La confrontation au deuil d’un pair chez une AJA atteinte de cancer. Une analyse phénoménologique interprétative
An AYA with Cancer Confronted with the Grief of a Peer: an Interpretative Phenomenological Analysis
Abstract
Aims: Adolescents and Young Adults (AYAs) with cancer facing the loss of another AYA with cancer may face a “triple task”: the process of adolescence, psychological adjustment to cancer, and the bereavement process of a sick peer. The aim of this study was to explore the processes underlying the loss of a sick peer in AYAs with cancer.
Procedure: A single interview was submitted to an Interpretative Phenomenological Analysis (IPA), designed to understand the system of meanings attached to a subjective and intimate phenomenon such as bereavement.
Results: Six major themes emerge from the IPA: the life course; the care course; perceptions of cancer, oneself, and the world; psychological adjustment to cancer; interpersonal relationships; and the loss of a sick AYA peer. The interpretative narrative showed the importance of the process of identification with sick peers, particularly to the deceased, in making sense of the cancer and bereavement. This bereavement experience includes negative aspects (e.g., the prospect of one’s own death, loss of reference point, fear of relapse) and positive aspects (e.g., continuing bonds with the deceased, change in perception of oneself and the world).
Conclusion: The study demonstrated the importance of considering these processes to support AYAs with cancer confronted with the death of a sick peer and proposed interventions adapted to this age group.
Résumé
Objectif : Les adolescents et jeunes adultes (AJA) atteints de cancer faisant face à la perte d’un autre AJA malade peuvent être confrontés à une « triple tâche » : le processus d’adolescence, l’ajustement psychologique au cancer et la mort d’un pair malade. L’objectif de l’étude a été d’explorer les processus sous-jacents à la perte d’un pair malade chez les AJA atteints de cancer.
Matériel et méthodes : Un entretien unique a été soumis à une Analyse phénoménologique interprétative (IPA), conçu pour comprendre le système de significations attaché à un phénomène subjectif et intime tel que le deuil.
Résultats : L’IPA a fait émerger six thèmes majeurs : le parcours de vie ; le parcours de soins ; les représentations du cancer, de soi et du monde ; l’ajustement psychologique au cancer ; les relations interpersonnelles ainsi que la perte d’un pair AJA malade. Le récit interprétatif montre la place centrale du processus d’identification aux pairs malades, notamment au défunt, dans la mise en sens du cancer et du deuil. Cette expérience du deuil d’un pair comporte des aspects négatifs (e.g., perspective de sa propre mort, perte de repère, peur de la rechute) et positifs (e.g., sentiment de continuité avec le défunt, changement de perception de soi et du monde).
Conclusion : L’étude montre l’importance de considérer ces processus dans l’accompagnement des AJA atteints de cancer confrontés à la mort d’un pair malade et de proposer des interventions adaptées à cette tranche d’âge.
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