Devlieger P, Piachaud J, Leung P, George N
University of Illinois at Urbana-Champaign 61801.
Int J Rehabil Res. 1994 Sep;17(3):251-64. doi: 10.1097/00004356-199409000-00006.
In this article, the experiences of persons with epilepsy were explored in terms of coping with providing a basis of discussion and training to support groups, particularly in Zimbabwe. Coping mechanisms lay stress upon the individual's control in mastering the disease. It was assumed that a systematic research effort of intra-cultural and cross-cultural sharing of experiences could enhance discussion and training in the support groups. Coping with epilepsy was explored with 37 adults (27 from Zimbabwe and 10 from the Midwest, USA) using open-ended questions in a written questionnaire. Questions aimed to elicit general feelings, experiences and strategies and skills in coping with epilepsy. The questionnaire covered such semantic domains as childhood, education, employment, friendships, relations within the family, and handling of seizures in public places. Coping mechanisms were categorized into two modes, one, adjustment to the disability (palliative), the other adjustment to the environment (problem-solving). In comparing the information between the two groups, some trends can be distinguished which need a larger scale validation. First, palliative skills during childhood in the Zimbabwean group is indicative for early development of personality characteristics and socialization as a result of the illness experiences. A great variety in palliative mechanisms in handling seizures indicates better familiarity with seizures in the Midwestern group. Similarities between the two groups are found in the friendship domain, where palliative coping skills seem to be of no importance, as well as in the domain of intimate relations, where a trend in adherence to medication is observed in both groups. Second, many problem-solving skills are developed in both groups but vary in context. In view of public education and training activities and the enhancement of problem-solving skills, the domain of education for the Zimbabwean group and the domains of friendship with the Midwestern group and the family perhaps deserve more attention. Third, coping skills in the Zimbabwean group tend to be related to the experience of 'being different', while in the Midwestern group 'not being able to doing things' is a major experience. Fourth, in linking coping mechanisms to the cultural environment, two major cultural influences in Zimbabwe stand out as being different from the Midwest, the first being the belief in external control and cause of mental and physical health, and the second, cultural conflict.
在本文中，对癫痫患者应对疾病的经历进行了探讨，旨在为支持小组提供讨论和培训的基础，特别是在津巴布韦。应对机制强调个人对疾病的掌控。假定通过系统的文化内和跨文化经验分享研究，可以加强支持小组中的讨论和培训。采用书面问卷中的开放式问题，对37名成年人（27名来自津巴布韦，10名来自美国中西部）应对癫痫的情况进行了调查。问题旨在引出应对癫痫的一般感受、经历以及策略和技能。问卷涵盖了童年、教育、就业、友谊、家庭关系以及在公共场所应对癫痫发作等语义领域。应对机制分为两种模式，一种是对残疾的调适（姑息性），另一种是对环境的调适（解决问题）。在比较两组信息时，可以区分出一些趋势，但需要更大规模的验证。首先，津巴布韦组童年时期的姑息性技能表明，由于患病经历，其人格特征和社会化发展较早。美国中西部组在处理癫痫发作时采用的姑息性机制种类繁多，表明他们对癫痫发作更为熟悉。两组在友谊领域存在相似之处，在该领域姑息性应对技能似乎并不重要；在亲密关系领域也存在相似之处，两组都有坚持服药的趋势。其次，两组都发展出了许多解决问题的技能，但背景有所不同。鉴于公共教育和培训活动以及解决问题技能的提升，津巴布韦组的教育领域、美国中西部组的友谊领域以及家庭领域可能值得更多关注。第三，津巴布韦组的应对技能往往与“与众不同”的经历相关，而在美国中西部组，“无法做事”是主要经历。第四，在将应对机制与文化环境联系起来时，津巴布韦有两种主要文化影响与美国中西部不同，第一种是对身心健康的外部控制和病因的信仰，第二种是文化冲突。
