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化疗、时钟与死亡意识:一项定量现象学研究。

Chemotherapy, clocks, and the awareness of death: A quantitative phenomenological study.

作者信息

Moskalewicz Marcin, Kordel Piotr, Wiertlewska-Bielarz Jadwiga

机构信息

Phenomenological Psychopathology and Psychotherapy, Psychiatric Clinic, University of Heidelberg, Heidelberg, Germany.

Philosophy of Mental Health Unit, Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Poznań, Poland.

出版信息

Front Psychol. 2023 Mar 14;14:1097928. doi: 10.3389/fpsyg.2023.1097928. eCollection 2023.

Abstract

Following a previous phenomenological study of lived time in ovarian cancer, this research aims to find how the frequency of chemotherapy affects orientation in time (the so-called "chemo-clock") and the awareness of mortality of service users with various cancers. For this purpose, a variation of a front-loaded phenomenological method that combines scientific hypothesis testing with phenomenological insights of both conceptual and qualitative nature was developed. The study is based on a purposive quota sample of 440 participants representative of the Polish cancer population in terms of sex (m:f ratio 1:1) and age ( > 65 = 61%; > 65 = 53%) and undergoing chemotherapy for at least a month. The exposure environmental factors of interest are temporal: the frequency of chemotherapy [weekly ( = 150), biweekly ( = 146), and triweekly ( = 144)] and time since the beginning of treatment. The study confirms the relevance of the "chemo-clock"-participants use the pace of hospital appointments for orientation in time, and significantly more often when in triweekly treatments (weekly 38%; biweekly 61%; triweekly 69.4%; V = 0.242, < 0.001, while neither age nor time since the beginning of treatment differentiate the usage of calendar categories and the "chemo-clock"). Simultaneously, chemotherapy increases their awareness of finitude, which again correlates neither with age nor time since the beginning of treatment but is significantly stronger in those with lower chemotherapy frequencies. Lower treatment frequencies are thus associated with its increased significance in terms of its impact on how people with cancer measure time and whether they increasingly consider their mortality.

摘要

在先前一项关于卵巢癌患者生存时间的现象学研究之后,本研究旨在探究化疗频率如何影响时间定向(即所谓的“化疗时钟”)以及各类癌症患者对死亡的认知。为此,开发了一种前馈现象学方法的变体,该方法将科学假设检验与概念性和质性的现象学见解相结合。本研究基于一个有目的的配额样本,共440名参与者,他们在性别(男:女比例为1:1)和年龄(>65岁 = 61%;≤65岁 = 53%)方面代表了波兰癌症患者群体,且接受化疗至少一个月。感兴趣的暴露环境因素是时间性的:化疗频率[每周一次(n = 150)、每两周一次(n = 146)和每三周一次(n = 144)]以及治疗开始后的时间。该研究证实了“化疗时钟”的相关性——参与者利用医院预约的节奏进行时间定向,在每三周一次的治疗中这种情况显著更常见(每周一次为38%;每两周一次为61%;每三周一次为69.4%;V = 0.242,p < 0.001,而年龄和治疗开始后的时间均未区分日历类别和“化疗时钟”的使用情况)。同时,化疗会增强他们对生命有限性的认知,这同样与年龄和治疗开始后的时间无关,但在化疗频率较低的患者中显著更强。因此,较低的治疗频率在其对癌症患者如何衡量时间以及他们是否越来越多地考虑自己的死亡率的影响方面,具有更大的重要性。

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The rhythm of chemotherapy and cancer patients' time perspectives.
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