Experiences of paradox: a qualitative analysis of living with cancer using a framework approach

被引:26
|
作者
Leal, Isabel [1 ,2 ]
Engebretson, Joan [3 ]
Cohen, Lorenzo [2 ]
Rodriguez, Alma [4 ,5 ]
Wangyal, Tenzin [6 ]
Lopez, Gabriel [2 ]
Chaoul, Alejandro [2 ]
机构
[1] Univ Texas Houston, Sch Publ Hlth, Houston, TX USA
[2] Univ Texas MD Anderson Canc Ctr, Dept Gen Oncol, Integrat Med Program, Houston, TX 77030 USA
[3] Univ Texas Hlth Sci Ctr Houston, Sch Nursing, Houston, TX 77030 USA
[4] Univ Texas MD Anderson Canc Ctr, Dept Lymphoma & Myeloma, Houston, TX 77030 USA
[5] Univ Texas MD Anderson Canc Ctr, Off Execut Vice President & Phys In Chief, Houston, TX 77030 USA
[6] Ligmincha Inst, Charlottesville, VA USA
关键词
cancer; oncology; qualitative research; paradox; meaning-making; dialectic; POSTTRAUMATIC-STRESS-DISORDER; BREAST-CANCER; OF-LIFE; PSYCHOSOCIAL ADJUSTMENT; PSYCHOLOGICAL DISTRESS; GROWTH; HEALTH; WOMEN; DEPRESSION; DIAGNOSIS;
D O I
10.1002/pon.3578
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
ObjectivesLife-threatening diseases such as cancer represent unique traumascompared with singular, time-limited traumatic eventsgiven their multidimensional, uncertain, and continuing nature. However, few studies have examined the impact of cancer on patients as a persistent stressor. The aim of this qualitative study is to explore patients' ongoing experiences of living with cancer and the changes encountered in this experience over time. MethodsWritten reflections to three open-ended questions collected from 28 patients on their experience of cancer at two time points were analyzed to explore participants' experiences and perspectives over time. Content analysis using a framework approach was employed to code, categorize, and summarize data into a thematic framework. ResultsData analysis yielded the thematic frameworkliving with paradox, consisting of four interrelated themes: sources, experiences, resolution of paradox, and challenges with medical culture/treatment. The primary theme concerned moving through a dualistic and complex cancer experience of concurrently negative and positive emotional states across the course of cancer. ConclusionsRespondents indicated that cycling through this contradictory trajectory was neither linear, nor singular, nor conclusive in nature, but reiterative across time. Recognition that patients' cancer experience may be paradoxical and tumultuous throughout the cancer trajectory can influence how practitioners provide patients with needed support during diagnosis, treatment, and recovery. This also has implications for interventions, treatment, and care plans, and adequately responding to the diversity of patient's psychosocial, physical, existential, and spiritual experience of illness. Copyright (c) 2014 John Wiley & Sons, Ltd.
引用
收藏
页码:138 / 146
页数:9
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