School of Social Work, Colorado State University, Fort Collins, CO.
Department of Health Services, University of Washington, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA.
Palliat Support Care. 2021 Aug;19(4):437-446. doi: 10.1017/S1478951520000656.
The diagnosis of an advanced cancer in young adulthood can bring one's life to an abrupt halt, calling attention to the present moment and creating anguish about an uncertain future. There is seldom time or physical stamina to focus on forward-thinking, social roles, relationships, or dreams. As a result, young adults (YAs) with advanced cancer frequently encounter existential distress, despair, and question the purpose of their life. We sought to investigate the meaning and function of hope throughout YAs' disease trajectory; to discern the psychosocial processes YAs employ to engage hope; and to develop a substantive theory of hope of YAs diagnosed with advanced cancer.
Thirteen YAs (ages 23-38) diagnosed with a stage III or IV cancer were recruited throughout the eastern and southeastern United States. Participants completed one semi-structured interview in-person, by phone, or Skype, that incorporated an original timeline instrument assessing fluctuations in hope and an online socio-demographic survey. Glaser's grounded theory methodology informed constant comparative methods of data collection, analysis, and interpretation.
Findings from this study informed the development of the novel contingent hope theoretical framework, which describes the pattern of psychosocial behaviors YAs with advanced cancer employ to reconcile identities and strive for a life of meaning. The ability to cultivate the necessary agency and pathways to reconcile identities became contingent on the YAs' participation in each of the psychosocial processes of the contingent hope theoretical framework: navigating uncertainty, feeling broken, disorienting grief, finding bearings, and identity reconciliation.
Study findings portray the influential role of hope in motivating YAs with advanced cancer through disorienting grief toward an integrated sense of self that marries cherished aspects of multiple identities. The contingent hope theoretical framework details psychosocial behaviors to inform assessments and interventions fostering hope and identity reconciliation.
青年期被诊断患有晚期癌症可能会使一个人的生活突然停止，这会引起人们对当下的关注，并对未来的不确定性感到痛苦。他们很少有时间或体力来关注前瞻性的、社会角色、人际关系或梦想。因此，患有晚期癌症的年轻人（YAs）经常会遇到存在主义的困扰、绝望，并质疑生活的意义。我们试图研究 YAs 在疾病过程中希望的意义和功能；辨别 YAs 用来培养希望的心理社会过程；并为诊断患有晚期癌症的 YAs 发展一个关于希望的实质性理论。
在美国东部和东南部各地招募了 13 名 YAs（年龄 23-38 岁），他们被诊断患有 III 或 IV 期癌症。参与者通过个人、电话或 Skype 完成了一次半结构化访谈，其中包括一个评估希望波动的原始时间表工具和一个在线社会人口统计学调查。格拉泽的扎根理论方法为数据收集、分析和解释的不断比较方法提供了信息。
这项研究的结果为发展新的有条件希望理论框架提供了信息，该框架描述了 YAs 患有晚期癌症时用来调和身份和争取有意义生活的心理社会行为模式。培养必要的机构和途径来调和身份的能力取决于 YAs 参与有条件希望理论框架的每个心理社会过程：驾驭不确定性、感觉破碎、迷失方向的悲伤、找到方向和身份和解。
研究结果描绘了希望在激励 YAs 患有晚期癌症方面的重要作用，通过使他们在迷失方向的悲伤中走向一个将多个身份的珍贵方面融合在一起的自我意识。有条件希望理论框架详细说明了心理社会行为，以告知评估和干预措施，促进希望和身份和解。
