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The impact of breast cancer on living an everyday life 4.5-5 years post-diagnosis: a qualitative prospective study of 39 women
Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå centrum för genusstudier (UCGS).
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
2011 (Engelska)Ingår i: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 50, nr 3, s. 399-407Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background. The survival of women with breast cancer has improved. There are many studies available describing different aspects of how the illness and its treatment affect the women. Usually these studies are cross-sectional and focus on assessments of a sample of women at a single point in time during post-treatment. These studies are important but of limited value if we are interested in understanding more about breast cancer in a life context. The present study is a contribution.

Methods. A consecutive sample of 39 women was followed up by means of repeated thematic interviews about how they lived their lives, from the end of radiation therapy to a point four years later, i.e. 4.5–5 years post diagnosis.

Results. Four different groups of women emerged. Largely, the first group evaluated the cancer initiated transformation of their lives in a positive way. The breast cancer helped them depart from a career treadmill or to positive interpersonal experiences. In the second group the cancer and its treatment seemed to pass without marked traces. The cancer made a difference for the third group, but both in positive and negative ways. A different life perspective or improved relationships were weighted against troublesome side effects from treatment. Finally, in the fourth group a bodily decline due to side effects and other health problems was predominant and this obstructed their chances of living a good life.

Discussion. The narratives showed that being diseased by breast cancer has different impacts depending on how the woman lives her life – it is very much a matter of transition in a life context. The results are furthermore discussed in relation to adaptation and coping theory.

Ort, förlag, år, upplaga, sidor
Informa Plc. , 2011. Vol. 50, nr 3, s. 399-407
Nationell ämneskategori
Genusstudier Socialt arbete
Identifikatorer
URN: urn:nbn:se:umu:diva-38974DOI: 10.3109/0284186X.2010.547216OAI: oai:DiVA.org:umu-38974DiVA, id: diva2:386716
Tillgänglig från: 2011-01-13 Skapad: 2011-01-13 Senast uppdaterad: 2018-06-08Bibliografiskt granskad
Ingår i avhandling
1. Betydelser av bröstcancer i ett livssammanhang
Öppna denna publikation i ny flik eller fönster >>Betydelser av bröstcancer i ett livssammanhang
2013 (Svenska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Alternativ titel[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. 

Ort, förlag, år, upplaga, sidor
Umeå: Umeå universitet, 2013. s. 90
Serie
Studier i socialt arbete vid Umeå universitet : avhandlings- och skriftserie, ISSN 0283-300X ; 80
Nyckelord
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'
Nationell ämneskategori
Socialt arbete
Identifikatorer
urn:nbn:se:umu:diva-82968 (URN)978-91-7459-757-8 (ISBN)
Disputation
2013-12-06, Samhällsvetarhuset, Hörsal B, Umeå universitet, Umeå, 13:00 (Svenska)
Opponent
Handledare
Forskningsfinansiär
Cancerfonden
Tillgänglig från: 2013-11-15 Skapad: 2013-11-14 Senast uppdaterad: 2018-06-08Bibliografiskt granskad

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Salander, PärLilliehorn, SaraHamberg, KatarinaKero, Anneli

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