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Admission into a helping plan: a watershed between positive and negative experiences in breast cancer
Umeå University, Faculty of Social Sciences, Department of Social Work. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
Umeå University, Faculty of Social Sciences, Department of Social Work.
Umeå University, Faculty of Social Sciences, Department of Social Work. Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
2010 (English)In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 19, no 8, 806-813 p.Article in journal (Refereed) Published
Abstract [en]

Cancer patients are in an exposed situation that raises certain psychosocial needs in contact with health care. Previous studies have mainly investigated these needs by assessments on predefined categories.Objective: The purpose of the present study is, from the patients' perspective, to identify breast cancer patients' psychosocial needs, and to synthesise them in a model reflecting the core of these needs.Methods: Seventy-one patients treated with radition therapy were consecutively included and repeatedly interviewed about their experiences of health care. 'Critical incidents' where identified from the interviews and analysed due to the similarities-differences technique in grounded theory.Results: Four categories of needs where detected: 'access', 'information', 'treatment', and 'how approached'. These categories and their properties merged into a core category - 'admission into a helping plan'. These findings are well understood in terms of attachment theory. In times of immanent danger and stress people strive to fina a 'safe haven' to attach to. Cancer patients' 'safe haven' can be described as 'a helping plan'. It is not the result of a separate patient-caregiver relationship but is created by a pattern of individual experiences from all kind of contacts with the health-care system as a whole.Conclusions: The presented model of patients needs as converging into 'admission into a helping plan' may serve as an easily comprehendible model for caregivers, guiding them to contribute to the patient's feeling of security and trust, and thus to the patient's own 'hoope work'.

Place, publisher, year, edition, pages
Wiley , 2010. Vol. 19, no 8, 806-813 p.
Keyword [en]
breast cancer, psycho-oncology, patient perspective, attachment theory, critical incident
National Category
Social Work
Research subject
URN: urn:nbn:se:umu:diva-26065DOI: 10.1002/pon.1619ISI: 000280897400002PubMedID: 19771573OAI: diva2:236384
Available from: 2009-09-22 Created: 2009-09-22 Last updated: 2016-01-04
In thesis
1. Betydelser av bröstcancer i ett livssammanhang
Open this publication in new window or tab >>Betydelser av bröstcancer i ett livssammanhang
2013 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[en]
Meanings of breast cancer in a life context
Abstract [en]

The aim of the thesis is to describe and analyse how a group of women experience that their every-day lives are affected during and after primary breast cancer treatment. The thesis is a consecutive, longitudinal study that takes an explorative qualitative approach. Seventy-one women younger than 60 years of age with primary breast cancer were consecutively included in the study. The women were interviewed four or five times over a period of 4 to 6 years from end of radiotherapy. The analyses of the interviews were inspired by grounded theory and narrative analysis. 

The thesis encompasses four papers. Paper I focused on the women’s contact with health care. The results of this study indicate that it is crucial for patients in a vulnerable situation to be admitted into a supportive system – ‘admitted into a helping plan’ – that, more or less explicitly, displays a well-thought-out plan of care. This is a process built on individual relationships with members of the health-care staff, but it ends up in a relationship to health care as a helping system, a ‘safe haven’ to attach to. Study II explored the women’s ideas about what motivated and discouraged their return to work. The results illustrate that the meaning of work fluctuates over time and that the processes of returning to work are conditioned by the patients’ individual life situations. Returning to work was regarded as an important part of the healing process because of how it generated and structured the women’s everyday lives. Returning to work meant demonstrating well-being and normalcy after breast cancer. Study III examined how life was lived and valued during and after treatment for breast cancer compared to pre-cancer life. The analysis showed that being afflicted with breast cancer was evaluated from a context of the women’s former everyday lives and stressed that how the women experienced breast cancer was a matter of personal circumstances. Study IV focused on how the women experienced and dealt with their altered bodies. The results showed that the women followed three different body-mind trajectories that depended to a significant extent on the severity of side effects and bodily alterations that resulted from their treatments.

Being afflicted by breast cancer implies vulnerability and losses, but it can also involve benefits and provide new perspectives on life. How the overall breast cancer experience is valued seems to be very much a matter of circumstances in everyday life. This thesis highlights circumstances that focus in particular on contacts with health care, the body, the work situation, and the family situation. 

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2013. 90 p.
Studier i socialt arbete vid Umeå universitet : avhandlings- och skriftserie, ISSN 0283-300X ; 80
breast cancer, psycho-oncology, oncology, everyday life, patient perspective, gender, sick leave, work, side effects, attachment, 'critical incidents', bröstcancer, psykosocial onkologi, onkologi, vardagsliv, patientperspektiv, genus, sjukskrivning, arbete, biverkningar, anknytning, 'critical incidents'
National Category
Social Work
urn:nbn:se:umu:diva-82968 (URN)978-91-7459-757-8 (ISBN)
Public defence
2013-12-06, Samhällsvetarhuset, Hörsal B, Umeå universitet, Umeå, 13:00 (Swedish)
Swedish Cancer Society
Available from: 2013-11-15 Created: 2013-11-14 Last updated: 2013-11-14Bibliographically approved

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Lilliehorn, SaraHamberg, KatarinaKero, AnneliSalander, Pär
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