School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
Qual Life Res. 2023 Mar;32(3):681-690. doi: 10.1007/s11136-022-03242-8. Epub 2022 Sep 1.
Resilience is a positive outcome in giving individuals strength to adapt to cancer and have better various aspects of health-related quality of life. However, research focusing on resilience in relation to colorectal cancer (CRC) is limited. Therefore, the aim of this study was to explore the process of resilience in individuals with CRC.
Sixteen individuals diagnosed with stage Ι to III CRC within the last five years were recruited from a CRC surgical outpatient department in a medical center in Northern Taiwan. Semi-structured interviews were used to explore the resilience process of living with CRC. Recorded interviews were transcribed verbatim and were analyzed using modified grounded theory.
Resilience is a dynamic three-phase process, including impact of CRC, adaptation or maladaptation following CRC, and growth from CRC experience. Resilience strategies (i.e., attitude adjustment, developing personal strategies to conquer CRC and side effects, setting new goals in life, and viewing death as a normal process), avoidance behaviors, and passive waiting strategy were shown across the resilience process.
All individuals showed negative impacts during CRC diagnosis and treatments, but some individuals used the resilience strategies in helping to promote positive adjustment and redirect to develop their resilience process. Furthermore, resilient and maladaptive individuals may change the situation depending on which strategies are used and on the progression of CRC because resilience is dynamic. Oncology clinicians should help individuals use resilience strategies to smoothly go through the resilience process.
韧性是一种积极的结果,可以赋予个体力量,帮助他们适应癌症,并改善与健康相关的生活质量的各个方面。然而,关于结直肠癌(CRC)与韧性相关的研究有限。因此,本研究的目的是探讨 CRC 个体的韧性发展过程。
从台湾北部一家医疗中心的 CRC 外科门诊招募了 16 名在过去五年内被诊断为 I 期至 III 期 CRC 的个体。采用半结构式访谈来探索他们在结直肠癌生存过程中的韧性发展过程。记录的访谈内容逐字转录,并使用修正后的扎根理论进行分析。
韧性是一个动态的三阶段过程,包括 CRC 的影响、CRC 后的适应或不适应,以及从 CRC 经历中成长。韧性策略(即,调整态度、制定个人策略来克服 CRC 和副作用、设定新的生活目标,以及将死亡视为正常过程)、回避行为和被动等待策略贯穿整个韧性发展过程。
所有个体在 CRC 诊断和治疗期间都表现出负面影响,但一些个体使用了韧性策略来帮助促进积极的调整,并重新定向以发展他们的韧性过程。此外,由于韧性是动态的,因此具有韧性和适应性差的个体可能会根据所使用的策略以及 CRC 的进展情况而改变情况。肿瘤临床医生应该帮助个体使用韧性策略,顺利地经历韧性发展过程。