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astrid on Dec 27, 2018 in
Issue 1, December 2018,
Volume 17 |
Comments Off on Negotiating Emotional Order: A Grounded Theory of Breast Cancer Survivors
Jennifer A. Klimek Yingling, Utica College Abstract In this article, classic grounded theory captures the processes of 12 women who had completed initial treatment for breast cancer. The qualitative data analysis reveals the basic social process of negotiating emotional order that describe how breast cancer survivors perceive their illness and decide to take action. From the data, five stages of the process of negotiating emotional order emerge: 1) Losing Life Order, 2) Assisted Life Order, 3) Transforming 4) Accepting, and 5) Creating Emotional Order. This study may help healthcare providers who care for breast cancer survivors understand the depth of perpetual emotional impact that breast cancer survivors endure. This study will potentially serve as a path for future research and aid in the understanding of the psychological impact that breast cancer has upon survivors. Keywords: breast cancer, survivor, chemotherapy, emotional order What Sparked This Research I cared for a patient who I had gotten to know as her child often visited the emergency department due to hemophilia. She was a pleasure to work with, strong, level headed, and upbeat. On this particular day she was the patient. Her complaint was simple: a cough and she clearly wasn’t herself emotionally. I was surprised to discover, when I took her past medical history, that she was a breast cancer survivor. After I discussed her chest x-ray results I sensed she was still upset and filled with uncertainty. Then the lightbulb went on. I asked her directly if she was concerned if the cancer was recurring. She said yes and her tears flowed. I do believe if I had not dug a little deeper into her emotional state she would have left the emergency department with much of the same emotional duress that she initially had. This interaction sparked my research as it was clear that breast cancer survivors endure a process after treatment ends. For these survivors the treatment is over but the emotional aspect of breast cancer is not. It also became evident to me that health care providers need to know more about this process on order to be able to treat patients holistically. Negotiating Emotional Order: A Grounded Theory of Breast Cancer Survivors Breast cancer is the most prevalent cancer found in women worldwide (American Cancer Society [ACS], 2016; Ferlay et al., 2104). In the United States, it is estimated that 3.5 million women have been diagnosed with breast cancer; 245,000 will be newly diagnosed; and, approximately 40,000 women will succumb to breast cancer annually (ACS, 2016; Breastcancer.org, 2016). Early detection and improved treatment is credited to the rising population of women who are breast cancer survivors (Howlader et al., 2015; McCloskey, Lee, & Steinburg, 2011). Concerns about the psychosocial ramifications of chronic illness have a long history. The Institute of Medicine (2009), American Cancer Society (2015), and the American Society of Clinical Oncology (2015) resonate concern about psychosocial hindrances regarding cancer patients, citing them as a critical area needing improvement within the nation’s health care system. The literature suggests breast cancer survivors endure psychological stressors after the completion of treatment including the following: loneliness (Marroquin, Czamanski-Cohen, Weihs, & Stanton, 2016; Rosedale, 2009), anxiety and depression (Walker, Szanton, & Wenzel, 2015), uncertainty (Dawson, Madsen, & Dains, 2016; Mishel et al., 2005), and fear of recurrence (McGinty, Small, Laronga, & Jacobsen, 2016). The phenomenon of breast cancer survivorship has been identified with qualitative methods, yet is lacking explanatory theory (Allen, Savadatti & Levy, 2009; Pelusi, 1997). Qualitative analysis uses...