Ware N C
Department of Social Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA.
Psychosom Med. 1998 Jul-Aug;60(4):394-401. doi: 10.1097/00006842-199807000-00003.
This study examines social processes that construct the course of chronic illness. Specifically, it identifies and describes mechanisms that constitute the process of role constriction in employment for individuals with chronic illness.
Sixty-six persons meeting the Centers for Disease Control case definition of chronic fatigue syndrome (CFS) participated in a longitudinal study involving three waves of data collection over 3 years. Qualitative and quantitative methods were combined in the research, which included face-to-face semistructured interviews, telephone interviews, and self-report questionnaires. Materials presented in this study are drawn principally from the Year 1 face-to-face and telephone interviews.
When patterns of symptoms and of the illness course in CFS intersect with work requirements, they impede performance and place ill individuals at risk for job loss. Persons with CFS devise and implement specific strategies to resist role constriction and remain in the work force.
Role constriction is a social process of marginalization in chronic illness. Opposing forces of marginalization and resistance define the social course in chronic illness and suggest that chronicity can be thought of as a marginalized position in social space.
本研究考察构建慢性病病程的社会过程。具体而言，它识别并描述构成慢性病患者就业中角色受限过程的机制。
66名符合美国疾病控制中心慢性疲劳综合征（CFS）病例定义的患者参与了一项纵向研究，该研究在3年中进行了三轮数据收集。研究中结合了定性和定量方法，包括面对面半结构化访谈、电话访谈和自我报告问卷。本研究呈现的材料主要取自第一年的面对面访谈和电话访谈。
当CFS的症状模式和病程与工作要求相交时，它们会妨碍工作表现，并使患病个体面临失业风险。CFS患者会设计并实施特定策略来抵制角色受限并继续留在劳动力队伍中。
角色受限是慢性病中一种边缘化的社会过程。边缘化和抵制的对立力量定义了慢性病的社会进程，并表明慢性病可被视为社会空间中的一种边缘化地位。
