Department of People and Technology, Roskilde University, Roskilde, Denmark.
Department of Cardiothoracic Surgery, Copenhagen University Hospital, Copenhagen, Denmark.
Eur J Cancer Care (Engl). 2022 Sep;31(5):e13633. doi: 10.1111/ecc.13633. Epub 2022 Jun 13.
Patients with operable lung cancer experience physical and psychosocial challenges early in their treatment trajectory. However, these patients have unmet needs for a dialogue with clinicians and report that especially psychosocial challenges are not addressed in the clinical encounter. Aiming to understand the reasons for this, this study explores dominant narratives about operable lung cancer.
An ethnographic study was conducted at a Danish hospital providing surgery for lung cancer. Interactions between patients, relatives and clinicians were observed during hospitalisation. Ten patients were included from September 2019 to March 2020.
One overarching dominant narrative of 'being lucky' was found, supported by three narrative subthemes, related to different aspects of the treatment. First, the possibility of surgical treatment was 'like winning the lottery'. Second, surgery was a minor intervention like 'a quiet day at the office'. Third, even if adjuvant chemotherapy was necessary, as long as the surgery went well, it was 'good news' in the outpatient clinic.
'Being lucky' is a dominant restitution narrative about operable lung cancer. A predominance of restitution narratives implies that clinicians are the active party, while patients remain passive, which limits their perspective and thus silences their concerns unrelated to curative treatment.
可手术肺癌患者在治疗早期会经历身体和心理社会方面的挑战。然而，这些患者需要与临床医生进行对话，但他们的需求未得到满足，他们报告说，特别是心理社会方面的挑战在临床接触中没有得到解决。为了了解其中的原因，本研究探讨了关于可手术肺癌的主导叙事。
在丹麦一家提供肺癌手术的医院进行了一项民族志研究。观察了住院期间患者、家属和临床医生之间的互动。2019 年 9 月至 2020 年 3 月期间纳入了 10 名患者。
发现了一个主导的叙事“幸运”，由三个与治疗不同方面相关的叙事子主题来支撑。首先，手术治疗的可能性“就像中彩票一样”。其次，手术是一种“像在办公室度过安静的一天”一样的小干预。第三，即使需要辅助化疗，只要手术顺利，在门诊就是“好消息”。
“幸运”是一个关于可手术肺癌的主导恢复性叙事。恢复性叙事的主导地位意味着临床医生是积极的一方，而患者则保持被动，这限制了他们的视角，从而使他们的关注与治疗无关的问题沉默不语。
