Native Hawaiian Women and the Experience of Breast Cancer

Corporeal Posttraumatic Growth As a Result of Breast Cancer: An Interpretative Phenomenological Analysis

Women’s traumatic experience of breast cancer (BC) can result in posttraumatic growth (PTG). Women’s embodied experiences of BC seem particularly pertinent to their experiences of both difficulty and growth. While PTG is usually conceptualized as having five domains, it seems that BC survivors experience a sixth domain—corporeal PTG (CPTG). CPTG was recently defined as a “reclaiming” and renewed connection to the body through increased appreciation of the physical self, a new sense of bodily responsibility, positive health changes, and a new sense of positive identification with the body. This study’s aim was to explore how women experience CPTG due to BC. In-depth interviews were conducted with female BC survivors. Interpretative phenomenological analysis extracted three themes: losing, regaining, and relinquishing ultimate control over the body, reconstructing embodied identity, and a newfound appreciation for the body. Participants spoke of a complicated journey from distress, loss, and fragmentation to a reshaping of their assumptions about their bodies. The findings suggest that the body plays a vital role in women’s traumatic and growth-related experiences of BC. Future research on the embodied experience of BC is recommended as it forms a crucial part of BC recovery.

Sharing Wisdom, Sharing Hope: Strategies Used by Native American Cancer Survivors to Restore Quality of Life

PURPOSE

The purpose of this study was to gain insight into the experiences of Native American cancer survivors in navigating life after cancer and what resources and strategies survivors found useful for coping and achieving optimal quality of life (QoL) after diagnosis (the terms "Native Americans" and "Natives" are used interchangeably in this article to describe American Indians and Alaska Natives). The research questions were What advice and words of wisdom do Native cancer survivors prioritize in messages to other Native cancer survivors? and What do those messages reveal about how Native cancer survivors interpret, experience, and restore QoL after diagnosis?

METHODS

This study used a qualitative phenomenologic descriptive study design. Researchers used thematic analysis to identify themes related to peer advice and QoL from transcripts of semi-structured interviews with 52 geographically and clinically diverse Native cancer survivors in the United States.

RESULTS

Survivors' lived experiences directly informed their advice to other survivors, which was characterized by four themes: listen to your body, advocate for yourself, embrace your culture and spirituality, and share your story. A deeper look into the origins of those messages revealed challenges survivors face balancing their responsibility to care for themselves while simultaneously embracing cultural values of selflessness.

CONCLUSION

Providers and researchers should work with Native cancer survivors to identify and leverage existing community strengths in ways that support all aspects of a survivors' QoL rather than limiting support to a single QoL domain (eg, physical, spiritual, mental/emotional, or social issues). Interventions should ensure that supports and services align with survivors' cultural values and attend to competing responsibilities to optimize QoL.

Women's stories of living with breast cancer: A systematic review and meta-synthesis of qualitative evidence

RATIONALE

Globally, breast cancer is by far the most frequently occurring cancer amongst women. Whilst the physical consequences of the disease and associated treatments are well documented, a comprehensive picture of how breast cancer is experienced at all stages of disease progression is lacking.

OBJECTIVE

This systematic review aimed to synthesize qualitative studies documenting women's breast cancer narratives into an empirically based explanatory framework.

METHODS

Two investigators independently searched Academic Search Premiere, CINAHL, Health Source: Nursing/Academic Edition, MEDLINE, PsycARTICLES, PubMed, Science Direct, SCOPUS, Web of Science and three international dissertation repositories using a pre-specified search strategy to identify qualitative studies on women's breast cancer narratives across all geographic and income-level settings. Of the 7840 studies that were screened for eligibility, included in the review were 180 studies, which were assessed using the Critical Appraisal Skills Programme. Using a 'meta-study' approach, an explanatory model of the breast cancer experience was formulated. Finally, we assessed the confidence in the review findings using the 'Confidence in the Evidence from Reviews of Qualitative Research' (CERQual) guidelines.

RESULTS

Eight core themes were identified: the burden of breast cancer, existential ordeal, illness appraisal, sources of support, being in the healthcare system, the self in relation to others, changes in self-image, and survivor identity. Together, these form the proposed Trajectory of Breast Cancer (TBC) framework.

CONCLUSION

The Trajectory of Breast Cancer explanatory framework offers a theoretically defensible synthesis of women's experiences of breast cancer. This framework provides an empirical basis for future reviewers conducting qualitative and narrative breast cancer research.

Spirituality in cancer survivorship with First Nations people in Canada

BACKGROUND

Advancements in cancer survivorship care have shown that holistic approaches, tailored to people's unique survivorship needs, can decrease cancer burden and enhance well-being and quality of life. The purpose of this study was to explore the meanings of spirituality in cancer survivorship for First Nations people, the largest Indigenous population in Canada, and describe how spiritual practices are incorporated into healing.

METHODS

This study is part of a larger arts-based project about cancer survivorship with First Nations people. Thirty-one cancer survivors discussed spirituality as part of their cancer survivorship experiences. Data were generated through sharing sessions (n = 8) and individual interviews (n = 31). Qualitative descriptive analysis was conducted.

RESULTS

Three themes emerged about the meaning of spirituality in cancer survivorship. Spirituality was expressed as a complex phenomenon that (1) interconnected self with traditional roots and culture, (2) merged the body and mind, and (3) gave meaning, strength, and faith in the cancer journey. First Nations people incorporated spirituality into cancer survivorship by giving thanks, attending places of spiritual connectedness, singing, praying, speaking to the Creator, and engaging the sun and moon.

CONCLUSION

First Nations cancer survivors have viewed cancer as an opportunity for emotional and spiritual growth that enabled healing. Understanding the role of spirituality in cancer survivorship is important to develop and deliver culturally safe health services that reduce the burden of cancer and ultimately improve outcomes for First Nations people in Canada.

Post-traumatic growth and life threatening physical illness: a systematic review of the qualitative literature

Post-traumatic growth (PTG) is the phenomenon of positive change through the experience of trauma and adversity (O'Leary & Ickovics, 1995). Research suggests that the type of trauma sustained could have differing processes and outcomes from each other (Demark-wahnefried et al., 2000; Sabiston, McDonough, and Crocker, 2007). The aim of this study was to synthesize qualitative data on PTG and illness related trauma. Fifty-seven published journal articles dating from before November 1st, 2007 in PsychINFO, MEDLINE, EMBASE, Web of Knowledge and from the authors own knowledge of the area were reviewed. Key words included PTG; benefit finding; thriving and positive changes. Key themes included: 'reappraisal of life and priorities'; 'trauma equals development of self'; 'existential re-evaluation'; and 'a new awareness of the body'. Findings suggest that there are unique elements to illness related PTG and a need for additional research into the processes and outcomes of physical illness related trauma.

Coping With Breast Cancer at the Nexus of Religiosity and Hawaiian Culture: Perspectives of Native Hawaiian Survivors and Family Members

This article describes research to develop a breast health intervention for women in Hawaiian churches. Native Hawaiian women are disproportionately burdened by breast disease and tend to be diagnosed at advanced stages when treatment options are more limited. Research suggests that cultural conflict may be a factor in Hawaiian women's underutilization of conventional health services. Phenomenological approaches guided data collection and analysis to explore the influence of religiosity and ethnocultural tradition in coping with breast cancer. The overarching theme was kakou (we or us), which emphasized ways of coping oriented to the family collective and focused on family well-being. Findings offer a portal for understanding the lived experience of survivors and families in Hawaiian churches. Considerations are suggested for those practitioners assisting clients from collectivist-oriented cultures.