Klitzman Robert
Bioethics Program, Columbia University, New York, NY, USA.
SSM Ment Health. 2023 Dec;3. doi: 10.1016/j.ssmmh.2023.100218. Epub 2023 May 4.
Patients often ask, "why me?" but questions arise regarding what this statement means, how, when and why patients ask, how they answer and why. Interviews were conducted as part of several qualitative research studies exploring how patients view and cope with various conditions, including HIV, cancer, Huntington's disease and infertility. A secondary qualitative analysis was performed. Many patients ask, "why me?" but this statement emerges as having varying meanings, and entailing complex psychosocial processes. Patients commonly recognize that this question may lack a clear answer and that asking it is irrational, but they ask nonetheless, given the roles of unknown factors and chance in disease causation, psychological stresses of illness and lack of definitive answers. Patients may focus on different aspects of the question - e.g., on possible of illness ( me? - whether God or randomness is involved) and/or on whether they are being (Why vs. someone else?). Patients frequently undergo , confronting this question at various points, and arriving at different answers, looking for explanations that have for them, and make sense to them emotionally. Social contexts can affect these processes, with friends, family, providers or others rejecting or accepting patients' responses to this question (e.g., beliefs about whether the patient is being punished and/or these questions are worth asking). Anger, depression, despair and/or resistance to notions about the roles of randomness or chaos can also shape these processes. While prior studies have each operationalized "why me?" in differing ways, focusing on varying aspects of it, the concept emerges here as highly multidimensional, involving complex processes and often affected by social contexts. These data, the first to examine key aspects and meanings of the phrase, "why me?" have critical implications for future practice, research and education.
“为什么是我?”但关于这句话的含义、患者提问的方式、时间、原因、回答方式及原因等问题随之而来。作为几项定性研究的一部分,开展了访谈,以探究患者如何看待和应对各种病症,包括艾滋病毒、癌症、亨廷顿舞蹈症和不孕症。进行了二次定性分析。许多患者会问:“为什么是我?”但这句话有着不同的含义,涉及复杂的心理社会过程。患者通常认识到这个问题可能没有明确答案,提问也不合理,但鉴于未知因素和机遇在疾病成因中的作用、疾病带来的心理压力以及缺乏确切答案,他们仍然会问。患者可能会关注问题的不同方面,例如疾病的可能性(为什么是我?——是上帝的旨意还是随机事件)和/或他们是否受到惩罚(为什么是我而不是别人?)。患者经常经历挣扎,在不同阶段面对这个问题,并得出不同答案,寻找对他们有意义且在情感上说得通的解释。社会环境会影响这些过程,朋友、家人、医护人员或其他人会拒绝或接受患者对这个问题的回答(例如,关于患者是否受到惩罚以及这些问题是否值得一问的看法)。愤怒、抑郁、绝望和/或对随机或混乱作用观念的抵触也会影响这些过程。虽然先前的研究对“为什么是我?”的定义各不相同,关注的方面也有所不同,但在此处这个概念呈现出高度的多维度性,涉及复杂的过程,且常常受到社会环境的影响。这些首次审视“为什么是我?”这一短语关键方面和含义的数据,对未来的实践、研究和教育具有至关重要的意义。