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首页> 外文学位 >Meaning-making in chronic disease: A qualitative study of how adults with epilepsy create a meaningful concept of illness.
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Meaning-making in chronic disease: A qualitative study of how adults with epilepsy create a meaningful concept of illness.

机译：慢性疾病中的意义产生：对患有癫痫病的成年人如何创造有意义的疾病概念的定性研究。

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This narrative study proposed to identify structures and concepts of meaning that constitute the elements of an evolving identity in the context of living a life disrupted by epilepsy, a chronic illness with sometimes devastating psychosocial sequelae. Temporal Lobe Epilepsy (TLE) or any temporal lobe and limbic system involvement in epilepsy can cause significant alterations in consciousness; the seizure experience may cover the spectrum from total blackout to mystical experience. Using a one-on-one semi-structured interview of up to two hours in length, six adults who met criteria intended to represent mainstream Americans living with epilepsy told their stories of diagnosis and of living with epilepsy over time. Narrative analysis was used to identify meaning concepts found throughout interview transcripts; from the constellation of these a further level of analysis identified structures of meaning. Each participant demonstrated one essential meaning-making structure that persisted over time; two participants appeared to share the same structure. Qualities of identity were not linked to specific structures of meaning-making, but were an impetus in processes of transformation within meaning-making structures. Unique variables in the experience of epilepsy are seizure content and control. Age of onset and degree of seizure control can impact the content of the meaning-making process. The findings may generalize to others with chronic illness and suggest the utility of employing meaning-making structures in a therapeutic context to help with stress reduction and possibly the reduction of seizures, especially for those individuals capable of self-observation. This last possibility holds implications for spiritual transformation in the experience of epilepsy and points to the process of integration of mind, body, and spirit that is at the heart of transpersonal psychology. Further research might test the clinical utility of these preliminary findings, explore whether a finite number of meaning-making structures exist, develop a more distinct picture of each one, and seek to identify processes of transformation specific to each structure.
机译：这项叙述性研究旨在确定意义结构和概念，这些概念和概念构成了在不断受到癫痫困扰的慢性生活中，不断演变的身份的要素，这种慢性疾病有时会破坏性的心理社会后遗症。颞叶癫痫（TLE）或任何颞叶和边缘系统参与癫痫可导致意识的重大改变；癫痫发作的经验可能涵盖从完全停电到神秘的经历。通过长达不超过两个小时的一对一半结构化访谈，六个符合标准的成年人代表了患有癫痫病的主流美国人，他们讲述了他们的诊断和一段时间内患有癫痫病的故事。叙事分析被用来识别整个访谈笔录中发现的意义概念。从这些观点出发，进一步的分析确定了意义的结构。每个参与者都展示了一个必不可少的意义形成结构，这种结构会随着时间的流逝而持续存在。两名参与者似乎共享相同的结构。同一性的质量与意义创造的特定结构无关，而是在意义创造结构内的转化过程中的动力。癫痫经验的独特变量是癫痫发作的内容和控制。发作的年龄和癫痫发作的控制程度会影响意义形成过程的内容。这些发现可能会推广到其他慢性病患者，并建议在治疗环境中采用有意义的结构来帮助减轻压力，并可能减少癫痫发作，特别是对于那些具有自我观察能力的人。这最后一种可能性在癫痫的经历中对精神转变产生了影响，并指出了超个人心理学的核心思想，身体和精神的整合过程。进一步的研究可能会测试这些初步发现的临床效用，探索是否存在有限数量的意义构建结构，为每个构建更清晰的图片，并寻求识别特定于每种结构的转化过程。

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