de Souza Institute, Toronto, ON M5T 1V4, Canada.
Department of Psychiatry, Faculty or Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada.
Medicina (Kaunas). 2021 Oct 27;57(11):1168. doi: 10.3390/medicina57111168.
: Individuals with cancer, especially advanced cancer, are faced with numerous difficulties associated with the disease, including an earlier death than expected. Those who are able to confront and accept the hardships associated with the disease in a way that aligns with their beliefs benefit from more positive psychological outcomes compared to those who are aware of their diagnosis but are unable to accept it. To date, there is limited research exploring factors contributing to illness and death acceptance in the context of advanced cancer in group therapy settings. : The current study used a Directed Content Analysis approach on transcripts of online advanced cancer support groups to investigate if and how Yalom's existential factors played a role in the emergence of acceptance. : The online support group platform, combined with the help of facilitators, offered supportive environments for individuals seeking help with cancer-related distress by helping patients move towards acceptance. Some participants had already begun the process of accepting their diagnosis before joining the group, others developed acceptance during the group process, while a few continued to be distressed. Our analysis revealed the emergence of four themes related to illness acceptance: (1) Facilitator-Initiated Discussion, including sub-themes of Mindfulness, Relaxation and Imagery, Changing Ways of Thinking, and Spirituality; (2) Personal attitudes, including sub-themes of Optimism and Letting Go of Control; (3) Supportive Environment, including the sub-themes of Providing Support to Others and Receiving Support from Others; and (4) Existential Experience, which included sub-themes of Living with the Diagnosis for an Extended Amount of Time, Legacy and Death Preparations, and Appreciating life. : With a paradigm shift to online delivery of psychological services, recognizing factors that contribute to acceptance when dealing with advanced cancer may help inform clinical practices. Future studies should explore patient acceptance longitudinally to inform whether it emerges progressively, which has been suggested by Kübler-Ross.
癌症患者，尤其是晚期癌症患者，面临着与疾病相关的诸多困难，包括比预期更早的死亡。那些能够以符合自己信仰的方式面对和接受与疾病相关的困难的人，与那些意识到自己的诊断但无法接受的人相比，会有更积极的心理结果。迄今为止，在团体治疗环境中，针对晚期癌症患者的疾病和死亡接受度的影响因素的研究还很有限。
本研究采用定向内容分析法，对在线晚期癌症支持小组的转录本进行分析，以探讨在这种情况下，是否以及如何出现了亚隆的存在主义因素，并对其进行分析。
在线支持小组平台，加上辅导员的帮助，为那些寻求癌症相关困扰帮助的人提供了支持性的环境，帮助患者走向接受。一些参与者在加入小组之前就已经开始接受诊断，另一些参与者在小组过程中发展出接受，而少数人则继续感到困扰。我们的分析揭示了与疾病接受相关的四个主题的出现：（1）辅导员发起的讨论，包括正念、放松和意象、改变思维方式和灵性等子主题；（2）个人态度，包括乐观和放弃控制等子主题；（3）支持性环境，包括向他人提供支持和从他人那里获得支持等子主题；（4）存在体验，包括长时间接受诊断、遗产和死亡准备以及欣赏生活等子主题。
随着心理服务向在线交付的范式转变，认识到在处理晚期癌症时有助于接受的因素，可能有助于为临床实践提供信息。未来的研究应该从纵向角度探讨患者的接受度，以了解它是否如库伯勒-罗斯所建议的那样逐渐出现。
