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A Grounded Theory Approach on Peoples' Adaptation Experience with Fibromyalgia Syndrome

섬유근통증후군 환자의 질병 적응경험에 관한 근거이론 연구

  • Received : 2016.08.31
  • Accepted : 2016.12.08
  • Published : 2016.12.31

Abstract

This was a qualitative study to explore and better understand the adaptation experience and processes of peoples with fibromyalgia syndrome (FMS), as well as to develop a substantive theory using the grounded theory method. There were 13 patients (12 females and 1 male) who received FMS treatment from Rheumatic Medicine outpatient department of one general hospital. The data were collected through an in-depth interview between January and May of 2014. Transcribed interview contents were analyzed by the grounded theory method of Corbin and Strauss (2008). As a result, a total of 98 concepts, 26 sub-categories, and 10 categories were identified through the open coding process. The process of adaptation experience showed 4 steps: perception of uncertainty and limited condition, evaluation of self-control possibility and determinations of expectations of life, searching and trying of strategies, as well as self-regulation. The 4 types of adaptation experience were expansionary, complacently, effusively and withering. The 'protective self-regulation' theory was derived from the core category of 'learning to self-regulation method'. Patients with FMS has repeatedly attempted these strategies of protective self-regulation in order to gain stability from uncertainty and limited condition of the disease. Based on these results, it is necessary to develop an educational program for patients and families which has appropriate nursing intervention strategies in accordance with the types of adaptation.

본 연구는 근거이론 연구방법을 통해 섬유근통증후군 환자의 질병경험과 적응과정을 파악하고 이해하여 실체이론을 도출하고자 하였다. 본 연구의 참여자는 1개의 종합병원 류마티스 내과 외래에서 섬유근통증후군를 치료 중인 13명(여성 12명과 남성 1명)이다. 자료 수집은 2014년 1월부터 5월까지 개별 심층면담을 통해 이루어졌다. 이론적 표본추출법은 이론적 포화의 시점을 적용하였다. 필사된 면담의 내용은 Corbin과 Strauss (2008)의 근거이론방법으로 분석하였다. 연구결과 개방코딩을 통해 총 98개 개념과 26개 하위범주, 10개 범주가 도출되었다. 섬유근통증후군 환자의 질병 적응과정은 '불확실성과 한계상황인식'과 '자기통제 가능성 평가와 기대수준 결정', '적응전략 개발과 시도', '자기조절'의 4단계로 나타났다. 섬유근통증후군환자의 질병적응 유형은 확장형과 안정형, 표출형, 위축형의 4가지 유형으로 파악되었다. 또한 핵심범주인 '자기조절법 터득하기'로부터 '보호적 자기조절' 이론이 도출되었다. 본 연구결과 섬유근통증후군 환자들은 질병으로 인해 불확실한 상황에서 안정상태를 찾기 위해 자기조절을 반복적으로 활용하여 적응해가고 있음을 알 수 있었다. 따라서 본 연구결과를 근거로 대상자들의 질병 적응 유형에 따른 적합한 간호중재 및 가족을 포함하는 교육 프로그램의 개발이 필요할 것으로 사료된다.

Keywords

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