背景:护理带来的巨大身心负担使被诊断患有晚期癌症的患者的亲密伴侣面临精神障碍的风险。然而,大多数伴侣似乎都受到韧性的保护。这样的复原过程是由某些个体特征(例如,灵活性,积极的态度,内部强度,平衡传入和传出信息的能力,以及请求和接受支持和建议的能力),以及支持网络的可用性,由家庭组成,朋友,和医疗保健专业人员。这样一个努力实现相同目标的异构群体可以被认为是一个复杂的自适应系统(CAS),源于复杂性科学的概念。
目的:通过复杂性科学的视角研究支持网络的行为,并为可用网络可能促进弹性的手段提供见解。
方法:使用CAS原则作为编码框架,对来自八个亲密伴侣的支持网络的成员进行了19次访谈,进行了演绎分析。随后,每个原则下的报价都是归纳编码的,以具体化支持网络的行为模式。最终,代码被绘制成一个矩阵,以识别CAS内和CAS间的相似性,差异,和模式。
结果:随着患者预后恶化,网络的行为会动态适应不断变化的环境。此外,该行为基于内化的基本规则(例如确保可用性和保持通信而不具有侵入性),吸引子(例如,感觉有意义,赞赏,或已连接),以及支持网络的历史。然而,交互是非线性的,并且由于上下文成员自己的关注而往往是不可预测的,需要,或情绪。
结论:将复杂性科学的视角应用于亲密伴侣的支持网络的行为,可以让我们深入了解网络的行为模式。的确,支持网络是一个动态系统,根据CAS的原则行事,并随着患者预后恶化而适应不断变化的环境。此外,支持网络的行为似乎促进了亲密伴侣在整个患者护理期间的复原过程。
BACKGROUND: The tremendous physical and mental burden that comes with caregiving puts the intimate partners of patients diagnosed with advanced cancer at risk for mental disorders. However, most partners seem to be protected by resilience. Such a resilience process is promoted by certain individual characteristics (e.g., flexibility, positive attitude, internal strength, capacity to balance incoming and outgoing information, and ability to ask for and accept support and advice) and by the availability of a support network, consisting of family, friends, and healthcare professionals. Such a heterogeneous group striving towards the same goals can be considered a complex adaptive system (CAS), a concept stemming from complexity science.
OBJECTIVE: To study the behavior of the support network through the lens of complexity science and to provide insights to the means by which an available network may promote resilience.
METHODS: Nineteen interviews with members from the support networks of eight intimate partners were analyzed deductively using the CAS principles as a coding framework. Subsequently, the quotes under each principle were coded inductively to concretize patterns in the behavior of the support networks. Eventually, the codes were charted into a matrix to identify intra- and inter-CAS similarities, differences, and patterns.
RESULTS: The network\'s behavior adapts dynamically to the changing circumstances as the patient\'s prognosis worsens. Furthermore, the behavior is based on internalized basic rules (such as reassuring availability and maintaining communication without being intrusive), attractors (e.g., feeling meaningful, appreciated, or connected), and the history of the support network. However, the interactions are non-linear and often unpredictable due to the context member\'s own concerns, needs, or emotions.
CONCLUSIONS: Applying the lens of complexity science to the behavior of an intimate partner\'s support network gives us insight into the network\'s behavioral patterns. Indeed, a support network is a dynamic system that behaves according to the principles of a CAS and adapts resiliently to the changing circumstances as the patient\'s prognosis worsens. Moreover, the behavior of the support network appears to promote the intimate partner\'s resilience process throughout the patient\'s care period.