Skip to main content
Top
Published in: Journal of Cancer Survivorship 4/2012

01-12-2012

Sources of uncertainty in cancer survivorship

Author: Laura E. Miller

Published in: Journal of Cancer Survivorship | Issue 4/2012

Login to get access

Abstract

Purpose

Previous research has demonstrated the common experience of illness-related uncertainty; however, little research has explored the specific sources of uncertainty throughout cancer survivorship. The purpose of this study is to investigate the experience of uncertainty for cancer survivors and their partners. Thus, the following research question is posed: What are the sources of uncertainty in cancer survivorship for survivors and partners?

Method

One-on-one interviews were conducted with 35 cancer survivors and 25 partners. Constant comparative methodologies were used to analyze the data.

Results

Participants described medical, personal, and social sources of uncertainty that persisted throughout survivorship. Medical sources of uncertainty included questions about the cancer diagnosis, treatment and prognosis. Personal sources of uncertainty included ambiguous valued identities and career-related questions. Social sources of uncertainty included unclear communicative, relational and familial consequences of illness.

Conclusion

Survivors and partners in this study experienced uncertainty that persisted long after the completion of cancer treatment. The participants also described sources of uncertainty unique to this illness context. These results have important implications for health care providers and intervention developers and imply that chronic uncertainty should be managed throughout survivorship.

