目的 基于建构主义扎根理论构建癌症生存者重返工作社会支持体系,为提升其重返工作稳定性提供理论依据。方法 采用质性研究方法,通过目的抽样、滚雪球抽样和理论抽样选取24名癌症生存者及16名社会支持提供者(家属、企业人员、医务人员等)进行半结构式深度访谈。遵循建构主义扎根理论,纳入先验理论视角,强化研究者反思性,运用扎根理论三级编码对资料进行分析。结果 形成由个体适应层、家庭支持层、组织支持层、医疗支持层、社会政策层构成的社会支持体系,含5项主范畴、16项副范畴,各层面均呈支持与阻碍并存双重属性;5层间通过双向反馈、动态协同,共同驱动重返工作适应性转型。结论 癌症生存者重返工作是多层面协同作用的动态适应过程,应从个体康复与职业重建、家庭支持边界、组织制度与人际支持、医疗-就业衔接及政策保障等方面完善社会支持体系,以促进其职业重建和社会融入。

Objective To construct a social support system for cancer survivors' return-to-work based on constructivist grounded theory,so as to provide a theoretical basis of its stability.Methods A qualitative research method was adopted.24 cancer survivors,and 16 social support providers (family members,enterprise personnel,medical staff,etc.) were selected by purposive sampling,snowball sampling and theoretical sampling for semi-structured in-depth interviews.Following the concept of constructivist grounded theory,prior theoretical perspectives were incorporated,researchers' reflexivity was strengthened,and the three-level coding of grounded theory was used to analyze the data.Results A social support system consisting of 5 main categories and 16 sub-categories was formed,encompassing individual adaptation level,family support level,organizational support level,medical support level,and social policy level.Each level exhibited the dual attributes of both support and obstruction.The 5 levels jointly drove the adaptive transformation of returning to work through two-way feedback and dynamic synergy.Conclusions Return-to-work of cancer survivors is a dynamic adaptive process involving multi-level synergy.The social support system should be improved in individual rehabilitation and vocational reconstruction,family support boundaries,organizational systems and interpersonal support,medical-employment linkage,and policy guarantees,so as to promote their vocational reconstruction and social integration.

R473.73

国家社会科学基金一般项目(21BSH007)