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五十岁以下女性与乳腺癌:创伤经历中意义建构的叙事标记

Underfifty Women and Breast Cancer: Narrative Markers of Meaning-Making in Traumatic Experience.

作者信息

Martino Maria Luisa, Lemmo Daniela, Gargiulo Anna, Barberio Daniela, Abate Valentina, Avino Franca, Tortoriello Raffaele

机构信息

Department of Humanistic Studies, University of Naples Federico II, Naples, Italy.

Clinical Psychology Unit, National Cancer Institute G. Pascale Foundation (IRCCS), Naples, Italy.

出版信息

Front Psychol. 2019 Mar 26;10:618. doi: 10.3389/fpsyg.2019.00618. eCollection 2019.

Abstract

A diagnosis of breast cancer is considered a potential traumatic event associated with physical and psychological effects. In literature, an exploration of breast cancer experience in young women is lacking, able to shed light on the narrative processes of meaning-making of the experience in specific phases of treatment, as may be the initial impact with the onset of the cancer. Meaning-making processes are determinant aspects when dealing with traumatic events. The research took place at National Cancer Institute Pascale of Naples. We collected 50 narrative interviews to explore the different domains of the experience with under-fifty women at the first phase of the hospitalization. The Narrative Interviews were analyzed through a qualitative methodology constructed . Starting from the functions of meaning-making that the narrative mediate we have highlight the different modes to articulate the narrative functions: The Organization of Temporality: chronicled (38%), actualized (26%), suspended (18%), interrupted (16%), and confused (2%). The Search for Meaning: internalized (42%); generalized (24%); externalized (18%); suspended (16%). The Emotional Regulation: disconnected (44%), splitted (28%), pervasive (26%), and connected (2%). The Organization of self-other Relationship: supportive (46%), avoidant (22%), overturned (16%), and sacrificial (16%). The Finding Benefit: revaluating (38%), flattened (34%), and postponed (28%). The Orientation to Action: combative (38%), blocked (36%), and suspended (26%). Findings capture the impact with the onset of the cancer, identifying both risk and resource aspects. The study allows to identify a specific use of narrative device by under-fifty women who impacted with the experience of breast cancer. The ways in which meaning-making functions are articulated highlight the specificity of the first phase of the treatment of the cancer. From a clinical psychology point of view, our findings can be used as clinical narrative markers to grasp, in a diachronic way, the process of meaning-making, integration, and coping during the first phase of breast cancer experience in young women. We consider it valuable to increase longitudinal studies with young women to highlight trajectories of meaning-making during the different phases of the treatment to think about personalized intervention practices diachronically to the experience.

摘要

乳腺癌的诊断被认为是一个与身体和心理影响相关的潜在创伤性事件。在文献中,缺乏对年轻女性乳腺癌经历的探索,而这能够揭示在治疗的特定阶段(如癌症初发时的最初影响)对该经历赋予意义的叙事过程。在应对创伤性事件时,赋予意义的过程是决定性的方面。该研究在那不勒斯的帕斯卡尔国家癌症研究所进行。我们收集了50份叙事访谈,以探索50岁以下女性在住院第一阶段的不同经历领域。通过构建的定性方法对叙事访谈进行了分析。从叙事所介导的赋予意义的功能出发,我们突出了阐明叙事功能的不同模式:时间性的组织:编年式(38%)、实现式(26%)、暂停式(18%)、中断式(16%)和混乱式(2%)。意义的探寻:内化式(42%);普遍化式(24%);外化式(18%);暂停式(16%)。情绪调节:分离式(44%)、分裂式(28%)、弥漫式(26%)和连接式(2%)。自我与他人关系的组织:支持式(46%)、回避式(22%)、颠覆式(16%)和牺牲式(16%)。发现益处:重新评估式(38%)、平淡式(34%)和推迟式(28%)。行动导向:战斗式(38%)、受阻式(36%)和暂停式(26%)。研究结果捕捉到了癌症初发时的影响,识别出了风险和资源方面。该研究能够确定受乳腺癌经历影响的50岁以下女性对叙事手段的特定运用。赋予意义功能的表达方式突出了癌症治疗第一阶段的特殊性。从临床心理学的角度来看,我们的研究结果可用作临床叙事标记,以历时性的方式把握年轻女性乳腺癌经历第一阶段的意义赋予、整合和应对过程。我们认为增加对年轻女性的纵向研究很有价值,以突出治疗不同阶段的意义赋予轨迹,从而针对该经历历时性地思考个性化干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2257/6448035/00d001b2ff4f/fpsyg-10-00618-g001.jpg

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