Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-25T20:59:17.683Z Has data issue: false hasContentIssue false

Strength through adversity: Bereaved cancer carers' accounts of rewards and personal growth from caring

Published online by Cambridge University Press:  18 June 2009

W.K. Tim Wong
Affiliation:
Gender, Culture, and Health Research Unit: PsyHealth, School of Psychology, University of Western Sydney, Australia
Jane Ussher*
Affiliation:
Gender, Culture, and Health Research Unit: PsyHealth, School of Psychology, University of Western Sydney, Australia
Janette Perz
Affiliation:
Gender, Culture, and Health Research Unit: PsyHealth, School of Psychology, University of Western Sydney, Australia
*
Address correspondence and reprint requests to: Jane Ussher, Gender, Culture, and Health Research Unit: PsyHealth, School of Psychology, University of Western Sydney, Locked Bag 1797, Penrith South DC, New South Wales 1797, Australia. E-mail: [email protected]

Abstract

Objective:

Many studies have identified negative and distressing consequences experienced by informal cancer carers, but less attention has been given to positive and beneficial aspects of caring. This qualitative study examined the positive aspects of caring as subjectively constructed by bereaved informal cancer carers, a group of individuals who are in a position to make sense of their caring experiences as a coherent whole.

Method:

Twenty-three bereaved informal cancer carers were interviewed, and their accounts were analyzed using a thematic analytical approach from a phenomenological perspective.

Results:

The participants were able to identify positive and beneficial aspects of caring. These included the discovery of personal strength, through adversity, acceptance, and necessity; the deepening of their relationship with the person for whom they cared; and personal growth through altered relationships with others and altered perspectives on living. Many participants gave accounts of focusing on these positive benefits when they reflected on their caring experiences.

Significance of results:

