Abstract:

Objective To explore the ways of breast cancer patients and family fusion and self-adjustment strategies，and to provide reference information for the adjustment of breast cancer patients and their families. Methods By purposive and theoretical sampling，we selected patients who sought medical treatment at a tertiary hospital from September 2020 to July 2023. The semi-structured interviews were conducted in the suspicion，diagnosis，treatment，and recovery periods，respectively. Charmaz’s constructivist grounded theory was used for data analysis. Results The behavioural characteristics of breast cancer patients’ fusion with their families throughout the disease trajectory were anxiety transmission，information sharing，emotional connection and experience review. The patient’s fusion behaviour can bring dual psychological experiences to the patients，including a sense of relaxation and anxiety，a sense of trust and loss of control，a sense of intimacy and constraint，and a sense of meaning and burden. Self-adjustment strategies，such as staying calm，opening communication，setting boundaries and self-identification，can promote patients’ and families’ adaptation. Conclusion The adjustment model of breast cancer patients and family fusion suggests medical staff to pay attention to the identification of emotional reactions of patients and their families in family fusion according to the behavioural characteristics of patients and family integration，and timely apply self-adjustment strategies to improve patients’ behavioural management ability，reduce negative emotions in the family system，and promote the adjustment of patients and families.

Key words: Breast Cancer, Family Support, Social Support, Family Fusion, Qualitative Research, Nursing Care

摘要：

目的 探索乳腺癌患者与家庭融合的特点以及自我调适策略，以期为乳腺癌患者及其家庭的调适提供借鉴。 方法 采用目的抽样法和理论抽样法，选取2020年9月—2023年7月在徐州市某三级甲等医院乳腺外科就诊的乳腺癌患者作为研究对象，在怀疑期、确诊期、治疗期、康复期分别对其进行半结构式访谈，采用Charmaz的建构型扎根理论进行资料分析。结果 在整个疾病轨迹中乳腺癌患者与家庭融合的行为特点依次为焦虑传递、信息分享、身心连结以及经历回顾。乳腺癌患者的融合行为会为其带来双重心理体验，包括轻松感与焦虑感、信任感与失控感、亲密感与约束感、意义感与负担感。保持冷静、开放沟通、建立边界、自我认同等自我调适策略可以促进乳腺癌患者和家庭的调适。结论 乳腺癌患者与家庭融合的调适模型提醒医护人员应根据患者与家庭融合的行为特点，关注、识别家庭融合中患者及家属的情绪反应，及时应用调适策略提高患者的行为管理能力，减少家庭系统中的负性情绪，促进患者及家庭的调适。

关键词: 乳腺癌, 家庭支持, 社会支持, 家庭融合, 质性研究, 护理