A grounded theory approach to understand the cancer-coping process

Objectives. A focus on individualistic coping strategies such as positivity and fighting spirit has done little to inform the development of interventions for people affected by cancer. The aim of this study was to conduct an inquiry, which focused on the ‘lived experience’ and the social context within which communication about cancer occurs. Design. A semi-structured interview schedule was used. These interviews were complemented by the Mini-International Neuropsychiatric Interview (M.I.N.I., Sheehan et al., 1998). Methods. Twenty participants with mixed diagnoses (13 female and seven male), ranging in age from 44 to 73 (Mean = 58.35, SD= 8.20) were interviewed. Consistent with Glaser's (1992) constant comparative method, research data were open coded, selectively coded, and then theoretically coded so that initial codes were collapsed into models and compared against existing literature for completeness. Results. Fifty percent of participants met criteria for an Axis 1 diagnosis. Three models emerged from the research interview; the first provides a description of the way in which patients evaluate the quality of care they receive across the cancer pathway. Other models refer to the cancer-coping process in which participants describe successful and unsuccessful attempts at coping via communication and whereby coping with cancer is characterized by a series of losses accompanied by increased distress. Conclusions. A research focus on the social environment in which cancer is experienced provides considerable insight into the cancer-coping process. As such, interventions focused on understanding the social context in which patients experience cancer, and attempt to cope, may facilitate improved adjustment for those directly, and potentially indirectly, affected by cancer. Further research is required to develop interventions to address the unique needs of survivors.Vikki Knott, Deborah Turnbull, Ian Olver and Anthony Winefiel