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Female breast cancer survivors : perceived stressors and coping strategies during treatment Musgrove, Tamiko Elizabeth

Abstract

Breast cancer is a major health concern for Canadian women. Women diagnosed with breast cancer undergo breast cancer treatment, and must deal with the stressors that treatment presents. The present study drew on Lazarus and Folkman's (1984) transactional model to ensure that the meanings of "stress" and "coping" were based on each woman's appraisals. For the purpose of the study, treatment was defined as at least one breast surgery (i.e., lumpectomy or mastectomy), and at least one form of adjuvant therapy (i.e., chemotherapy, radiation therapy, or hormone therapy). Ten Caucasian women, aged 47 to 74, took place in an audio-taped, semi-structured interview. On average, the interviews were one hour in length. The research question that guided each interview was: "At each stage of breast cancer treatment what was the most salient stressor, and how did the women cope with that stressor?" The interviews were transcribed and analyzed using the constant comparative method (Strauss & Corbin, 1990). Data analysis also included open coding and memo writing. The findings revealed that, for these women, breast cancer treatment presented a number of stressors, and the women responded by mobilizing predominantly active coping strategies. In addition to a lack of concrete links between stressors and coping strategies, a clear progression in the coping strategies of the women throughout treatment was not apparent. However, the themes indicate that the appraisal processes of the women during treatment were complex and dynamic. Seven themes emerged from the analysis that represented the salient stressors and coping strategies during treatment. The themes included: (a) Dimensions of Time, (b) Physical Effects of Treatment, (c) Being Prepared, (d) Emotionality During Treatment, (e) Support from Others, (f) Thoughts to Self, and (g) Doing for Self. What each woman appraised as a stressor depended on her unique interaction with her environment, and the coping strategies she mobilized depended on her view of the world, her coping resources, and her context. An understanding that each woman's appraisal process (i.e., what are stressors) is unique, and that multiple elements contribute to coping is valuable to clinicians working with women undergoing breast cancer treatment.

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