Author Affiliation: Indiana University School of Nursing, Indianapolis.
Cancer Nurs. 2020 Jan/Feb;43(1):69-77. doi: 10.1097/NCC.0000000000000653.
Adolescent/young adult (AYA) cancer survivors experience greater psychosocial distress than younger or older adults. To address their psychosocial distress, it is important that healthcare providers (HCPs) foster connectedness with AYAs; however, some HCPs' words and behaviors may actually create a sense of disconnectedness with AYAs.
The aim of this study was to describe AYA cancer survivors' experiences of disconnectedness from HCPs during cancer treatment.
This empirical phenomenological study sample included 9 AYA cancer survivors (aged 20-23 years) diagnosed during adolescence. In-person interviews were conducted using a broad data-generating question and analyzed using an adapted Colaizzi's method.
Healthcare providers' behaviors that create disconnectedness include (1) exhibiting a lack of appreciation for AYAs' personhood, (2) inflicting unnecessary harm or discomfort, (3) being apathetic of needs and preferences, (4) treating AYAs like they have minimal rights, (5) speaking in a patronizing manner, (6) ignoring their requests, and (7) failing to be vigilant for basic needs. When AYAs experience disconnectedness, they feel dehumanized, powerless, and a lack of self-determination.
Findings highlight disturbing HCP behaviors that create AYA disconnectedness. Despite generally feeling connected to HCPs, AYA cancer survivors' experiences of disconnectedness leave lingering feelings of anger and resentment, even after treatment ends. Preventing disconnectedness behaviors must be a priority.
AYA cancer survivors' can benefit from having the opportunity to share their experiences of disconnectedness and having the chance to be autonomous in their care. Bringing awareness to HCPs about what behaviors cause disconnectedness is essential in preventing the behaviors.
青少年/年轻成人(AYA)癌症幸存者比年轻或年长的成年人经历更大的心理社会困扰。为了解决他们的心理社会困扰,重要的是医疗保健提供者(HCP)与 AYA 建立联系;然而,一些 HCP 的言语和行为实际上可能会与 AYA 产生脱节感。
本研究旨在描述 AYA 癌症幸存者在癌症治疗期间与 HCP 脱节的体验。
本实证现象学研究样本包括 9 名 AYA 癌症幸存者(年龄 20-23 岁),他们在青春期被诊断出患有癌症。使用广泛的数据生成问题进行面对面访谈,并使用改编的 Colaizzi 方法进行分析。
造成脱节的 HCP 行为包括:(1)表现出不尊重 AYA 的人格,(2)造成不必要的伤害或不适,(3)对需求和偏好漠不关心,(4)对待 AYA 就像他们的权利最小化,(5)以屈尊的方式说话,(6)忽视他们的请求,以及(7)未能警惕基本需求。当 AYA 感到脱节时,他们会感到被非人化、无力和缺乏自我决定。
研究结果突出了令人不安的 HCP 行为,这些行为会导致 AYA 脱节。尽管 AYA 癌症幸存者通常感到与 HCP 有联系,但他们与 HCP 脱节的经历会留下挥之不去的愤怒和怨恨情绪,即使在治疗结束后也是如此。防止脱节行为必须是当务之急。
AYA 癌症幸存者可以从分享他们脱节的经历和有机会自主护理中受益。让 HCP 意识到哪些行为会导致脱节感对于防止这些行为至关重要。