Young women's construction of their post-cancer fertility
Young women's construction of their post-cancer fertility
复制标题
DOI：
10.1080/08870446.2014.932790
复制
发表时间：
2014-01-01
影响因子：
3.3
通讯作者：
Perz, Janette
中科院分区：
文献类型：
--
作者：
Dryden, Amy;Ussher, Jane M.;Perz, Janette
被诊断患有癌症的年轻女性通常会因为治疗而面临生育能力下降的问题。然而，以前的研究采用了生育的生物医学模型，并使用了假设演绎的研究方法，这并没有考虑到充分探索女性的主体性。这项研究从社会建构主义认识论的角度探讨了年轻女性癌症后生育能力的构成，以及她们与医疗保健专业人员对生育能力的讨论。对8名年龄在18-26岁的女性进行了半结构化的一对一采访，涉及各种癌症类型。福柯的话语分析确定了与生育问题相关的三个主题立场：“不充分的妇女：接受母亲的强制要求”；“适当的妇女：抵制母亲的强制要求”；以及“适者生存：妇女具有基因缺陷”。这些受试者的立场包括不充分、恐惧和毁灭的感觉；对恋人不受欢迎的感觉；以及对遗传癌症阳性基因的担忧。在描述医疗保健专业互动时，女性采用了“满意的病人”、“被动的接受者”或“抵制被动的病人”的立场。对信息提供不足的描述与愤怒和沮丧有关，而感觉信息充分与对做出关于保留生育的决定的满意度有关。这些结果表明，生育力对年轻女性癌症幸存者来说很重要，而生育力受损会对主观性产生负面影响。
Younger women diagnosed with cancer often face compromised fertility as a result of their treatment. However, previous research has adopted a biomedical model of fertility and utilised hypothetico-deductive research methods which have not allowed for full exploration of women's subjectivity. This study explored younger women's construction of their fertility post-cancer, and their discussions of fertility with healthcare professionals, from a social constructionist epistemology. Semi-structured one-to-one interviews were conducted with eight women aged 18-26, across a variety of cancer types. Foucaultian Discourse Analysis identified three subject positions associated with fertility concerns: 'Inadequate woman: Accepting the motherhood mandate'; 'Adequate woman: Resisting the motherhood mandate'; and 'Survival of the fittest: Woman as genetically defective'. Implications of these subject positions included feelings of inadequacy, fear and devastation; feeling undesirable to romantic partners; and concern about passing on cancer-positive genes. In describing healthcare professional interactions, women adopted positions of 'Satisfied patient'; 'Passive recipient patient'; or 'Resisting the passive patient position'. Accounts of inadequate information provision were associated with anger and frustration, whereas feeling adequately informed was associated with satisfaction at making decisions about fertility preservation. These results suggest that fertility is of importance to young women cancer survivors, and that compromised fertility can negatively impact subjectivity.