,其特征是存在多种不确定性,这些不确定性既与癌症可能复发有关,也与从诸如勃起功能障碍和排尿功能障碍等副作用中恢复过来有关。临界状态会使癌症患者难以讲述自己的经历,因为他们的故事缺乏明确的结局。在采访了22名接受过前列腺根治术的芬兰男性后,我们分析了男性在其疾病叙述中是如何实现结局感的。这些受访者关注复查的时间线或他们预期从副作用中恢复的情况,在看似混乱的未来中寻求暂时的确定性。通过将勃起功能障碍置于更广阔的人生历程背景中,并将他们逐渐衰退的性功能解释为衰老的“自然”结果,这些男性正在适应他们的术后生活。我们的研究进一步表明,无法将个人经历调整到积极的、具有文化普遍性的故事情节中,而这些故事情节为生活的叙事重构提供了机会,可能会导致实质性的负面后果,比如关系破裂。

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