Resilience in middle-aged partners of patients diagnosed with incurable cancer: A thematic analysis

Abstract

Background Providing care for patients with advanced cancer is often the responsibility of the partner. Being confronted with an incurable cancer diagnosis can be highly disruptive for the patient’s partner and can be considered a potentially traumatic event. However, most caregivers seem to adapt well during the process of providing care. This finding is in line with the concept of resilience in literature: a dynamic process of adapting well, resulting from the interplay between intrinsic and extrinsic resources and risks. Resilience is age-related, with the elderly population being higher in resilience as compared to the younger generation. However, resilience has been understudied in middle-aged caregivers. Aim To explore what intrinsic and extrinsic resources facilitate or hamper resilience in the middle-aged partner of a patient with incurable cancer. Methods Nine middle-aged partners of patients who died at home of cancer were selected and interviewed in depth within the first year following the death of their partner. A thematic analysis utilizing an inductive approach was conducted. Findings Resilience was challenged by the partner’s diagnosis of incurable cancer. All participants made use of a set of interacting, caregiver-specific and context-related resources, facilitating a resilient process and leading to positive feelings and even personal growth. The partners demonstrated individual competences: adaptive flexibility, positivism, a sense of self-initiative and adaptive dependency. Furthermore, they relied on their context: cancer-related professionals and relatives. Context and situation interact continuously. The resulting dynamics were based on the context-availability, meaningful relationships and the patient’s role. Conclusion A resilient trajectory results from an interplay between individual and contextual resources. To build resilience in middle-aged partners of patients with incurable cancer, health care professionals should address all available resources. Moreover, they should be aware of being part of the caregiver’s context, a complex adaptive system that can be either resilience-supporting or -threatening.

Resilience in family caregivers of patients diagnosed with advanced cancer – unravelling the process of bouncing back from difficult experiences, a hermeneutic review

“…However limited, these studies enhance the knowledge and insight into the intrinsic and extrinsic resources that either facilitate or hamper resilience after having lost a family member diagnosed with advanced cancer. In their qualitative study, Opsomer et al report on how the caregivers' pre-adversity capacity can lead to a resilient process throughout caregiving, characterised by a positive outcome [4]. The study findings fit into Bonanno's framework as follows:…”

“…Very few studies addressing resilience in adult caregivers of adult cancer patients have been published [ 4 , 6 , 7 ]. However limited, these studies enhance the knowledge and insight into the intrinsic and extrinsic resources that either facilitate or hamper resilience after having lost a family member diagnosed with advanced cancer.…”

“…However limited, these studies enhance the knowledge and insight into the intrinsic and extrinsic resources that either facilitate or hamper resilience after having lost a family member diagnosed with advanced cancer. In their qualitative study, Opsomer et al report on how the caregivers’ pre-adversity capacity can lead to a resilient process throughout caregiving, characterised by a positive outcome [ 4 ]. The study findings fit into Bonanno’s framework as follows: The resilient processes were facilitated by interacting, intrinsic resources (adaptive flexibility, positivism, a sense of self-initiative and adaptive dependency) and context-related resources (availability of the context, meaningful relationships and the quality of the marital relationship).…”

“…Studies on resilience in caregivers of advanced cancer patients are scarce [4,6,7,14], and the information needed to develop a resilience-supporting intervention in primary cancer care is still lacking. Hence, more research in this field is vital.…”

“…Hence, some caregivers may be at risk of psychological, physical and social dysfunction (e.g. major depression, anxiety, fatigue, sleeplessness or social isolation) [ 3 ], while others will not experience the diagnosis as a traumatic event [ 4 ]. However, after a short period of disruption, a significant group will probably follow a resilient process, characterised by recovery to a status of healthy functioning, or will even find benefits in caregiving [ 5–7 ].…”