Fife B L
Indiana University School of Nursing, Center for Nursing Research, Indianapolis 46202, USA.
Soc Sci Med. 1995 Apr;40(8):1021-8. doi: 10.1016/0277-9536(94)00174-r.
A scale is presented that operationalizes the concept of meaning as it is constructed within the context of life-threatening illness. Development of the scale is based on a symbolic interactionist perspective. The reliability and validity of the scale are examined using a sample of 422 persons with a variety of types of cancer at specified points in the illness trajectory. The scale was found to have item-total correlations ranging from 0.50 to 0.73, all significant at P < 0.01, and a Cronbach's alpha of 0.81. A factor analysis indicated the total scale explained 57.3% of the variance. Evidence of the scale's validity was found in its ability to differentiate persons who were newly diagnosed as having non-metastatic cancer from those individuals experiencing the first recurrence of cancer and those with metastatic disease, as well as individuals experiencing a first remission from those experiencing a first recurrence or those with metastatic disease. In addition, using regression analysis meaning was found to be predicted by social support and specific coping strategies, and to be predictive of personal control, body image and psychological adjustment. A bi-directional relationship was demonstrated between the construction of meaning (primarily a cognitive phenomenon) and emotional response, which is congruent with the bi-directional relationship between cognition and emotion as proposed in the theory of Lazarus and Folkman.
本文提出了一种量表，该量表将意义的概念进行了操作化定义，此概念是在危及生命的疾病背景下构建的。该量表的开发基于象征互动主义视角。使用422名患有各种癌症的患者样本，在疾病轨迹的特定时间点对该量表的信效度进行了检验。结果发现，该量表的项目与总分的相关性在0.50至0.73之间，在P < 0.01时均具有显著性，克朗巴哈系数为0.81。因子分析表明，总量表解释了57.3%的方差。该量表效度的证据体现在其能够区分新诊断为非转移性癌症的患者与首次复发癌症的患者以及转移性疾病患者，还能区分首次缓解的患者与首次复发或患有转移性疾病的患者。此外，通过回归分析发现，社会支持和特定应对策略可以预测意义，意义又可以预测个人控制感、身体意象和心理调适。意义构建（主要是一种认知现象）与情绪反应之间呈现出双向关系，这与拉扎勒斯和福克曼理论中提出的认知与情绪之间的双向关系相一致。