Implications for cancer survivors

The sources of uncertainty described in the current study have important implications for cancer survivors' management of uncertainty. Cancer survivors and their family members must first know the common sources of uncertainty to adaptively adjust to an uncertain survivorship trajectory. The present investigation provides insight into the uncertainty experiences of cancer survivors and implies that continued care may improve well-being after the completion of cancer treatment.
Literature
5.
go back to reference Manne S, Badr H. Intimacy and relationship processes in couples’ psychosocial adaptation to cancer. Cancer Suppl. 2008;112:2541–55. Manne S, Badr H. Intimacy and relationship processes in couples’ psychosocial adaptation to cancer. Cancer Suppl. 2008;112:2541–55.
6.
go back to reference Acitelli LK, Badr HJ. My illness or our illness? attending to the relationship when one partner is ill. In: Revenson TA, Kayser K, Bodenmann G, editors. Couples coping with stress: emerging perspectives on dyadic coping. Washington: American Psychological Association; 2005. p. 121–56.CrossRef Acitelli LK, Badr HJ. My illness or our illness? attending to the relationship when one partner is ill. In: Revenson TA, Kayser K, Bodenmann G, editors. Couples coping with stress: emerging perspectives on dyadic coping. Washington: American Psychological Association; 2005. p. 121–56.CrossRef
7.
go back to reference Oberst MT, James RH. Going home: patient and spouse following cancer surgery. Topics Clin Nurs. 1985;7:46–57. Oberst MT, James RH. Going home: patient and spouse following cancer surgery. Topics Clin Nurs. 1985;7:46–57.
8.
go back to reference Carter BJ. Long-term survivors of breast cancer: a qualitative descriptive study. Cancer Nurs. 1993;16:354–61.PubMedCrossRef Carter BJ. Long-term survivors of breast cancer: a qualitative descriptive study. Cancer Nurs. 1993;16:354–61.PubMedCrossRef
9.
go back to reference Moyer A, Salovey P. Predictors of social support and psychological distress in women with breast cancer. J Health Psych. 1999;4:177–91.CrossRef Moyer A, Salovey P. Predictors of social support and psychological distress in women with breast cancer. J Health Psych. 1999;4:177–91.CrossRef
10.
go back to reference Dow KH. The enduring seasons in survival. Oncol Nurs Forum. 1990;17:511–6.PubMed Dow KH. The enduring seasons in survival. Oncol Nurs Forum. 1990;17:511–6.PubMed
11.
go back to reference Nelson JP. Struggling to gain meaning: living with the uncertainty of breast cancer. Adv Nurs Sci. 1996;18:59–76. Nelson JP. Struggling to gain meaning: living with the uncertainty of breast cancer. Adv Nurs Sci. 1996;18:59–76.
12.
go back to reference Gilbar O, Ben-Zur H. Cancer and the family caregiver: distress and coping. Springfield: Thomas; 2002. Gilbar O, Ben-Zur H. Cancer and the family caregiver: distress and coping. Springfield: Thomas; 2002.
13.
go back to reference Hagedoorn M, Sanderman R, Bolks HN, Tuinstra J, Coyne JC. Distress in couples coping with cancer: a meta-analysis and critical review of role and gender effects. Psych Bull. 2008;134:1–30.CrossRef Hagedoorn M, Sanderman R, Bolks HN, Tuinstra J, Coyne JC. Distress in couples coping with cancer: a meta-analysis and critical review of role and gender effects. Psych Bull. 2008;134:1–30.CrossRef
14.
go back to reference Brashers DE, Neidig JL, Russell JA, Cardillo LW, Haas SM, Dobbs LK, et al. The medical, personal, and social causes of uncertainty in HIV illness. Issues Ment Health Nurs. 2003;24:497–522.PubMedCrossRef Brashers DE, Neidig JL, Russell JA, Cardillo LW, Haas SM, Dobbs LK, et al. The medical, personal, and social causes of uncertainty in HIV illness. Issues Ment Health Nurs. 2003;24:497–522.PubMedCrossRef
15.
go back to reference Goldsmith DJ, Lindholm KA, Bute JJ. Dilemmas of talking about lifestyle changes among couples coping with a cardiac event. Soc Sci Med. 2006;63:2079–90.PubMedCrossRef Goldsmith DJ, Lindholm KA, Bute JJ. Dilemmas of talking about lifestyle changes among couples coping with a cardiac event. Soc Sci Med. 2006;63:2079–90.PubMedCrossRef
16.
go back to reference Stone AM, Jones CL. Sources of uncertainty: experiences of Alzheimer’s disease. Issues Ment Health Nurs. 2009;30:677–86.PubMed Stone AM, Jones CL. Sources of uncertainty: experiences of Alzheimer’s disease. Issues Ment Health Nurs. 2009;30:677–86.PubMed
18.
go back to reference Mishel MH. Uncertainty in chronic illness. Annu Rev Nurs Res. 1999;17:269–94.PubMed Mishel MH. Uncertainty in chronic illness. Annu Rev Nurs Res. 1999;17:269–94.PubMed
19.
