Lebensqualität aus der Sicht darmkrebserkrankter Frauen und Männer: Rekonstruierte Lebens- und Krankengeschichten und ihre Bedeutungen für eine patienten- und patientinnenorientierte Versorgung
|Other Titles:||Quality of life from the perspective of colorectal cancer diseased women and men: Reconstructed biographical- and illness stories and their meaning for a gender- and patient-oriented health care||Authors:||Wachtlin, Martina||Supervisor:||Kolip, Petra||1. Expert:||Kolip, Petra||2. Expert:||Schmidt-Semisch, Henning||Abstract:||
Background of the problem: In contrast to an increasing incidence of colorectal cancer, the mortality of affected men and women is constantly decreasing (GEKID 2010). Typically cancer of the colon proceeds in a chronic course, leading to the necessity of maintaining or improving quality of life of the patients by ensuring the best possible patient care. The task of health care research is, particularly with regard to an effective and patient-oriented health care, to analyze and characterize the determinants of quality of life under disease conditions (Pfaff 2003; SVR 2000/2001, 2003). Concerning that goal also gender-specific differences must be taken into account (Kuhlmann/Kolip 2005). Current state of research on subjective quality of life of patients suffering from colorectal cancer is regarding gender aspects considered to be insufficient, due to mainly relying on objectifying measuring methods. Goal of this work: What are the expectations of men and women suffering from colorectal cancer concerning their quality of life and what s the significance of these expectations in respect of a patient- or gender-oriented health care? Theoretical framework: In the present study, the trajectory framework for management of chronic illness of Corbin and Strauss (1988, 2004) was chosen as a theoretical frame of reference. With respect to empirical studies, this framework primarily served as a heuristic model, leading to the development of new questions and theories, respectively. Methods: The empirical studies of the present work are based on the scientific approach of the grounded theory (Glaser&Strauss 1968). Ten narrative-biographical interviews with men and women suffering from colorectal cancer were conducted (Schütze 1977). Six of these interviews (3 with affected females, 3 with affected males) were evaluated in terms of the method of biographic case reconstructions by Gabriele Rosenthal (1995). Results: Due to their medical history, one of the central ideas of quality of life of both sexes is reflected by the chances and possibilities to participate in everyday life (i.e. work, relationships). The genesis of this idea, the experience of participatory action strategies and the way of narrative representation, partly appear to be gender-specific, though. An improved participation represents the central aim of colorectal cancer patients, also concerning a direct interaction with health professionals. In the present study, this need for interaction, appearing as a part of the efforts to cope with disease- and everyday-life related work (Corbin/Strauss 2004) was categorized as a reference. The affected men and women often don t pronounce their subjective requirements from health professionals clearly. The main reason for that is that health professionals often address the patients with a lack of empathy, especially at the beginning of personal contact and treatment. Conclusions: Quality of life from the perspective of individuals suffering from colorectal cancer is not simply explainable as a deterministic condition, but as a process that s influenced by the biography of the patients and sometimes even gender-specificity as well as the manner of interaction. Objectives for the further development of quality of life-oriented concepts of health care for persons affected by colorectal cancer include in particular: 1) Improvement of the interaction between health care professionals and patients based on empiric, gender-sensitive research, taking also theoretical approaches of communication and findings of emotion-psychological studies in account. 2) The intensified focus on gender-specificity in tertiary prevention and health promotion, also considering psychosocial pressures and the competence of participation of the patients.
|Keywords:||colorectal cancer, quality of life, biographical research, gender differences, patient-oriented health care||Issue Date:||20-Jul-2011||URN:||urn:nbn:de:gbv:46-00102349-12||Institution:||Universität Bremen||Faculty:||FB11 Human- und Gesundheitswissenschaften|
|Appears in Collections:||Dissertationen|
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