Breast cancer diagnosis and its treatment affecting the self: a meta-synthesis.

There has been a great deal of qualitative research conducted that has examined the impact of breast cancer on the Self, however, there has been little effort to analyze these findings from a meta-perspective. This study sought to fill this gap by conducting a meta-synthesis of the qualitative research on breast cancer and its treatments affecting the Self. Meta-method and meta-synthesis techniques were used to integrate findings across 30 qualitative research reports conducted between 1990 and 2003 with a total of 795 women, from several different countries.The fusions identified from this meta-synthesis revealed 4 aspects of the Self affected by the diagnosis of breast cancer and its treatment: awareness of their own mortality, living with an uncertain certainty, attachment validation, and redefinition of Self. These findings were validated through use of a comparison study. The women adapt to being a breast cancer patient; redefining their lives and their self. This study highlights the existential process that women of many cultures move through as they incorporate the meaning of breast cancer into their lives. Nurses who are aware of these processes are better able to link women with resources to help them in their adaptation to living with breast cancer.

Women's perceptions of the effectiveness of telephone support and education on their adjustment to breast cancer.

PURPOSE/OBJECTIVES: Social support is believed to be important in helping women adjust to breast cancer. Reports have suggested limited positive effects of social support on well-being, mood disturbances, and relationships with significant others for women who receive telephone support. Women's perceptions of the role of social support in recovery, however, has had limited study. The purpose of this study was to describe women's perceptions of their emotional and interpersonal adaptations to breast cancer after their involvement in a randomized clinical trial in which one group received educational materials and telephone support from oncology nurses and another group received educational materials only. RESEARCH APPROACH: Content analysis was used to discover women's perceptions of their emotional and interpersonal adaptation to breast cancer following their participation in a study in which one group received educational materials and telephone support from oncology nurses and another group received educational materials only. SETTING: All participants were interviewed by telephone in their homes. PARTICIPANTS: 77 of 106 women with breast cancer from a randomized clinical trial were interviewed about their expectations of their adaptations and the effectiveness of the experimental and social support intervention delivered by telephone. METHODOLOGIC APPROACH: Telephone interviews were recorded on audiotape and transcribed for analysis. Structured interviews were completed by a non-nurse interviewer. Frequency counts were obtained from the responses to items and comments were clustered for themes. MAIN RESEARCH VARIABLES: Emotional and interpersonal adaptations to breast cancer, educational materials, and telephone support from oncology nurses. FINDINGS: Fifty-four percent of the women who received the telephone support interventions reported improvement in attitude, whereas 43% of the interviewed women in the control group reported improvement. Only three participants, all in the control group, reported worsened emotional status. The percentage of those reporting improved or unchanged physical status was about equal in each group. The majority of participants in both groups indicated that their levels of involvement in activities remained the same or increased. Forty-six percent of participants in the intervention group reported improved relationships with their spouses compared to 38% in the control group. Women from both groups indicated that the diagnosis of cancer had caused them to review their lives and make changes in their relationships and activities. CONCLUSIONS: Participants who received telephone support for one year, in addition to educational materials, reported improvement in their attitudes toward their breast cancer and better relationships with their significant others. INTERPRETATION: The women's perceptions are consistent with quantitative results from the clinical trial. This article reports additional evidence that telephone support is an effective alternative to support groups and may be appropriate for those with limited access to such groups because of geography, work demands, or family situations.