Date of Award

2012

Degree Type

Thesis

Degree Name

Master of Nursing

School

Nursing and Midwifery

Faculty

Computing, Health and Science

First Advisor

Associate Professor Anne Williams

Second Advisor

Professor Leanne Monterosso

Abstract

This study explored and described the experience of people with a diagnosis of cancer, as they transitioned from life as a chemotherapy patient to life after treatment as a cancer survivor. The purpose of this study was to ultimately improve the care of people as they transitioned into life after completion of chemotherapy treatment. There is minimal information related to this phase of the cancer trajectory, therefore this study was intentionally exploratory and descriptive. To achieve the proposed outcome a two-phased approach was undertaken. In Phase One a qualitative approach was followed using Grounded Theory to the descriptive level of data analysis. The study was undertaken in a large tertiary hospital in Western Australia. The sample comprised of 14 cancer survivors who had completed chemotherapy treatment in the previous four to twelve weeks. Data was collected via semi structured telephone interviews. Descriptors of issues and experiences that arose in the first six months following completion of chemotherapy were elicited. Data was subsequently transcribed, coded and organised into themes of congruent relevance. Cancer survivors were found to transition through two stages in the early weeks following completion of chemotherapy. When physical symptoms and emotional losses were all encompassing, the survivors displayed vulnerability due to the loss of the treatment environment and a range of challenging emotions. As the weeks passed and physical symptoms began to abate, the survivors began to display characteristics of resilience, self empowerment and information seeking strategies which both informed and protected the survivor. The domains that challenged the survivor throughout this transition period encompassed physical, social, psychological and spiritual issues. In Phase Two of the study, key findings from Phase One were utilised to inform the adaptation of an existing quality of life tool, Quality of life – Cancer Survivor, which was identified following an extensive literature review. The adapted tool, Quality of Life – Chemotherapy Cancer Survivor, was assessed for clarity, content validity and apparent internal consistency by an expert panel of six oncology nurses who were employed within the same tertiary hospital setting. Feedback from this process was used to further amend the original tool. The researcher intends to pilot test the revised tool with cancer survivors in preparation for a larger scale population based study following this Masters study. This study has provided an insight into the survivorship issues as people transition to life after chemotherapy and findings begin to fill a gap in understanding which has not previously be addressed in the available literature. Implications for future research and clinical practice including, gaps in survivor’s knowledge and transition process issues, are provided.

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