Negotiating emotional order: A grounded theory of the survivorship process in women who have completed treatment for breast cancer

Abstract

<p><strong>Rationale:</strong> Decades of research focusing on treatment and detection of breast cancer has promoted better outcomes in treating the disease and longer survival rates. Despite this there is a significant gap in the literatures regarding the survivorship process. Breast cancer survivorship needs to be fully understood by nurses and health care providers (HCP) in order to obtain optimal health outcomes for this ever growing population.</p> <p><strong>Method:</strong> Classic grounded theory was used in this study to explore the process of transitional survivorship from the prospective of women who had completed initial treatment for breast cancer. Approval by the Institutional Board of Research at Rutgers University and Faxton St. Luke&rsquo;s Healthcare was obtained prior to the commencement of the research. Twelve women, who had completed initial treatment for breast cancer were interviewed. Interviews were transcribed verbatim and analysis by constant comparison as described by Glaser.</p> <p><strong>Results:</strong> In this study, the basic social process describing how women with breast cancer perceive their illness and take action was negotiating emotional order. Participants were attempting to bring the psychological aspect of having breast cancer into a state of order by negotiating control with cancer, themselves and external factors. From the data a five stages latent process of negotiating emotional order consists of: 1) Losing Life Order, 2) Assisted Life Order, 3) Assuming Life Order 4) Accepting the Things Cannot Control, and 5) Creating Emotional Order. This latent process also had a cyclical property as evidenced by the data collected from participants that had experienced cancer more than once or had a time period where they were being tested for cancer recurrence.</p> <p><strong>Conclusion:</strong> This research method provided this population of concern with a voice to assist nurses explore the dynamic challenge women experience once they have completed breast cancer treatment and enter extended survivorship. This study&rsquo;s findings may help healthcare providers who care for breast cancer survivors understand the depth and perpetual emotional impact that breast cancer survivors endure. This study will potentially serve as path for future research and aid in the understanding of the psychological impact that breast cancer has upon survivors.</p>