We concluded that benefit finding in the face of adverse events serves an important function in allowing individuals to incorporate difficult experiences into their worldview in a meaningful way, thus maintaining positive beliefs about the world. This has implications for the development of interventions for informal cancer carers and for those who are bereaved following caring.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Addington-Hall, J. & Ramirez, A. (2006). The carers. In ABC of Palliative Care (2nd ed.), Fallon, M. & Hanks, G. (eds.), pp. 5658. Malden, MA: Blackwell Publishing.Google Scholar
Andershed, B. & Ternestedt, B.-M. (1999). Involvement of relatives in care of the dying in different care cultures: Development of a theoretical understanding. Nursing Science Quarterly, 12, 4551.Google Scholar
Aranda, S.K. & Hayman-White, K. (2001). Home caregivers of the person with advanced cancer: An Australian perspective. Cancer Nursing, 24, 300307.Google Scholar
Bonanno, G.A., Papa, A. & O'Neill, K. (2002). Loss and human resilience. Applied and Preventive Psychology, 10, 193206.Google Scholar
Boyatzis, R.E. (1998). Transforming Qualitative Information: Thematic Analysis and Code Development. Thousand Oaks, CA: Sage.Google Scholar
Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77101.Google Scholar
Carter, P.A. (2001). A not-so-silent cry for help: Older female cancer caregivers' need for information. Journal of Holistic Nursing, 19, 271284.CrossRefGoogle ScholarPubMed
Cherlin, E.J., Barry, C.L., Prigerson, H.G., et al. (2007). Bereavement services for family caregivers: How often used, why, and why not. Journal of Palliative Medicine, 10, 148158.CrossRefGoogle ScholarPubMed
Coyle, N. (2004). Commentary: Positive aspects and challenges associated with caring for a dying relative at home. International Journal of Palliative Nursing, 10, 65.Google Scholar
Davis, C.G., Nolen-Hoeksema, S. & Larson, J. (1998). Making sense of loss and benefiting from the experience: Two construals of meaning. Journal of Personality and Social Psychology, 75, 561574.Google Scholar
Fife, B.L. (1994). The conceptualization of meaning in illness. Social Science and Medicine, 38, 309316.CrossRefGoogle ScholarPubMed
Folkman, S. (1997). Use of bereavement narratives to predict well-being in gay men whose partners died of AIDS: Four theoretical perspectives. Journal of Personality and Social Psychology, 72, 851854.CrossRefGoogle ScholarPubMed
Gaston-Johansson, F., Lachica, E.M., Fall-Dickson, J.M., et al. (2004). Psychological distress, fatigue, burden of care, and quality of life in primary caregivers of patients with breast cancer undergoing autologous bone marrow transplantation. Oncology Nursing Forum, 31, 11611169.Google Scholar
Gergen, K.J. (1985). The social constructionist movement in modern psychology. American Psychologist, 40, 266275.Google Scholar
Gergen, K.J. & Gergen, M.M. (1993). Narrative and the self as relationship. In Refiguring Self and Psychology, Gergen, K.J. (ed.), pp. 201240. Aldershot: Dartmouth.Google Scholar
Germino, B.B., Fife, B.L. & Funk, S.G. (1995). Cancer and the partner relationship: What is its meaning? Seminars in Oncology Nursing, 11, 4350.Google Scholar
Grbich, C., Parker, D. & Maddocks, I. (2001). The emotions and coping strategies of caregivers of family members with a terminal cancer. Journal of Palliative Care, 17, 3036.Google Scholar
Harré, R. (2006). Phenomenology. In The Sage Dictionary of Social Research Methods, Jupp, V. (ed.), pp. 220222. London: Sage.Google Scholar
Hodges, L.J., Humphris, G.M. & Macfarlane, G. (2005). A meta-analytic investigation of the relationship between the psychological distress of cancer patients and their carers. Social Science & Medicine, 60, 112.Google Scholar
Hudson, P. (2004). Positive aspects and challenges associated with caring for a dying relative at home. International Journal of Palliative Nursing, 10, 5864.Google Scholar
Hudson, P. (2006). How well do family caregivers cope after caring for a relative with advanced disease and how can health professionals enhance their support? Journal of Palliative Medicine, 9, 694703.CrossRefGoogle ScholarPubMed
Hudson, P., Aranda, S. & Hayman-White, K. (2005). A psycho-educational intervention for family caregivers of patients receiving palliative care: A randomized controlled trial. Journal of Pain and Symptom Management, 30, 329341.Google Scholar
Jo, S., Brazil, K., Lohfeld, L., et al. (2007). Caregiving at the end of life: Perspectives from spousal caregivers and care recipients. Palliative and Supportive Care, 5, 1117.CrossRefGoogle ScholarPubMed
Kim, Y., Schulz, R. & Carver, C.S. (2007). Benefit-finding in the cancer caregiving experience. Psychosomatic Medicine, 69, 283291.Google Scholar
Koop, P.M. & Strang, V.R. (2003). The bereavement experience following home-based family caregiving for persons with advanced cancer. Clinical Nursing Research, 12, 127144.Google Scholar
Kramer, B.J. (1997). Gain in the caregiving experience: Where are we? What next? The Gerontologist, 37, 218232.Google Scholar
Lazarus, R.S. (1998). Fifty Years of the Research and Theory of R.S. Lazarus: An Analysis of Historical and Perennial Issues. Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
Leedham, B. & Meyerowitz, B.E. (1999). Responses to parental cancer: A clinical perspective. Journal of Clinical Psychology in Medical Settings, 6, 441461.Google Scholar
Leonard, V.W. (1994). A Heideggerian phenomenological perspective on the concept of person. In Interpretive Phenomenology, Benner, P. (ed.), pp. 4363. Thousand Oaks, CA: Sage.Google Scholar
Manne, S., Babb, J., Pinover, W., et al. (2004). Psychoeducational group intervention for wives of men with prostate cancer. Psycho-Oncology, 13, 3746.Google Scholar
Marshall, C. & Rossman, G.B. (1999). Designing qualitative research (3rd ed.). Thousand Oaks, CA: Sage.Google Scholar
Monroe, B. & Oliviere, D. (2007). Unlocking resilience in palliative care. In Resilience in Palliative Care: Achievement in Adversity, Monroe, B. & Oliviere, D. (eds.), pp. 17. Oxford: Oxford University Press.Google Scholar
Neimeyer, R.A. (2006). Making meaning in the midst of loss. Grief Matters, 9, 6265.Google Scholar
Neimeyer, R.A., Baldwin, S.A. & Gillies, J. (2006). Continuing bonds and reconstructing meaning: Mitigating complications in bereavement. Death Studies, 30, 715738.CrossRefGoogle ScholarPubMed
Nelson, J.P. (1996). Struggling to gain meaning: Living with the undertainty of breast cancer. Advances in Nursing Science, 18, 5976.Google Scholar
O'Connor, D.L. (2007). Self-identifying as a caregiver: Exploring the positioning process. Journal of Aging Studies, 21, 165174.Google Scholar
Pakenham, K.I. (2005). The positive impact of multiple sclerosis (MS) on carers: Associations between carer benefit finding and positive and negative adjustment domains. Disability & Rehabilitation, 27, 985997.CrossRefGoogle ScholarPubMed
Payne, S., Smith, P. & Dean, S. (1999). Identifying the concerns of informal carers in palliative care. Palliative Medicine, 13, 3744.Google Scholar
Sears, S.R., Stanton, A.L. & Danoff-Burg, S. (2003). The yellow brick road and the emerald city: Benefit finding, positive reappraisal coping and posttraumatic growth in women with early-stage breast cancer. Health Psychology, 22, 487497.CrossRefGoogle ScholarPubMed
Sinding, C. (2003). “Because you know there's an end to it”: Caring for a relative or friend with advanced breast cancer. Palliative and Supportive Care, 1, 153163.Google Scholar
Soothill, K., Morris, S.M., Harman, J.C., et al. (2001). Informal carers of cancer patients: What are their unmet psychosocial needs? Health and Social Care in the Community, 9, 464475.Google Scholar
Taylor, G.W. & Ussher, J.M. (2001). Making sense of S&M: A discourse analytic account. Sexualities, 4, 293314.CrossRefGoogle Scholar
Thomas, C. & Morris, S.M. (2002). Informal carers in cancer contexts. European Journal of Cancer Care, 11, 178182.Google Scholar
Thomas, C., Morris, S.M. & Harman, J.C. (2002). Companions through cancer: The care given by informal carers in cancer contexts. Social Science & Medicine, 54, 529544.Google Scholar
Thornton, A.A. (2002). Perceiving benefits in the cancer experience. Journal of Clinical Psychology in Medical Settings, 9, 153165.Google Scholar
Ussher, J. & Sandoval, M. (2008). Gender differences in the construction and experience of cancer care: The consequences of the gendered positioning of carers. Psychology & Health, 23, 945963.CrossRefGoogle ScholarPubMed
Waldrop, D.P. (2007). Caregiver grief in terminal illness and bereavement: A mixed-methods study. Health & Social Work, 32, 197206.Google Scholar