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Experiences of women with breast cancer : a critical incident study Crawford, Frederick

Abstract

Breast cancer is a disease that affects many thousands of Canadian women every year. Battling such a disease often involves an arduous and highly invasive regime of eradicative medical treatment, including perhaps surgery, chemotherapy, radiation and/or hormonal therapy. A growing body of literature is available which aims at illuminating the various experiences women undergo while receiving such medical treatment. While the majority of the available literature focuses on studies of a quantitative nature, a few are in existence which report on qualitative studies, studies where women undergoing the process of treatment for breast cancer are viewed as the "experts" of this process. The aim of this study was to explore the experiences of twelve women, aged from 41 to 70 years (M= 55 years old) who underwent eradicative medical treatment for breast cancer, from their own perspectives. To this end, the critical incident technique was used (Flannagan, 1954), through which women were asked to identify, during audiotaped interviews, experiences which both helped and hindered their treatment processes. Each of the twelve participants, or co-researchers, were interviewed twice; from these interviews, a total of 453 critical incidents were identified, and used to develop 15 thematic categories of experience for the participants involved: (a) relations with the medical team and any support staff (helpful vs. hindering), (b) medical treatment and services (helpful vs. hindering), (c) personal support (helpful vs. hindering), (d) activities/things which aid in treatment and recovery (or which did not help), (e) locus of control (helped vs. hindered), (f) availability and presentation of appropriate educational information (helpful vs. hindering), (g) attitude towards life and the human community (helpful), (h) support/psychoeducational agencies/groups/centres (helpful vs. hindering), (i) maternal/caregiving role/behavior (helpful vs. hindering), (j) career as a medical professional (helpful vs. hindering), (k) spiritual beliefs (helpful), (1) career (helpful vs. hindering), (m) personal involvement in decision making (helpful), (n) physical appearance (helpful vs. hindering), and (o) alternative treatments (helpful). Category validity was tested through four procedures: (a) cross-checking by the co-researchers, of the incidents (and their appropriate category placement) during the second interviews, (b) exhaustiveness of the categories, where two complete interviews were put aside, and their incidents later placed in the already existing 15 formed categories, (c) the services of an external rater, who independently placed 100 of the 453 critical incidents into the already existing categories, and (d) linking the categories to some of the existing literature on theories related to counselling psychology, particularly those involving crisis, transition and resiliency, implications for counselling research and practice are briefly discussed.

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