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The lived experience of life-prolonging treatment of recurring ovarian cancer
Örebro University, School of Health and Medical Sciences.
Institutionen för vårdvetenskap, Ersta Sköndals Högskola, Stockholm.
Örebro University, School of Health and Medical Sciences.ORCID iD: 0000-0002-5063-631X
Örebro University, School of Health and Medical Sciences.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

There has been an improvement in the effectiveness of chemotherapy agents to restrain recurring ovarian cancer, such that women live with the disease for longer than they used to. However, there is a knowledge gap concerning how patients define their world from a lifeworld perspective, when living with life-prolonging treatment. The aim of the study was to illuminate the phenomenon of living with life-prolonging treatment of recurring ovarian cancer. Four women were interviewed twice, once in 2003, three years after the first recurrence, and again in 2005. The method was based on Giorgi’s phenomenological method. A situated structure for each woman was followed by a transformation into a general structure for all women, which communicates the most invariant meaning of the phenomenon.

The general structure showed the growing threat to the women’s existence and their perception that time was short, yet extendable. Awareness of life’s limitedness evoked gratitude for the possibility to postpone death. The body’s strength was increasingly fragile and jeopardized the restraining of the disease. The amount of strength available was unpredictable, which meant a break in the rhythm of everyday life. Strength had to be captured and cared for.

The wish to share the meaning of the disease with others was expressed as unattainable. The women were unable to realize the desire to be seen as an example of someone living with ongoing treatments. In encounters with other people, the cancer-afflicted body stood out as a barrier to communication. Inability to share their experience was also manifested in the women’s encounters with caregivers, which were characterized by an objective attitude. The women met with a gradual compliance their caregivers’ inability to respond to them.

National Category
Nursing Social Sciences Interdisciplinary
Research subject
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-8580OAI: oai:DiVA.org:oru-8580DiVA: diva2:277135
Available from: 2009-11-16 Created: 2009-11-13 Last updated: 2016-12-12Bibliographically approved
In thesis
1. Women's experiences of gynecological cancer and interaction with the health care system through different phases of the disease
Open this publication in new window or tab >>Women's experiences of gynecological cancer and interaction with the health care system through different phases of the disease
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis explores women’s experiences of being diagnosed with gynecological cancer, during different phases of the disease trajectory. The women were undergoing treatment for primary gynecological cancer (study I) and for recurring ovarian cancer (studies II–IV). The focus of studies I and III was the women’s interactions with the health care system, while the experience of recurring ovarian cancer was sought in studies II and IV. Interviews were made and the text was tape-recorded and transcribed. The women in studies I-III were interviewed at the end of their treatment periods.

The method used in studies I and III was subjected to qualitative content analysis.

The aim of study I was to illuminate what women, diagnosed with primary gynecological cancer, reported to be important in their interactions with the health care system. Fourteen women were interviewed. The results were described in three categories: optimal care, good communication, and maintained self-image and sexuality.

The aim in study III was to explore what women with the first recurrence of ovarian cancer perceived as important in their interactions with the health care team. Twelve women were interviewed. The main finding was that the women needed help from the health care team to familiarize themselves with the disease. This theme was supported by the following sub-themes: being confirmed as a person, getting help in making sense of the information about the disease and its treatment, having the opportunity to be involved and to share responsibility, and feeling confident that medical expertise is good enough.

A phenomenological method was used in studies II and IV. The aim of study II was to deepen the understanding of women’s experiences of the first recurrence of ovarian cancer. Twelve women were interviewed. The findings showed three key constituents: being denied one’s future while simultaneously hoping to be able to delay the cancer’s advancement; feeling alienated from both oneself and one’s surroundings; and being responsible. The key constituents was integrated into a structure: living in limbo, characteristic of an existential loneliness.

In study IV, four of the women from studies II–III were interviewed twice, three and five years after the first recurrence. The aim was to illuminate the phenomenon of living with life-prolonging treatment of recurring ovarian cancer. The analysis started with creation of the situated structure for each woman. The situated structures were transformed into a general structure of living with life-prolonging treatment of recurring ovarian cancer that was formulated as follows: time was experienced as short, yet extendable; the body became increasingly fragile; strength proved itself to be unpredictable; and the wish to share the meaning of the disease with others was experienced as unattainable.

The findings produced important knowledge that increases the understanding of the needs of women living with gynecological cancer. This knowledge provides a basis to shape health care delivery in accordance with the needs of the women.

 

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2009. 68 p.
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 37
Keyword
Women`s perspective, gynecological cancer, recurring ovarian cancer, professional-patient relations.
National Category
Surgery Nursing
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-8588 (URN)978-91-7668-701-7 (ISBN)
Public defence
2009-12-10, Wilandersalen, M-huset, Universitetssjukhuset, 701 85 Örebro, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2009-11-16 Created: 2009-11-16 Last updated: 2011-05-02Bibliographically approved

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