NDLI: Interconnection: A qualitative analysis of adjusting to living with renal cell carcinoma.

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Interconnection: A qualitative analysis of adjusting to living with renal cell carcinoma.

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Interconnection: A qualitative analysis of adjusting to living with renal cell carcinoma.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Leal, Isabel Milbury, Kathrin Engebretson, Joan Matin, Surena Jonasch, Eric Tannir, Nizar Wood, Christopher G. Cohen, Lorenzo
Description	Author Affiliation: Leal I ( Department of Palliative, Rehabilitation, and Integrative Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.); Milbury K ( Department of Palliative, Rehabilitation, and Integrative Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.); Engebretson J ( School of Nursing at the University of Texas Health Science Center,Houston,Texas.); Matin S ( Department of Urology, Division of Surgery,The University of Texas MD Anderson Cancer Center,Houston,Texas.); Jonasch E ( Department of Genitourinary Medical Oncology, Division of Cancer Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.); Tannir N ( Department of Genitourinary Medical Oncology, Division of Cancer Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.); Wood CG ( Department of Urology, Division of Surgery,The University of Texas MD Anderson Cancer Center,Houston,Texas.); Cohen L ( Department of Palliative, Rehabilitation, and Integrative Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.)
Abstract	OBJECTIVE: Adjusting to cancer is an ongoing process, yet few studies explore this adjustment from a qualitative perspective. The aim of our qualitative study was to understand how patients construct their experience of adjusting to living with cancer. METHOD: Qualitative analysis was conducted of written narratives collected from four separate writing sessions as part of a larger expressive writing clinical trial with renal cell carcinoma patients. Thematic analysis and constant comparison were employed to code the primary patterns in the data into themes until thematic saturation was reached at 37 participants. A social constructivist perspective informed data interpretation. RESULTS: Interconnection described the overarching theme underlying the process of adjusting to cancer and involved four interrelated themes: (1) discontinuity-feelings of disconnection and loss following diagnosis; (2) reorientation-to the reality of cancer psychologically and physically; (3) rebuilding-struggling through existential distress to reconnect; and (4) expansion-finding meaning in interconnections with others. Participants related a dialectical movement in which disruption and loss catalyzed an ongoing process of finding meaning. SIGNIFICANCE OF RESULTS: Our findings suggest that adjusting to living with cancer is an ongoing, iterative, nonlinear process. The dynamic interactions between the different themes in this process describe the transformation of meaning as participants move through and revisit prior themes in response to fluctuating symptoms and medical news. It is important that clinicians recognize the dynamic and ongoing process of adjusting to cancer to support patients in addressing their unmet psychosocial needs throughout the changing illness trajectory.
File Format	HTM / HTML
ISSN	14789515
Journal	Palliative and Supportive Care
e-ISSN	14789523
Language	English
Publisher	Cambridge University Press
Publisher Date	2017-03-06
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Palliative Care Discipline Psychology
Content Type	Text
Resource Type	Article
Subject	Nursing Clinical Psychology Psychiatry and Mental Health

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