Currin-McCulloch Jennifer, Kaushik Shivani, Jones Barbara
Author Affiliations: Colorado State University School of Social Work, Fort Collins (Dr Currin-McCulloch and Ms Kaushik); and University of Texas at Austin Steve Hicks School of Social Work (Dr Jones).
Cancer Nurs. 2022;45(2):E355-E363. doi: 10.1097/NCC.0000000000000977.
The diagnosis of an advanced cancer during young adulthood frequently entails the loss of confidence in physical function, as well as the certainty of achieving future social, vocational, and existential aspirations. These losses leave young adults with tenuous holds on facets of their life that foster hope and meaning.
The aim of this study was to explore the unique physical and psychosocial-spiritual losses and patterns of grief responses among young adults living with advanced cancer.
INTERVENTIONS/METHODS: Theoretical sampling led to the recruitment of 13 young adults, ages 23 to 38 years, diagnosed with stage III or IV cancer. Participants completed 1 semistructured interview, a timeline of pivotal moments throughout their illness, and a sociodemographic survey. Glaser's grounded theory methods informed the study design and analysis.
Young adults displayed patterns of disorienting grief, which left them bereft of almost all familiar facets of their pretrauma lives and identities. Disorienting physical and psychosocial-spiritual losses presented in the following subcategories: disorientation to all aspects of former life, lost identity, and isolation.
Findings from this study reveal a novel framework from which to interpret grief experiences among young adults living with advanced cancer.
The implementation of grief assessments and interventions during pivotal stages in young adults' cancer treatment and recovery may ameliorate psychological distress and normalize perceptions of life disruptions. Nursing education before treatment initiation and termination can reduce young adults' fears surrounding unfamiliar symptoms and prepare them for the physical and emotional uncertainties that often accompany remission or end-of-life.
在成年早期被诊断出患有晚期癌症，往往意味着对身体功能的信心丧失，以及对实现未来社会、职业和人生抱负的确定性丧失。这些损失使年轻成年人对生活中那些孕育希望和意义的方面把握得很脆弱。
本研究的目的是探讨晚期癌症年轻成年人独特的身体和心理社会精神损失以及悲伤反应模式。
干预措施/方法：理论抽样导致招募了13名年龄在23至38岁之间、被诊断为III期或IV期癌症的年轻成年人。参与者完成了1次半结构化访谈、一份贯穿其疾病过程的关键时刻时间表以及一项社会人口学调查。格拉泽的扎根理论方法为研究设计和分析提供了指导。
年轻成年人表现出令人迷失方向的悲伤模式，这使他们几乎失去了创伤前生活和身份的所有熟悉方面。令人迷失方向的身体和心理社会精神损失呈现为以下子类别：对以前生活各方面的迷失方向、身份丧失和孤立。
本研究结果揭示了一个新的框架，可据此解释晚期癌症年轻成年人的悲伤经历。
在年轻成年人癌症治疗和康复的关键阶段实施悲伤评估和干预措施，可能会减轻心理困扰，并使对生活干扰的认知正常化。在治疗开始和结束前进行护理教育，可以减少年轻成年人对不熟悉症状的恐惧，并使他们为缓解期或生命末期常常伴随的身体和情感不确定性做好准备。
