Date of Award
Spring 1994
Document Type
Thesis - Restricted
Degree Name
Master of Science (MS)
Department
Nursing
First Advisor
Lough, Mary Ann
Second Advisor
Shaw, Christine R.
Third Advisor
Rapp, Cathy
Abstract
Cancer poses many physical and psychological challenges to an individual, from the moment it is diagnosed, through surgical intervention, to subsequent medical care and treatments. Although a variety of research has been undertaken to study a patient's response to cancer illness, there remains a need to further explore issues related to needs, adjustment, and coping of persons with cancer from their perspectives. Decreasing length of hospital stays, and the constantly changing and evolving health care system, can impact on a patient's response to cancer. The age or gender of a patient, availability of support, and others factors may create needs and concerns for the patient after discharge. In this study, the investigator questioned what effect a cancer diagnosis had on young to middle aged women undergoing surgery for breast or gynecologic surgery. The multiple roles and responsibilities of this age group of women may place an even greater strain on the individual's ability to cope with a cancer diagnosis. The researcher sought to determine if nurses and/or other health care providers were supplying these patients with the information they needed to care for themselves after hospitalization and make a successful recovery from their cancer surgery and beyond. The purpose of this study was to uncover a social psychological process to describe the experience of young to middle aged women with breast or gynecologic cancer in the first few weeks after surgery. Additional purposes were to identify from the women's perspectives, their discharge needs after surgery for breast and gynecologic cancers, how those needs changed over time, and how well the health care system was meeting the needs of these women once they were at home. This study was conducted utilizing the grounded theory approach as presented by Strauss and Corbin (1990). The sample consisted of five women, aged 33-49, who had undergone surgery for breast or gynecologic cancers. The convenience sample was drawn from the surgical care unit of a 567 bed, private urban hospital. Subjects were interviewed, utilizing a series of open-ended questions formulated by this researcher, at three points in time: within 24 hours of discharge, one week after discharge and three weeks after discharge. Patients were also asked to keep a written journal of their needs and experiences for a three week period after discharge. Data were analyzed via the constant comparative method. By making comparisons and asking questions of the data, the researcher identified seven categories of discharge needs as perceived by the respondents. Those categories of needs were: physical, emotional, role/responsibility, informational, relationship/support, body image/sexuality, and treatment decision. The investigator further described how those needs changed in a three· week period after discharge from the hospital. While many of the physical and role/relationship needs were resolved in this time period, many of the emotional relationship/support, and body image needs were still of great concern. Respondents verbalized that questions and concerns did arise at home for which they had not been adequately prepared. They offered several suggestions to remedy some of these problems. Although theory generation was beyond the scope of this study, the investigator uncovered a process and several common themes from the stories of these women. The findings suggested that the social psychological process of this period of adjustment after discharge was managing the threat. The women described many strategies to cope with the impact of cancer in their lives. The major themes were: returning to normal, facing an uncertain future, and making sense of the experience. A model was proposed to represent this social psychological process a woman experiences after cancer surgery. These findings point to practice implications for nurses and other health care professionals working with women after cancer surgery. They include more extensive teaching related to physical care, providing more information about the disease process and treatment, and arranging for referrals for ongoing emotional needs, such as support groups. Further research is also indicated to determine the long term needs of women after surgery for cancer.
Recommended Citation
Dunbar, Cynthia M., "Perceived Discharge Needs of Women after Surgery for Breast or Gynecologic Cancer" (1994). Master's Theses (1922-2009) Access restricted to Marquette Campus. 3528.
https://epublications.marquette.edu/theses/3528