Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-25T22:57:21.500Z Has data issue: false hasContentIssue false
  • English
  • Français

Cancer treatment experiences among survivors of childhood sexual abuse: A qualitative investigation of triggers and reactions to cumulative trauma

Published online by Cambridge University Press:  15 August 2017

Julie B. Schnur ,
Matthew J. Dillon ,
Rachel E. Goldsmith  and
Guy H. Montgomery
Julie B. Schnur*
Affiliation:
Department of Oncological Sciences, Integrative Behavioral Medicine Program, Icahn School of Medicine at Mount Sinai, New York, New York
Matthew J. Dillon
Affiliation:
Department of Oncological Sciences, Integrative Behavioral Medicine Program, Icahn School of Medicine at Mount Sinai, New York, New York
Rachel E. Goldsmith
Affiliation:
Department of Oncological Sciences, Integrative Behavioral Medicine Program, Icahn School of Medicine at Mount Sinai, New York, New York
Guy H. Montgomery
Affiliation:
Department of Oncological Sciences, Integrative Behavioral Medicine Program, Icahn School of Medicine at Mount Sinai, New York, New York
*
Address correspondence and reprint requests to: Julie B. Schnur, Department of Oncological Sciences, Box 1130, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, New York 10029-6574. E-mail: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Some 25% of women and 8% of men in the United States have experienced childhood sexual abuse (CSA) before the age of 18. For these individuals, healthcare visits and interactions can be retraumatizing due to perceived similarities to past abuse (e.g., pain, undressing, lack of control). However, no prior studies have provided formal qualitative analyses regarding CSA survivors' reactions to cancer treatment. Therefore, our study's objective was to identify key themes pertaining to CSA survivors' cancer treatment experiences.

Method:

Male and female members of the Amazon Mechanical Turk (N = 159, mean age = 44.27 years, SD = 10.02) participated in an anonymous online survey study. The inclusion criteria included reporting: history of CSA; a diagnosis of colorectal, gynecological, breast, or skin cancer; and experience of triggers and/or difficulties during cancer treatment. Participants' responses to open-ended questions were analyzed using inductive thematic analysis.

Results:

We identified two primary themes describing CSA survivors' experiences: Theme 1: treatment-related triggers (key subthemes: procedure-related, provider-related, and emotional triggers); and Theme 2: questioning the meaning of cumulative trauma (e.g., “Why me again?”).

Significance of results:

For CSA survivors, cancer and its treatment can trigger thoughts and emotions associated with the original abuse as well as negative evaluations of themselves, the world, and their future. Our findings are consistent with past research on CSA survivors' experiences in non-cancer healthcare settings and add to the literature by highlighting their struggles during cancer treatment. The present results can inform further research on trauma survivors' reactions to cancer treatment and give cancer care providers the context they need to understand and sensitively serve a substantial yet often overlooked patient group.

Keywords

CancerQualitativeChildhood sexual abuseRetraumatizationPatient experience
Type
Original Article
Information
Palliative & Supportive Care , Volume 16 , Issue 6 , December 2018 , pp. 767 - 776
Copyright
Copyright © Cambridge University Press 2017 

