The phenomenology of coping with a diagnosis of early stage breast cancer : the influence of intrapersonal and social context variables

Despite substantial research into psychosocial factors associated with adjustment to a diagnosis of breast cancer, contradictory or limited research evidence exists in certain areas. In particular, questions arise concerning the efficacy of coping reactions such as acceptance and denial/avoidance behaviours. Using as a conceptual framework the Lazarus and Folkman (1984) cognitive-phenomenological model of psychological stress, the present study explores these questions through analysis of two cycles of indepth interviews. Participants were 19 w o m e n with a relatively recent diagnosis of early stage breast cancer. The aim was to chart their coping reactions over a six month period. Major themes associated with healthy adjustment include high levels of acceptance, low denial, an expressed positive outlook, creation and utilisation of constructive emotional support, increased self-care, and drawing on a life philosophy. These themes reflected underlying tasks for the women, that is, making meaning of their experience with cancer and seeking to regain control over their situation. At follow-up these themes/tasks are still present although less salient for those without ongoing physical difficulties. The strengths and weaknesses of the research were evaluated and theoretical and implications for future research and clinical practice were discussed