go back to reference Mishel MH. Reconceptualization of the uncertainty in illness theory. Image J Nurs Sch. 1990;22:256–62.PubMedCrossRef Mishel MH. Reconceptualization of the uncertainty in illness theory. Image J Nurs Sch. 1990;22:256–62.PubMedCrossRef
20.
go back to reference Brashers DE. Communication and uncertainty management. J Commun. 2001;51:477–98.CrossRef Brashers DE. Communication and uncertainty management. J Commun. 2001;51:477–98.CrossRef
21.
go back to reference Main DS, Nowels CT, Cavender TA, Etschmaier M, Steiner F. A qualitative study of work and work return in cancer survivors. Psycho-Oncol. 2005;14:992–1004.CrossRef Main DS, Nowels CT, Cavender TA, Etschmaier M, Steiner F. A qualitative study of work and work return in cancer survivors. Psycho-Oncol. 2005;14:992–1004.CrossRef
22.
go back to reference Leininger M. Evaluation criteria and critique of qualitative research studies. In: Morse JM, editor. critical issues in qualitative research methods. Thousand Oaks: Sage; 1994. p. 95–115. Leininger M. Evaluation criteria and critique of qualitative research studies. In: Morse JM, editor. critical issues in qualitative research methods. Thousand Oaks: Sage; 1994. p. 95–115.
23.
go back to reference Lincoln YS, Guba EG. Naturalistic inquiry. Newbury Park: Sage; 1985. Lincoln YS, Guba EG. Naturalistic inquiry. Newbury Park: Sage; 1985.
24.
go back to reference Charmaz K. The grounded theory method: an explication and interpretation. In: Emerson R, editor. Contemporary field research. Prospect Heights, IL: Waveland; 1983. p. 109–26. Charmaz K. The grounded theory method: an explication and interpretation. In: Emerson R, editor. Contemporary field research. Prospect Heights, IL: Waveland; 1983. p. 109–26.
25.
go back to reference Strauss A, Corbin J. Basics of qualitative research: grounded theory procedures and techniques. Newbury Park: Sage; 1990. Strauss A, Corbin J. Basics of qualitative research: grounded theory procedures and techniques. Newbury Park: Sage; 1990.
27.
go back to reference Mullan F. Seasons of survival: Reflections of a physician with cancer. N Engl J Med. 1985;313:270–3.PubMedCrossRef Mullan F. Seasons of survival: Reflections of a physician with cancer. N Engl J Med. 1985;313:270–3.PubMedCrossRef
28.
go back to reference Thewes B, Butow P, Girgis A, Pendlebury S. The psychosocial needs of breast cancer survivors: a qualitative study of the shared and unique needs of younger versus older survivors. Psycho-Oncol. 2004;13:177–89.CrossRef Thewes B, Butow P, Girgis A, Pendlebury S. The psychosocial needs of breast cancer survivors: a qualitative study of the shared and unique needs of younger versus older survivors. Psycho-Oncol. 2004;13:177–89.CrossRef
29.
go back to reference Gray RE, Fitch M, Greenberg M, Hampson A, Doherty M, Labrecque M. The information needs of well, longer-term survivors of breast cancer. Pat Edu Counsel. 1998;33:245–55.CrossRef Gray RE, Fitch M, Greenberg M, Hampson A, Doherty M, Labrecque M. The information needs of well, longer-term survivors of breast cancer. Pat Edu Counsel. 1998;33:245–55.CrossRef
30.
go back to reference Mishel MH, Germino BB, Gil KM, Belyea M, Carlton Laney I, Stewart J, et al. Benefits from an uncertainty management intervention for African-American and Caucasian older long-term breast cancer survivors. Psycho-Oncol. 2005;14:962–78.CrossRef Mishel MH, Germino BB, Gil KM, Belyea M, Carlton Laney I, Stewart J, et al. Benefits from an uncertainty management intervention for African-American and Caucasian older long-term breast cancer survivors. Psycho-Oncol. 2005;14:962–78.CrossRef
31.
go back to reference Brashers DE, Neidig JL, Cardillo LW, Dobbs LK, Russell JA, Haas SM. ‘In an important way, I did die:’ uncertainty and revival in persons living with HIV or AIDS. AIDS Care. 1999;11:201–19.PubMedCrossRef Brashers DE, Neidig JL, Cardillo LW, Dobbs LK, Russell JA, Haas SM. ‘In an important way, I did die:’ uncertainty and revival in persons living with HIV or AIDS. AIDS Care. 1999;11:201–19.PubMedCrossRef
32.
go back to reference Hodgkinson K, Butow P, Hunt GE, Wyse R, Hobbs KM, Wain G. Life after cancer: couples’ and partners’ psychological adjustment and supportive care needs. Supp Care Cancer. 2007;15:405–15.CrossRef Hodgkinson K, Butow P, Hunt GE, Wyse R, Hobbs KM, Wain G. Life after cancer: couples’ and partners’ psychological adjustment and supportive care needs. Supp Care Cancer. 2007;15:405–15.CrossRef
Metadata
Title
Sources of uncertainty in cancer survivorship
Author
Laura E. Miller
Publication date
01-12-2012
Publisher
Springer US
Published in
Journal of Cancer Survivorship / Issue 4/2012
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-012-0229-7

Other articles of this Issue 4/2012

Journal of Cancer Survivorship 4/2012 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine