Disrupted lives and threats to identity: The experiences of people with colorectal cancer within the first year following diagnosis

Abstract

Fax: +44(0)1786 460060 Word count 7853Dr Gill Hubbard is a senior research fellow who leads the 'Cancer as a long-term condition' research programme at CCRC. She has a background in sociology and social policy.Dr Lisa Kidd is a research fellow at CCRC. She has a background in nursing and has recently been awarded a Doctor of Philosophy for a study of perceived control and involvement in self care for people with cancer.Professor Nora Kearney is Director of CCRC. She has a background in nursing and an extensive track record in cancer care research, in particular, in symptom improvement and patient experiences. 1 Disrupted lives and threats to identity: The experiences of people with colorectal cancer within the first year following diagnosis AbstractIn this paper we focus on the experiences of 18 people with colorectal cancer, involved in a large longitudinal qualitative study to explore people's experiences of cancer within the first year following diagnosis. Three depth interviews over the course of the year were carried out.During analysis, we drew on biographically informed approaches of understanding chronic illness, particularly the work of Bury (1982;2001;1991) and Charmaz (1994;1983;1995;2002) to explore the extent to which people within the first year following diagnosis experience cancer as biographically disruptive. We explore the biographical work that individuals carry out in the context of an assault on their identity and discuss the relevance of the concept biographical disruption for people who experience cancer as an acute, chronic and/or life-threatening condition. We also discuss the concept's relevance for people who have lived a hard life and, hence, may anticipate these types of disruptions in their lives and experience their impact differently. We conclude that universal application of the concept biographical disruption to the experience of cancer within the first year of diagnosis is not appropriate. This study has implications for cancer services, in particular, the findings call for the development of interventions to support those people who experience cancer as an assault on their identity.

Living and dying with metastatic bowel cancer: Serial in-depth interviews with patients

“…Fluctuations in psycho‐social and spiritual wellbeing also occur as patients suffer gradual social decline and seek meaning and purpose in their distress (Murray et al., 2007). Patients may also reflect on life's value as the illness progresses (Houldin & Lewis, 2006; Sjovall, Gunnars, Olsson, & Thome, 2011) and their sense of self is compromised, which can result in social isolation and existential distress (Hubbard, Kidd, & Kearney, 2010; Kidd, Kearney, O'Carroll, & Hubbard, 2008; Little, Jordens, Paul, Montgomery, & Philipson, 1998; Rozmovits & Ziebland, 2004; Taylor, 2001). …”

Primeiro ano de pós-operatório: significado para a pessoa com estoma intestinal por câncer colorretal

“…O impacto sobre o self da pessoa é decorrente das mudanças física, emocional e social, que podem torná-la uma estranha para si mesma. Esta ruptura pode ser temporária ou permanente, mas o que determina a extensão é a repercussão na identidade da pessoa e o por vir da incapacidade ou deficiência (BURY, 1982;CHARMAZ, 1983CHARMAZ, , 1995HUBBARD;KIDD;KEARNEY, 2010).…”

“…Ocorre uma transição da focalização inicial das mudanças corporais da pessoa para as repercussões destas mudanças na sua identidade, com a mobilização da pessoa e de seus recursos para o enfrentamento do adoecimento oncológico por CCR (BURY, 1982;CHARMAZ, 1983CHARMAZ, , 1995HUBBARD;KIDD;KEARNEY, 2010).…”

Paciente com câncer colorretal em quimioterapia adjuvante: evidências para os cuidados com estoma e equipamentos coletores

“…No caso específico dos pacientes com câncer colorretal (CCR), além do enfrentamento do adoecimento, o paciente e a família se deparam com os tratamentos e suas consequências, que modificam o seu cotidiano e assim necessitam de suporte profissional ao longo de sua sobrevivência (SONOBE; BARICHELLO; ZAGO, 2002;SOUZA et al, 2010;HUBBARD;KIDD;KEARNEY, 2010;MOTTA, 2013;BUETTO, 2014;LENZA et al, 2013;LENZA et al, 2015;SANTOS, 2015).…”

“…Assim, no período de cerca de seis meses de pós-operatório, estes necessitam de maior suporte multiprofissional, principalmente, para a adaptação à nova condição e para a realização dos tratamentos adjuvantes, quer sejam QtA ou radioterapia (SONOBE; BARICHELLO; ZAGO, 2002;HUBBARD;KIDD;KEARNEY, 2010;MOTTA, 2013;BUETTO, 2013;LENZA et al, 2013;LENZA et al, 2015;SANTOS, 2015). (BRASIL, 2008;BRASIL, 2013;BRASIL, 2014;BRASIL, 2015).…”