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

Alcala, H.E., Mitchell, E. & Keim-Malpass, J. (2016). Adverse childhood experiences and cervical cancer screening. Journal of Women's Health (Larchmont), 26(1), 58–63.Google Scholar
Arch, J.J. & Carr, A.L. (2016). Using Mechanical Turk for research on cancer survivors. Psycho-Oncology. doi: 10.1002/pon.4173. Epub ahead of print Jun 10.Google Scholar
Babcock, R.L. & DePrince, A.P. (2012). Childhood betrayal trauma and self-blame appraisals among survivors of intimate partner abuse. Journal of Trauma & Dissociation, 13(5), 526–538.Google Scholar
Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.Google Scholar
Breiding, M., Basile, K., Smith, S., et al. (2014). Sexual Violence Surveillance: Uniform Definitions and Recommended Data Elements, Version 2.0. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Available from https://www.cdc.gov/violenceprevention/pdf/sv_surveillance_definitionsl-2009-a.pdf,Google Scholar
Brière, J. & Hodges, M. (2010). Assessing the impacts of early and later childhood trauma in adults. In The Impact of Early Life Trauma on Health and Disease: The Hidden Epidemic. Lanius, R.A. et al. (eds.), pp. 207–216. New York: Cambridge University Press.Google Scholar
Brown, M.J., Thacker, L.R. & Cohen, S.A. (2013). Association between adverse childhood experiences and diagnosis of cancer. PLoS One, 8(6), e65524. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679131/.Google Scholar
Buhrmester, M., Kwang, T. & Gosling, S.D. (2011). Amazon's Mechanical Turk: A new source of inexpensive, yet high-quality, data? Perspectives on Psychological Science, 6(1), 3–5.Google Scholar
Cadman, L., Waller, J., Ashdown-Barr, L. & Szarewski, A. (2012). Barriers to cervical screening in women who have experienced sexual abuse: An exploratory study. The Journal of Family Planning and Reproductive Health Care, 38(4), 214–220.Google Scholar
Caplan, S.E. & Turner, J.S. (2007). Bringing theory to research on computer-mediated comforting communication. Computers in Human Behavior, 23(2), 985–998.Google Scholar
Clark, L., Beesley, H., Holcombe, C., et al. (2011). The influence of childhood abuse and adult attachment style on clinical relationships in breast cancer care. General Hospital Psychiatry, 33(6), 579–586.Google Scholar
Dallam, S.J. (2010). A Model of the Retraumatization Process: A Meta-Synthesis of Childhood Sexual Abuse Survivors' Experiences in Healthcare. Doctoral dissertation, Graduate Program in Nursing. Lawrence: University of Kansas. Available from https://search.proquest.com/docview/305205775.Google Scholar
East, L., Jackson, D., O'Brien, L., et al. (2008). The benefits of computer-mediated communication in nursing research. Contemporary Nurse, 30(1), 83–88.Google Scholar
Gallo-Silver, L. & Weiner, M.O. (2006). Survivors of childhood sexual abuse diagnosed with cancer: Managing the impact of early trauma on cancer treatment. Journal of Psychosocial Oncology, 24(1), 107–134.Google Scholar
Gesink, D. & Nattel, L. (2015). A qualitative cancer screening study with childhood sexual abuse survivors: Experiences, perspectives and compassionate care. BMJ Open, 5(8), e007628. Available from https://www.ncbi.nlm.nih.gov/pubmed/26246075.Google Scholar
Griffin, M.G., Resick, P.A., Waldrop, A.E., et al. (2003). Participation in trauma research: Is there evidence of harm? Journal of Traumatic Stress, 16(3), 221–227.Google Scholar
Havig, K. (2008). The health care experiences of adult survivors of child sexual abuse: A systematic review of evidence on sensitive practice. Trauma, Violence & Abuse, 9(1), 19–33.Google Scholar
Janoff-Bulman, R. (1992). Shattered Assumptions: Towards a New Psychology of Trauma. New York: Free Press.Google Scholar
Leeners, B., Stiller, R., Block, E., et al. (2007). Effect of childhood sexual abuse on gynecologic care as an adult. Psychosomatics, 48(5), 385–393.Google Scholar
Malterud, K. (2001). Qualitative research: Standards, challenges, and guidelines. Lancet, 358(9280), 483–488.Google Scholar
McGregor, K., Julich, S., Glover, M., et al. (2010). Health professionals' responses to disclosure of child sexual abuse history: Female child sexual abuse survivors' experiences. Journal of Child Sexual Abuse, 19(3), 239–254.Google Scholar
Monahan, K. & Forgash, C. (2000). Enhancing the health care experiences of adult female survivors of childhood sexual abuse. Women & Health, 30(4), 27–41.Google Scholar
Paolacci, G., Chandler, J. & Ipeirotis, P.G. (2010). Running experiments on Amazon Mechanical Turk. Judgment and Decision Making, 5(5), 411–419.Google Scholar
Pereda, N., Guilera, G., Forns, M., et al. (2009). The prevalence of child sexual abuse in community and student samples: A meta-analysis. Clinical Psychology Review, 29(4), 328–338.Google Scholar
Rand, D.G. (2011). The promise of Mechanical Turk: How online labor markets can help theorists run behavioral experiments. Journal of Theoretical Biology, 299, 172–179.Google Scholar
Roberts, S.J., Reardon, K.M. & Rosenfield, S. (1999). Childhood sexual abuse: Surveying its impact on primary care. AWHONN Lifelines, 3(1), 39–45.Google Scholar
Salmon, P., Holcombe, C., Clark, L., et al. (2007). Relationships with clinical staff after a diagnosis of breast cancer are associated with patients' experience of care and abuse in childhood. Journal of Psychosomatic Research, 63(3), 255–262.Google Scholar
Schachter, C.L., Stalker, C.A. & Teram, E. (1999). Toward sensitive practice: Issues for physical therapists working with survivors of childhood sexual abuse. Physical Therapy, 79(3), 248–261.Google Scholar
Schachter, C.L., Radomsky, N.A., Stalker, C.A., et al. (2004). Women survivors of child sexual abuse: How can health professionals promote healing? Canadian Family Physician, 50, 405–412.Google Scholar
Schachter, C.L., Stalker, C.A., Teram, E., et al. (2009). Handbook on Sensitive Practice for Health Care Practitioners: Lessons from Adult Survivors of Childhood Sexual Abuse. Ottawa: Public Health Agency of Canada. Available from http://publications.gc.ca/collections/collection_2010/aspc-phac/HP20-11-2009-eng.pdf.Google Scholar
Schnur, J.B. & Goldsmith, R.E. (2011). Through her eyes. Journal of Clinical Oncology, 29(30), 4054–4056.Google Scholar
Shapiro, D.N., Chandler, J. & Mueller, P.A. (2013). Using Mechanical Turk to study clinical populations. Clinical Psychological Science, 1(2), 1–8.Google Scholar
Siegel, R.L., Miller, K.D. & Jemal, A. (2016). Cancer statistics, 2016. CA: A Cancer Journal for Clinicians, 66(1), 7–30.Google Scholar
Sikkema, K.J., Hansen, N.B., Kochman, A., et al. (2007). Outcomes from a group intervention for coping with HIV/AIDS and childhood sexual abuse: Reductions in traumatic stress. AIDS and Behavior, 11(1), 49–60.Google Scholar
Sprouse, J. (2011). A validation of Amazon Mechanical Turk for the collection of acceptability judgments in linguistic theory. Behavior Research Methods, 43(1), 155–167.Google Scholar
Tong, A., Sainsbury, P. & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357.Google Scholar
Willumsen, T. (2004). The impact of childhood sexual abuse on dental fear. Community Dentistry and Oral Epidemiology, 32(1), 73–79.Google Scholar
Wygant, C., Hui, D. & Bruera, E. (2011). Childhood sexual abuse in advanced cancer patients in the palliative care setting. Journal of Pain and Symptom Management, 42(2), 290–295.Google Scholar
Supplementary material: File

Schnur supplementary material

Tables S1-S2

Download Schnur supplementary material(File)
File 21.5 KB