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当癌症成为自我:血液病癌症患者身份体验的阐释性描述。

When Cancer Is the Self: An Interpretive Description of the Experience of Identity by Hematology Cancer Patients.

机构信息

Author Affiliations: Faculty of Health Disciplines, Athabasca University, Alberta, Canada (Dr Stephens); and School of Nursing, University of British Columbia, Vancouver, Canada (Dr Thorne).

出版信息

Cancer Nurs. 2022;45(2):E504-E513. doi: 10.1097/NCC.0000000000000984.

Abstract

BACKGROUND

The term "cancer" is imbued with identity signals that trigger certain assumed sociocultural responses. Clinical practice with hematological cancer patients suggests the experience of these patients may be different than that of solid tumor cancer patients.

OBJECTIVE

We sought to explore the research question: How are identity experiences described and elucidated by adult hematological cancer patients?

METHODS

This qualitative study was guided by interpretive description as the methodological framework.

RESULTS

Preexisting identity labels and assumptions assigned to the overarching "cancer" diagnosis were viewed by patients as entirely inadequate to fully describe and inform their experience. Instead, findings revealed the propensity of adult hematology oncology patients to co-create and enact new identities increasingly reflective of the nonlocalized nature of their cancer subtype. Three themes that arose from the data included the unique cancer-self, the invasion of cancer opposed to self, and the personification of the cancer within self.

CONCLUSIONS

Hematology oncology patients experience and claim a postdiagnosis identity that is self-described as distinct and highly specialized, and are distinct to solid tumor patients in aspects of systemic and total consumption of the self. This uniqueness is extended to the specific hematological cancer subtype down to genetics, indicating a strong "new" sense of self.

IMPLICATIONS FOR PRACTICE

The manner in which hematology oncology patients in this study embraced notions of transformed self and isolating uniqueness provides practitioners with a lens through which new and innovative interventions can be constructed to improve patient care and psychosocial outcomes.

摘要

背景

“癌症”一词带有身份信号,会引发某些既定的社会文化反应。对血液癌症患者的临床实践表明,这些患者的体验可能与实体瘤癌症患者不同。

目的

我们试图探讨研究问题:成人血液癌症患者如何描述和阐明其身份体验?

方法

本定性研究以解释性描述为方法论框架。

结果

患者认为,预先存在的身份标签和对总体“癌症”诊断的假设完全不足以充分描述和告知他们的体验。相反,研究结果揭示了成人血液肿瘤患者倾向于共同创造和实施新的身份认同,这些新的身份认同越来越能反映他们癌症亚型的非局部性质。从数据中出现了三个主题,包括独特的癌症自我、癌症对自我的入侵,以及自我内部的癌症人格化。

结论

血液肿瘤患者体验并声称自己具有一种独特的、高度专业化的诊断后身份,与实体瘤患者在自我的系统性和全面消耗方面存在明显差异。这种独特性延伸到特定的血液学癌症亚型,甚至延伸到遗传学,表明了强烈的“新”自我意识。

对实践的影响

本研究中血液肿瘤患者对自我转变和孤立独特性的观念的接受方式,为从业者提供了一个视角,可以通过这个视角构建新的创新干预措施,以改善患者的护理和心理社会结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6c8/8849130/40846dadb0e0/cn-45-e504-g001.jpg

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