School of Nursing, University of British Columbia, Vancouver, BC, Canada.
Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Qual Health Res. 2023 Apr;33(5):412-425. doi: 10.1177/10497323231158629. Epub 2023 Feb 24.
In cancer care, gaps in support to help patients manage and live with the side-effects from cancer treatments have increased the emphasis on empowering patients to be more active and involved in managing their own health. However, empowerment in relation to promoting self-management behaviors is not well understood. Using the social constructivist grounded theory approach, our goal was to develop a theoretical understanding of this phenomenon in relation to the self-management behaviors of post-treatment cancer patients. Twenty-two post-treatment cancer patients participated in a semi-structured focused interview to co-construct with us how empowerment is defined, described, and experienced in relation to their capacity to self-manage. Through this co-construction, we defined empowerment as a process of personal growth, a display of fortitude and strength when participants confronted the impact of their illness that emerged in two dynamic and paradoxical ways: 1) establishing control over the impact of the illness as a means to maintain normalcy and to circumvent change over an eroding and changing sense of self and 2) relinquishing control over aspects of the illness deemed irrepressible and acknowledging and accepting change. When successful at establishing and/or relinquishing control, participants no longer viewed cancer as a threat, but re-interpreted their illness as also having a beneficial "empowering" experience and more capable of managing. Findings will guide the development of self-management interventions that use empowerment as a core construct.
在癌症护理中，帮助患者管理和应对癌症治疗副作用的支持方面存在差距，这使得人们更加重视赋予患者更多自主权，让他们更积极主动地参与自身健康管理。然而，关于促进自我管理行为的赋权问题，人们的理解还不够充分。本研究采用社会建构主义扎根理论方法，旨在从理论上深入了解治疗后癌症患者的自我管理行为与赋权之间的关系。22 名治疗后癌症患者参与了半结构化焦点访谈，与我们共同构建了赋权的定义、描述和体验，以及他们自我管理能力的相关内容。通过这种共同构建，我们将赋权定义为一个个人成长的过程，当参与者面对疾病的影响时，表现出坚韧和力量，这种影响以两种动态和矛盾的方式出现：1）通过控制疾病的影响来维持常态，并避免自我和不断变化的感觉发生变化；2）放弃对疾病不可控制部分的控制，并承认和接受变化。当参与者成功地建立或放弃控制时，他们不再将癌症视为威胁，而是将疾病重新解释为也具有有益的“赋权”体验，从而更有能力进行管理。研究结果将为以赋权为核心构建的自我管理干预措施的发展提供指导。
