Abstract

Concepts of health and illness have changed across cultures and centuries along with methods of inquiry and treatment. In this article, illness experience is explored from the perspective of Personal Construct Psychology (PCP) and a coherent methodology of enquiry is proposed. A study of the medically unexplained symptoms of eye floaters is presented as an exemplification. Participants suffering from eye floaters perceive flashes and spots in their perceptive fields, but they do not necessarily have an eye disease. The aim of this study is to understand the experience of these participants, differentiate them, and propose a personalized care approach. Eye examinations and echography, individual semi-structured interviews were carried out and dependency grids were used. Qualitative analysis showed that the illness experience depended on the perception of the disease, the personal explanation given, the solutions tried, the trust placed in medicine, self-construction, and the dispersion of dependency. Cases exhibiting similar experiences were grouped based on these categories, and four illness trajectories were identified by referring to Kelly’s transitions: aggressiveness, threat, constriction, and guilt. These trajectories were subsequently verified in the context of other chronic illnesses, in the health attitudes of people without particular illnesses, and finally with the families of chronically ill children. In all these cases, a different health status or illness progression corresponded to each trajectory. These studies illustrate a new way to understand illness based on PCP and on a specific methodology of inquiry, which may be useful for future studies and clinical practice.

摘要

随着探究和治疗的方法，健康和疾病的概念在不同文化和几个世纪中发生了变化。本文从个人建构心理学（PCP）的角度探讨疾病体验，并提出了一种连贯的探究方法。以医学上无法解释的飞蚊症症状的研究为例。患有飞蚊症的参与者在他们的感知领域会感觉到闪光和斑点，但他们不一定患有眼部疾病。本研究的目的是了解这些参与者的经历，区分他们，并提出个性化的护理方法。进行了眼科检查和超声检查，进行了个人半结构化访谈，并使用了依赖网格。定性分析表明，疾病体验取决于对疾病的认知、个人的解释、尝试的解决方案、对医学的信任、自我构建和依赖的分散。根据这些类别对表现出相似经历的病例进行分组，并通过参考凯利的转变确定了四种疾病轨迹：攻击性、威胁性、收缩性和内疚感。这些轨迹随后在其他慢性病的背景下、在没有特定疾病的人的健康态度中得到验证，最后在慢性病儿童的家庭中得到验证。在所有这些情况下，不同的健康状况或疾病进展对应于每个轨迹。