Hilton B A
University of British Columbia School of Nursing in Vancouver, Canada.
Oncol Nurs Forum. 1996 May;23(4):605-14.
To describe the process of normalization as it emerged from a study of families coping with early stage breast cancer.
Qualitative, grounded theory.
Fifty-five women newly diagnosed with early stage breast cancer and their families. Fifty-eight percent had lumpectomy, and the remainder had mastectomy. Some had no further treatment, but others received radiation, chemotherapy, or tamoxifen. Nineteen women had positive nodes.
Five semistructured family and couple interviews for each family from diagnosis to one year later.
Process of normalization, issues and challenges faced, and problems coping.
Getting back to normal, defined as a safe, desirable, and stable state, was important for these families. Strategies used to get back to normal included seeing their families as normal, maintaining or returning to usual patterns quickly, minimizing disruptiveness, deemphasizing sick role demands, reframing negatives, and putting the cancer behind them. Factors influencing the process were family perspective of cancer, visibility or disruptiveness of symptoms of and treatments for cancer, family flexibility, experience with illness, life stage, and congruency of views.
Families who adjust more easily view changes from normal as temporary, are flexible, see themselves as normal given the demands of their situation, share similar views, experience less major disruption or intrusiveness from treatments and their side effects, and appropriately use strategies to get back to normal.
Study findings emphasize the importance of maintaining normal routines as much as possible and getting back to normal quickly. Nurses must accurately assess family coping to identify those having difficulty and those at risk for difficulty. Nurses can support families' efforts to be normal and get back to normal by providing information about what is generally expected and what resources are available that might be helpful. Nurses need to be accessible to provide counseling and/or refer as needed.
描述从一项关于应对早期乳腺癌家庭的研究中得出的正常化过程。
定性的扎根理论研究。
55名新诊断为早期乳腺癌的女性及其家人。58%的患者接受了乳房肿瘤切除术，其余患者接受了乳房切除术。一些患者没有接受进一步治疗，但其他患者接受了放疗、化疗或他莫昔芬治疗。19名女性有阳性淋巴结。
对每个家庭从确诊到一年后进行五次半结构化的家庭及夫妻访谈。
正常化过程、面临的问题和挑战以及应对问题。
恢复到正常状态，即一种安全、理想且稳定的状态，对这些家庭来说很重要。恢复正常的策略包括将家庭视为正常状态、迅速维持或回归日常模式、尽量减少干扰、淡化患病角色要求、重新诠释负面因素以及将癌症抛在脑后。影响这一过程的因素包括家庭对癌症的看法、癌症症状及治疗的可见性或干扰性、家庭灵活性、患病经历、生活阶段以及观点的一致性。
更容易适应的家庭将与正常状态的差异视为暂时的，具有灵活性，在自身情况要求下视自己为正常，观点相似，较少受到治疗及其副作用带来的重大干扰或侵扰，并能适当地运用恢复正常的策略。
研究结果强调尽可能维持正常日常活动并迅速恢复正常的重要性。护士必须准确评估家庭应对情况，以识别出有困难的家庭和有困难风险的家庭。护士可以通过提供关于一般预期情况以及可能有用的可用资源的信息，来支持家庭努力保持正常并恢复正常。护士需要随时提供咨询和/或根据需要进行转介。
