SAILING A COURSE THROUGH CHEMOTHERAPY: THE EXPERIENCE OF WOMEN WITH BREAST CANCER.

Description

In the United States, over 100,000 women receive chemotherapy for breast cancer each year. This treatment is administered primarily on an outpatient basis, leaving women to manage the experience and side effects on their own. Although incidence and severity of chemotherapy side effects have been researched, less is known about the distress associated with treatment. The purpose of this study was to describe, from a woman's perspective, experience with breast cancer chemotherapy, associated side effects and resultant distress. Twenty women participated in unstructured interviews and completed the Adapted Symptom Distress Scale (ASDS) - Form 2 (Rhodes, Watson & Johnson, 1984). Interviews were analyzed using the grounded theory method (Strauss & Corbin, 1990). Women clustered into three groups based on the focus they placed on the chemotherapy experience in their lives: centralized, integrated or segmented. Within each focus group, women adopted either a direct or indirect control style to manage the challenges which arose during the four temporal phases of the course (discovery, setting the course, the long haul and moving on). Often, management strategies used by women in different cluster groups were very similar, however unique distinctions were also identified. Chronbach's alpha for the ASDS ranged from 0.873 to 0.734 for the total symptom experience, total symptom distress, and total symptom occurrence subscales. The most common side effects were changes in appearance, temperature and bowel movements changes and fatigue. The most distressing effects were difficulty sleeping, nausea, fatigue and temperature change. Several of these effects reflect the marked impact of chemotherapy-induced menopause in the relatively young sample (X = 47). Since an estimated 30% of women newly diagnosed with breast cancer are premenopausal, these findings represent an important area which has not yet been researched. Comparisons between quantitative and qualitative data demonstrated several side effects and areas of distress present in the interviews but not measured by the instrument. In addition, design and administration difficulties were found with the ASDS. Suggestions for future research include examination of sleep disturbances, impact of chemotherapy on premenopausal women, culturally diverse populations and better quantitative measures of chemotherapy distress.

Subjects