Breast cancer survivors: concerns and coping.

With 5-year cancer survival rates increasing and breast cancer appearing in one of eight women in the United States, health-care providers need to become aware of issues common to this population. Knowledge of coping strategies can be used to improve the lives of survivors. This descriptive study used a semistructured interview to delineate concerns and coping as perceived by 14 women who had lived at least 5 years after a diagnosis of breast cancer. Informants gave evidence of a survivor personality as they described the use of multiple coping strategies, with information-seeking, work, spirituality, and family being predominant. The majority indicated that awareness of vulnerability had effected changes in how they viewed life. Their major concern was fear of recurrence. These women made adjustments to living with cancer and were able to describe positive aspects of their cancer experiences.

A model for improving cancer patient education.

Adjustment to cancer requires modification of behavior that may be aided through patient education. Numerous programs have been developed to meet this need; however, studies show that even after being taught, patients are not well informed. It seems that the process of educating cancer patients needs to be improved. Authors suggest a progression of psychosocial stages of adjustment to serious illness during which specific behaviors are exhibited and coping mechanisms utilized. Understanding the nature of this process forms the basis for effective patient education since theories of adaptation describe behaviors that impact on motivation to learn, information required, and teaching methodology. Failure to attend to this variable of emotional response to the disease can prevent learning. This article integrates the theories of Weisman, Crate, Engle, and Kubler-Ross into an educational model for the cancer patient consisting of six periods. The model suggests nursing approaches, educational topics, and teaching strategies based on the patient's behavioral responses. Use of this model can improve teaching effectiveness in clinical practice by ensuring that the patient is ready to learn prior to teaching and by utilizing teaching strategies appropriate to the educational period. It can further be used as a tool to teach students of nursing how to use the stages of adjustment to chronic illness when planning patient teaching.