Fulton G, Madden C, Minichiello V
Department of Health Studies, University of New England, Armidale, New South Wales, Australia.
Soc Sci Med. 1996 Nov;43(9):1349-58. doi: 10.1016/0277-9536(95)00447-5.
As medical technology prolongs life and facilitates the early diagnosis of terminal illnesses such as AIDS, the concept of anticipatory grief requires further scrutiny. The original concept of anticipatory grief has become widely accepted. This paper, however, argues that the uncritical acceptance of this concept rests primarily on the authority of the biomedical model, which has focused analysis on the predictable symptomatology of the grief process, integrating this understanding into health care. This paper provides a critical review of the concept of anticipatory grief, highlighting conceptual shifts which are required if the concept is to be relevant to the subjective experiences of people who are confronted with life-threatening illness. The paper discusses the relevance of understanding the conceptual confusion which exists in the literature between "anticipatory grief" and "forewarning of loss". It is argued that grief may be the response to a loss of meaning, and that the psychological process of adjustment to loss requires individuals to engage in the reconstitution of purpose and meaning in their lives. Distinguishing between what is being expressed for past and present losses and what responses occur when individuals focus on various aspects of their future may shed light on some of the inconsistent and contradictory findings surrounding research on anticipatory grief.
随着医学技术延长寿命并促进对艾滋病等晚期疾病的早期诊断，预期性悲伤的概念需要进一步审视。预期性悲伤的最初概念已被广泛接受。然而，本文认为，对这一概念的不加批判的接受主要基于生物医学模式的权威性，该模式将分析重点放在悲伤过程的可预测症状学上，并将这种理解融入医疗保健中。本文对预期性悲伤的概念进行了批判性审视，强调了如果该概念要与面临危及生命疾病的人的主观体验相关，就需要进行的概念转变。本文讨论了理解文献中“预期性悲伤”和“丧失预警”之间存在的概念混淆的相关性。有人认为，悲伤可能是对意义丧失的反应，而适应丧失的心理过程要求个人在生活中重新构建目标和意义。区分对过去和现在丧失的表达以及当个人关注未来的各个方面时会出现何种反应，可能会揭示围绕预期性悲伤研究的一些不一致和矛盾的发现。
