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从疾病中重塑自我:克罗恩病患者创伤后成长的建构主义扎根理论研究。

Reconstructing self from the illness: a constructivist grounded theory study of posttraumatic growth in patients with Crohn's disease.

机构信息

School of Nursing, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang, China.

出版信息

BMC Gastroenterol. 2023 Jul 18;23(1):244. doi: 10.1186/s12876-023-02878-1.

Abstract

BACKGROUND

Some patients with Crohn's disease report posttraumatic growth, which can promote reductions in anxiety and depression, and improve the patient's quality of life. However, the process of posttraumatic growth remains unclear. The objectives of this study were to explore the social-psychological process of posttraumatic growth in patients with Crohn's disease in the context of Chinese culture and construct an interpretive understanding based on the perspectives of patients.

METHODS

This research adopted Charmaz's constructivist grounded theory. Nineteen participants with Crohn's disease were selected by purposive and theoretical sampling from three hospitals in Hangzhou, Zhejiang Province, as well as from the China Crohn's & Colitis Foundation. In-depth interviews were conducted. Data analysis was based on initial, focused and theoretical coding strategies, and methods such as constant comparison and memo writing were adopted. The Consolidated Criteria for Reporting Qualitative Research, a 32-item checklist for interviews and focus groups, was utilised.

RESULTS

An interpretive understanding of posttraumatic growth in patients with Crohn's disease was constructed. The core category was "reconstructing self from the illness", which included the following four categories: "suffering from the illness", "accepting the illness", "dancing with the illness" and "enriching life beyond the illness". However, not every patient reached the last phase. Before patients enter the next stage, they might begin a new cycle by experiencing new suffering or discovering new unacceptable facts about the illness.

CONCLUSIONS

This interpretive understanding reveals a growth process centred on "reconstructing self from the illness". These findings provide knowledge on the process of posttraumatic growth in patients with Crohn's disease within the wider sociocultural context.

摘要

背景

一些克罗恩病患者报告创伤后成长,这可以促进焦虑和抑郁的减少,并提高患者的生活质量。然而,创伤后成长的过程尚不清楚。本研究的目的是探索中国文化背景下克罗恩病患者创伤后成长的社会心理过程,并基于患者的观点构建解释性理解。

方法

本研究采用 Charmaz 的建构主义扎根理论。通过目的性和理论性抽样,从浙江省杭州市的三家医院以及中国克罗恩病与结肠炎基金会中选择了 19 名克罗恩病患者作为参与者。进行了深入访谈。数据分析基于初始、聚焦和理论编码策略,并采用了恒比比较和备忘录写作等方法。采用了 32 项清单的“定性研究报告统一标准”,用于访谈和焦点小组。

结果

构建了克罗恩病患者创伤后成长的解释性理解。核心类别是“从疾病中重建自我”,包括以下四个类别:“疾病的痛苦”、“接受疾病”、“与疾病共舞”和“超越疾病丰富生活”。然而,并非每个患者都能达到最后一个阶段。在患者进入下一个阶段之前,他们可能会因为经历新的痛苦或发现疾病的新的不可接受的事实而开始新的循环。

结论

这种解释性理解揭示了一个以“从疾病中重建自我”为中心的成长过程。这些发现为在更广泛的社会文化背景下了解克罗恩病患者创伤后成长的过程提供了知识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80a1/10354879/0fe5a4194ff3/12876_2023_2878_Fig1_HTML.jpg

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