Transcending breast cancer: making meaning from diagnosis and treatment.

PURPOSE: This qualitative approach study describes the experience of self-transcendence in women newly diagnosed with breast cancer. METHOD: Fourteen women participated from a larger sample of women in a support group project. Each woman was interviewed three times over an 8-month period. Audiotaped transcripts were analyzed using Colaizzi's phenomenological techniques. FINDINGS: Loss of a personal perception of good health and fear of dying from cancer forced women to reach both inside and outside of themselves for support and information. Bonding with other women with breast cancer led to further expansion of self-boundaries that brought comfort, a desire to modify life priorities, and enhanced appreciation of supportive others and of life itself. Over time, clarification and modification of values and behaviors assisted women to create meaning from their experiences. IMPLICATIONS: Nurse referrals to support groups or other resources (such as cancer advocacy organizations) where women interact with similar others may facilitate transcending breast cancer.

Recovery through reconnection: a cultural design for family bereavement in Taiwan.

Using reanalyzed data from ethnographic research performed in Taiwan during the 1990s, the authors inspect Taiwanese cultural patterns as they affect adaptation to loss in the form of death. The data include participant observations and the narratives of 52 widows and 30 of their children. An analysis of interview transcripts suggests that the most common form of return to a harmony house among the participants was achieving a sense of reconnection with the deceased. According to the narratives, the Taiwanese concept of reconnection entails (a) maintaining the status quo, (b) restoring images of the deceased in family affairs, and (c) communicating with the dead. Each theme represents the efforts of bereaved families to retain a sense of wholeness (a central Chinese goal) and to preserve symbolic images of fathers and husbands. The authors suggest that reconnection is a culturally specific and accepted means of resolving grief among Taiwanese.

Resolution of spiritual disequilibrium by women newly diagnosed with breast cancer.

PURPOSE/OBJECTIVES: To describe the experience of restoring and maintaining spiritual equilibrium over a 14-month period by women newly diagnosed with breast cancer. RESEARCH APPROACH: Qualitative approach, longitudinal design. SETTING: Urban breast cancer resource center. PARTICIPANTS: 10 women initially one to five months from diagnosis, 5 of whom attended an eight-week self-transcendence theory-based breast cancer support group. METHODOLOGIC APPROACH: Audiotaped interviews conducted within five months of diagnosis, two to three months later, and one year after that. Narratives were analyzed using Colaizzi's phenomenologic approach. MAIN RESEARCH VARIABLES: Spiritual disequilibrium resolution, breast cancer, self-transcendence. FINDINGS: Spiritual disequilibrium characteristics, as described in several studies of women with breast cancer, were fear of dying and a sense of aloneness in a struggle to maintain self-identity. Disequilibrium triggered all participants to reach outwardly for information and support from other people and faith resources and to reach inwardly to examine life values. Shortly after diagnosis, and continuing throughout the study period, most participants also reached outwardly to support others and conduct breast cancer advocacy work. CONCLUSION: Resolving spiritual disequilibrium for women with newly diagnosed breast cancer means restoring a sense of connection to self, others, and/or a higher power. Self-transcendence views and behaviors evolving over time help women to restore their sense of connectedness, maintain hope for a future, and find renewed purpose and meaning. INTERPRETATION: An initial breast cancer diagnosis may be associated with spiritual disequilibrium that can be as problematic as the physical effects of cancer and cancer treatment. Women restore equilibrium through resolving their sense of disconnectedness and regaining a positive self-identity.

Disability rites: the cultural shift following impairment.

Persons with disabilities experience barriers to health within a culture. The local culture assigns meanings to those with impairments and their activities. In order to understand the experience of disability as influenced by culture, anthropological models of rites of passage and liminality have been used, but these can be extended further. The authors posit that local cultures should be the context for studying disability, and thus extend on previous work by Murphy on the rites of passage for persons with disabilities. This article will: (1) review how disability has been culturally created and defined, (2) provide additional evidence for the argument regarding the existence of disability culture, and (3) extend the work on rites of passage for persons with disabilities. A brief discussion of how this expanded model might guide the understanding of disability and the understanding of barriers to health follows.

Making use of qualitative research.

Many have discussed the importance of using research in practice. To understand this issue, we examined what authors of qualitative research in oncology said about the uses of their research findings. Analysis ofthe authors' implications sections was conducted with 42 articles published between 1995 and 2001 and indexed in either Medline or CINAHL The two categories from this analysis were implications for future research and communication. The categories and related subcategories are illustrated with selected quotes from some of the articles. Findings confirm the importance of language in health and illness.

No more the same: the lives of adolescents in Taiwan who have lost fathers.

This article offers a reconstruction of the life worlds of 30 adolescents, aged 9 to 18, from 20 families who have lost their fathers through death. Through interviews designed to measure the impact of culture on adolescent coping, six themes on rebuilding their lives, "no more the same," were identified: (1) isolation from death, (2) incompleteness, (3) staying inside, (4) worrying with mother, (5) building connections with fathers, and (6) restructuring the family. By exploring the lives of fatherless adolescents in Taiwan, the findings of this study illustrate a metaphor "no more the same" to represent life after father's death in such culture.