Kosir Urska, Bowes Lucy, Taylor Rachel M, Gerrand Craig, Windsor Rachael, Onasanya Maria, Martins Ana
Department of Experimental Psychology, Oxford University, Oxford, Oxfordshire, UK
Department of Experimental Psychology, Oxford University, Oxford, Oxfordshire, UK.
BMJ Open. 2020 Nov 23;10(11):e038799. doi: 10.1136/bmjopen-2020-038799.
This study explored factors that play a role in psychological adaptation and recovery of young people with sarcoma.
Qualitative study.
National Health Service hospitals in the UK.
Using purposive sampling, participants were recruited for semistructured interviews over the telephone or face to face in order to answer questions about how cancer impacted various domains of their life. Data were analysed using a framework approach.
Thirty participants, aged 15-39 years with primary sarcoma diagnosis provided in-depth accounts of their experience. Emerging themes from the interviews were grouped into two overarching themes that relate to one's adaptation to illness: individual level and environmental level. The qualitative nature of our study sheds light on meaningful connections between various factors and their role in one's psychological adaptation to sarcoma. We devised a visual matrix to illustrate how risk and protective factors in adaptation vary between and within individuals.
This study demonstrates that young people with sarcoma report an array of both positive and negative factors related to their illness experience. The route to recovery is a multifactorial process and a one-size-fits-all approach to psychosocial care proves inadequate. We propose that moving beyond the latent constructs of resilience and psychopathology towards a dynamic model of psychological adaptation and recovery in this population can result in optimisation of care. We offer some recommendations for professionals working with young people with sarcoma in clinic and research.
本研究探讨了在肉瘤青年患者心理适应和康复过程中发挥作用的因素。
定性研究。
英国国民健康服务体系医院。
采用目的抽样法，通过电话或面对面方式招募参与者进行半结构化访谈，以回答癌症如何影响其生活各个领域的问题。采用框架分析法对数据进行分析。
30名年龄在15 - 39岁、被诊断为原发性肉瘤的参与者深入讲述了他们的经历。访谈中出现的新主题被归纳为与个体疾病适应相关的两个总体主题：个体层面和环境层面。我们研究的定性性质揭示了各种因素之间有意义的联系及其在个体对肉瘤心理适应中的作用。我们设计了一个可视化矩阵来说明适应过程中的风险和保护因素在个体之间以及个体内部是如何变化的。
本研究表明，肉瘤青年患者报告了一系列与他们疾病经历相关的积极和消极因素。康复之路是一个多因素过程，一刀切的心理社会护理方法被证明是不够的。我们建议，在这一人群中，从复原力和精神病理学的潜在结构转向心理适应和康复的动态模型，可实现护理的优化。我们为在临床和研究中与肉瘤青年患者打交道的专业人员提供了一些建议。
