Sufian Sandy, Mueller Rebecca, Langfelder-Schwind Elinor, Caldwell Katherine, Brown Georgia, Ruben Molly, Mody Sheila, Walker Patricia, Godfrey Emily
University of Illinois at Chicago, United States.
University of Pennsylvania, United States.
SSM Qual Res Health. 2024 Jun;5. doi: 10.1016/j.ssmqr.2024.100412. Epub 2024 Feb 24.
This article offers the case of cystic fibrosis (CF), a multi-system disease, to illustrate how individuals with chronic illness cultivate and apply embodied knowledge to optimize their well-being. We identified three interrelated processes that occur when disease chronicity and menstrual cyclicity meet: 1) knowledge production with a period-tracking app; 2) application of embodied knowledge to manage life with menstrual-related CF symptoms; 3) cultivation of the body-self as a menstruating woman with CF. These dynamic processes capture how cis-gender women with CF attune to their bodies, navigate their illness, and situate themselves within their lifeworlds. Genetic conditions like CF are apt for studying these processes because adults have managed their disease for decades, with longitudinal experience that often exceeds that of their clinicians. Our evidence elucidates the co-constitutive nature of chronic disease, gendered subjectivity, and biological processes in flux. We explored the menstrual cyclicity of chronic disease symptoms by having 72 participants track their CF symptoms across 4 menstrual cycles on a customized period-tracking app. We performed semi-structured interviews with 20 participants to understand how they interpreted these cyclical CF symptoms. We learned that digital tracking attuned participants to monthly fluctuations in CF symptoms. They applied this knowledge to manage their lives and shape their sense of self. We argue that women with CF produce distinct embodied knowledge during their reproductive years, shaping their illness experience, disease management, overall health, quality of life, and selfhood. The dynamics we describe may reflect broader patterns by which women with other chronic illnesses experience their bodies and understand themselves in the world.
本文以多系统疾病囊性纤维化(CF)为例,来说明慢性病患者如何培养和运用身体知识来优化自身健康状况。我们确定了疾病慢性化与月经周期相遇时会出现的三个相互关联的过程:1)使用经期追踪应用程序进行知识生成;2)运用身体知识来应对与月经相关的CF症状以管理生活;3)将身体自我培养成患有CF的经期女性。这些动态过程展现了患有CF的顺性别女性如何感知自己的身体、应对疾病以及在其生活世界中定位自己。像CF这样的遗传性疾病适合研究这些过程,因为成年人已经管理自己的疾病数十年,其纵向经验往往超过临床医生。我们的证据阐明了慢性病、性别化主体性和不断变化的生物过程的共同构成性质。我们通过让72名参与者在一款定制的经期追踪应用程序上记录他们在4个月经周期内的CF症状,来探究慢性病症状的月经周期。我们对20名参与者进行了半结构化访谈,以了解他们如何解读这些周期性的CF症状。我们了解到,数字追踪使参与者能够感知CF症状的月度波动。他们运用这些知识来管理自己的生活并塑造自我认知。我们认为,患有CF的女性在其生育年限会产生独特的身体知识,塑造她们的疾病体验、疾病管理、整体健康、生活质量和自我身份。我们所描述的动态过程可能反映了患有其他慢性病的女性体验自己身体并在世界中理解自我的更广泛模式。