Aromaa Eeva, Eriksson Päivi, Koskinen Satu
Business School, University of Eastern Finland, Kuopio, Finland.
Free Researcher, Entrepreneur at Boardcoach, Joensuu, Finland.
Qual Health Res. 2025 Jun;35(7):793-806. doi: 10.1177/10497323241285959. Epub 2024 Oct 18.
Through collaborative autoethnography, we studied shifts in cancer patients' sense of agency and the meaning of cancer during the diagnostic and treatment phases. This article contributes to the illness management literature by adopting sense of agency perspective that provides new understanding of retrospective interpretation of cancer patients' agency. The authors' experiences of receiving cancer diagnoses and a related, collectively written story illustrate how relational and contextual elements facilitate rapid shifts in cancer patients' sense of agency and illness management. The findings illustrate shifts in the sense of agency as a collaborative and reflexive process between cognitive, emotional, and bodily constraints and adjustments. We demonstrate how shifts in patients' sense of agency and respective changes in meanings attached to cancer were shaped by near ones, healthcare actors, and other cancer patients, as well as the COVID-19 pandemic and the fear of military conflict due to Finland neighbor Russia's war on Ukraine. Furthermore, the study illustrates how shifts in sense of agency shape and are shaped by changes in the understanding of cancer as either a secondary issue, ambiguous stranger, travel companion, or enemy.
通过合作自我民族志，我们研究了癌症患者在诊断和治疗阶段能动性意识的转变以及癌症的意义。本文通过采用能动性意识视角为疾病管理文献做出了贡献，该视角为癌症患者能动性的回顾性解读提供了新的理解。作者们接受癌症诊断的经历以及一个共同撰写的相关故事，说明了关系和背景因素如何促进癌症患者能动性意识和疾病管理的快速转变。研究结果表明，能动性意识的转变是认知、情感和身体限制与调整之间的一个合作性和反思性过程。我们展示了患者能动性意识的转变以及赋予癌症的相应意义变化是如何受到亲人、医疗保健人员、其他癌症患者，以及新冠疫情和因芬兰邻国俄罗斯对乌克兰的战争而产生的军事冲突恐惧的影响。此外，该研究还说明了能动性意识的转变如何塑造了对癌症的理解，以及如何被对癌症理解的变化所塑造，这种理解将癌症视为次要问题、模糊的陌生人、旅行伙伴或敌人。
