Subjective psychosocial experiences of South African breast cancer patients receiving diagnosis and treatment

Sutherland, Elna (2018-03)

Thesis (MA)--Stellenbosch University, 2018.

Thesis

ENGLISH SUMMARY: The present study is an attempt to explore, describe, and interpretively understand the lived psychosocial experiences of individual breast cancer patients receiving diagnosis and treatment from a first-person perspective. The aim of this study was to provide subjective evidence of high significance, emphasizing the importance of incorporating customized psychosocial support as part of multidisciplinary health care. Customized psychosocial support could potentially increase positive health outcomes. This qualitative study adopted a case study design using a phenomenological research approach. Interpretative Phenomenological Analysis (IPA) was the explorative and flexible research method of choice. The participants were purposively selected. Participant selection was based on shared characteristics. Data were collected from 10 eligible breast cancer patients reporting at the Breast Clinic, from which three case studies were selected for analysis. Semi-structured interviews were employed for data collection. Narratives were audio recorded and transcribed by the researcher. The analysis of each of the selected three case studies led to the emergence of a single overarching psychological concept of what it means to live with breast cancer, namely, loss of personal identity. The findings across the three case studies revealed similarities within different experiences, as well as differences within similar experiences. Perceptions of breast cancer were shaped by parental influences, perceived lack of knowledge and obscurity. Experiences pertaining to breast cancer diagnosis included repudiation, experiential avoidance, fatalism and transient global amnesia. Experiences related to treatment interventions contained the following descriptions: trauma, mortification, indignity, maiming, humiliation, and demoralization. Meaning-making included incremental living, mindfulness, self-transcendence, as well as surrender. Two main theoretical frameworks namely, the Biopsychosocial Spiritual Model and Constructivism were identified for contextualization of interpreted findings. Participants’ descriptions demonstrated the significant impact of breast cancer on psychological, emotional, social and physical domains of women’s lives. The loss of a woman’s breasts comprises more than just a physical loss. The loss of a woman’s breast encompasses a loss of personal identity. Living with breast cancer and related experiences are unexplored areas in South African Women’s Health Psychology. This study illustrates the value of exploring particular existential breast cancer experiences in developing customized health care. This study provides a foundation for future(larger and more representative) studies that can build on the findings of this study.

AFRIKAANSE OPSOMMING: Die huidige studie het ten doel om die geleefde ervaringe van individuele borskanker pasiënte, ten opsigte van diagnose en behandeling, te ondersoek, beskryf en met begrip te interpreteer vanuit ‘n eerste-persoon perspektief. Die doel van die studie was om subjektiewe bewyse van hoë betekenis te lewer, met ‘n klem op die belangrikheid van insluiting van persoonlike psigososiale ondersteuning as deel van multidisiplinêre gesondheidsorg. Persoonlike psigososiale ondersteuning kan moontlik ‘n verhoging in positiewe gesondheidsuitkomste tot gevolg hê. Hierdie kwalitatiewe studie het ‘n gevallestudie ontwerp en maak gebruik van ‘n fenomenologiese navorsingsbenadering. Interpretatiewe Fenomenologiese Analise was die ondersoekende en buigsame navorsingsmetode van keuse. Die deelnemers was doelgerig gekies. Deelnemer seleksie was gebasseer op gemene eienskappe. Inligting is verkry van 10 verdienstelike deelnemers wat aanmeld by die Borskliniek, waaruit drie gevalle studies geselekteer is vir ontleding. Semi-gestruktureerde onderhoude is gebruik om inligting te versamel. Vertellings is aangeteken as klankopnames en deur die navorser getranskribeer. Die analisering van die gekose gevallestudies het aanleiding gegee tot die ontluiking van ’n enkel, oorkoeplende psigologiese konsep rakende die betekenis van ‘n lewe met borskanker, naamlik die verlies van persoonlike identiteit. Die bevindinge van die drie gevallestudies het getoon daar is verskille in ooreenstemmende ervaringe asook ooreenkomste in verskillende ervaringe. Persepsies van borskanker is onder andere beinvoed deur ouerlike invloede, verwagte verlies aan kennis en onbekendheid. Ervaring wat verband hou met borskanker diagnose sluit in verwerping, vermyding van die ervaring, fatalisme en verbygaande globale amnesie. Ervaringe wat verband hou met behandeling omvat die volgende beskrywings naamlik, trauma, tugtiging, vernedering, verminking en demoralisering. Betekenis maak sluit in inkrementele lewe, bewustheid, selftransendensie en oorgawe. Twee hoof teoretiese raamwerke naamlik die Biopsigososiale Spirituele model en Konstruktivisme is geidentifiseer vir kontekstualisering van geinterpreteerde bevindinge. Deelnemers se beskrywinge het gedemonstreer dat borskanker ‘n betekenisvolle impak het op psigologiese, emosionele, sosiale en fisiese vlakke van ‘n vrou se lewe. Die verlies van ‘n vrou se bors (borste) is meer as net ‘n fisiese verlies. Die verlies van ‘n vrou se bors omvat die verlies van persoonlike identiteit. Om te leef met borskanker, en verwante ervaringe, is onverkende areas in Suid Afrikaanse Vroue Gesondheidpsigologie. Hierdie studie illustreer die waarde van die verkenning van spesifieke eksistensiële borskanker ervaringe om persoonlike gesondheidsorg te ontwikkel. Die bevindinge van hierdie studie kan dien as ‘n basis vir toekomstige (groter en meer verteenwoordigende) studies .

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/103326
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