Exploring the perception of survivors on the bidirectional impact between cancer and their social contexts: A mixed-methods approach

Abstract

ObjectiveThe purpose of the current study was to use a mixed-methods approach to assess the perspective of cancer survivors on the bidirectional impact between cancer and their social contexts.MethodA fixed concurrent triangulation mixed-methods survey design was used with open- and closed-ended questions that were predetermined and administered to participants. Quantitative items included demographic questions and the Life Impact Checklist. Qualitative questions were designed to explore the bidirectional impact between the patient and specific contexts including spirituality/faith, the spousal/partner relationship, and the family. A cross-sectional descriptive approach was used to evaluate the quantitative items and the constant comparative method guided the analysis of open-ended questions.ResultAmong 116 participants (mean age 58.4 years), the majority were female (66.7%) with breast cancer (27.9%). Nearly one-half the respondents endorsed a positive impact of cancer on their spirituality/faith, but qualitative results suggested less of a bidirectional impact. The importance of the spouse/partner during the cancer experience was emphasized, including the subthemes of instrumental and emotional support; however, there was often a negative impact of cancer on the spouse/partner relationship, including sexual functioning. Survivors indicated family members provided instrumental and emotional support, but not as regularly or directly as a spouse/partner.Significance of resultsSocial contexts are important among cancer survivors, with many cancer survivors relying more on their spouse/partner than other family members for support. The cancer experience is stressful not only for survivors, but also for individuals in their social contexts and relationships.

The religious/spiritual beliefs and needs of cancer survivors who underwent cancer-directed surgery

“…The Institute of Medicine describes patient-centered care as “providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions” (Institute of Medicine, 2001). For many patients, this undoubtedly includes R&S beliefs and practices (Palmer Kelly et al, 2019 a ; Merath et al, 2019). This facet of a patient's life is, however, often overlooked despite increased recognition of its importance from organizations such as the American Society of Clinical Oncology (Pargament et al, 2004; Puchalski et al, 2019).…”

A mixed‐methods approach to comparing perceptions of cancer patients' and cancer care providers' religious and spiritual beliefs, behaviours, and attitudes

“…This may be in part due to patient R&S beliefs before their cancer diagnosis. Specifically, patients with R&S beliefs before a cancer diagnosis may use them as a positive means to cope with their diagnosis and treatment (Palmer Kelly et al, 2019; Puchalski, 2012). Current research on patients with terminal or advanced cancer diagnosis has suggested that as many as 40% of individuals reported a stronger commitment to their religious beliefs or renewed spirituality in the year before their death (Puchalski et al, 2006).…”

“…Current research on patients with terminal or advanced cancer diagnosis has suggested that as many as 40% of individuals reported a stronger commitment to their religious beliefs or renewed spirituality in the year before their death (Puchalski et al, 2006). It is less likely that patients report adapting R&S beliefs as a reaction to a cancer diagnosis if those beliefs were not present pre‐diagnosis (Merath et al, 2019; Palmer Kelly et al, 2019). Continuing to understand how patient R&S beliefs and needs may evolve across the cancer care trajectory, as well as how providers can assess and adapt their approach to patients changing needs, will be important to improving spiritual care.…”