Comparisons Between Cancer Survivors and Family Members on Meaning of the Illness and Family Quality of Life

Suzanne Mellon

ONF 2002, 29(7), 1117-1125. DOI: 10.1188/02.ONF.1117-1125

Purpose/Objectives: To explore the meaning of the illness to the family and family quality of life (QOL) for survivors and family members and to describe similarities and differences between survivors' and family members' meaning of the illness and family QOL.

Research Approach: Descriptive, qualitative.

Setting: Homes of survivors and family members in an urban metropolitan area in the midwestern United States.

Participants: A sample of 123 Caucasian and African American cancer survivors, one to six years after treatment had ended, and their family members (N = 246). Four cancer diagnoses (i.e., breast, colon, prostate, and uterine) were represented.

Methodologic Approach: Two open-ended questions derived from a family model of survivorship. Content analysis was used to analyze the responses.

Main Research Variables: Meaning of the illness and family QOL.

Findings: The positive dimensions of survivorship in meaning of the illness and family QOL were seen for patients and family members, although long-term stressors also were reported. More similarities than differences in meaning and QOL were noted between survivors and family members.

Conclusions: Patients' and family members' perspectives of the meaning of the illness and family QOL are important to assess during survivorship to address both individual- and family-level perspectives in cancer care.

Implications for Nursing: Nurses should offer opportunities for patients and family members to search for positive meaning in the cancer illness, develop strategies to handle stressors that are present during survivorship, and enhance family strengths and resources to promote family QOL.

Jump to a section

    References

    Aaronson, N.K., Meyerowitz, B.E., Bard, M., Bloom, J.R., Fawzy, F.I., Feldstein, M., et al. (1991). Quality of life research in oncology. Cancer, 67, 839-843.

    Baider, L., Koch, U., Esacson, R., & De-Nour, A.K. (1998). Prospective study of cancer patients and their spouses: The weakness of marital strength. Psycho-Oncology, 7, 49-56.

    Bush, N.E., Haberman, M., Donaldson, G., & Sullivan, K.M. (1995). Quality of life of 125 adults surviving 6-18 years after bone marrow transplantation. Social Science and Medicine, 40, 479-490.

    Carter, B.J. (1993). Long-term survivors of breast cancer: A qualitative descriptive study. Cancer Nursing, 16, 354-361.

    Cella, D.F. (1994). Quality of life: Concepts and definition. Journal of Pain and Symptom Management, 9, 186-192.

    Davis-Ali, S.H., Chesler, M.A., & Chesney, B.K. (1993). Recognizing cancer as a family disease: Worries and support reported by patients and spouses. Social Work in Health Care, 19(2), 45-65.

    Dow, K.H., Ferrell, B.R., Haberman, M.R., & Eaton, L. (1999). The meaning of quality of life in cancer survivorship. Oncology Nursing Forum, 26, 519-528.

    Dow, K.H., Ferrell, B.R., Leigh, S., Ly, J., & Gulasekaram, P. (1996). An evaluation of the quality of life among long-term survivors of breast cancer. Breast Cancer Research and Treatment, 39, 261-273.

    Ersek, M., Ferrell, B.R., Dow, K.H., & Melancon, C.H. (1997). Quality of life in women with ovarian cancer. Western Journal of Nursing Research, 19, 334-350.

    Feetham, S.L. (1999). Families and the genetic revolution: Implications for primary healthcare, education, and research. Families, Systems and Health, 17(1), 27-43.

    Ferrans, C.E. (1994). Quality of life through the eyes of survivors of breast cancer. Oncology Nursing Forum, 21, 1645-1651.

    Ferrell, B.R., Dow, K.H., Leigh, S., Ly, J., & Gulasekaram, P. (1995). Quality of life in long-term cancer survivors. Oncology Nursing Forum, 22, 915-922.

    Ferrell, B.R., Grant, M., Funk, B., Otis-Green, S., & Garcia, N. (1998a). Quality of life in breast cancer. Part II: Psychological and spiritual well-being. Cancer Nursing, 21, 1-9.

    Ferrell, B.R., Grant, M.M., Funk, B.M., Otis-Green, S.A., & Garcia, N.J. (1998b). Quality of life in breast cancer survivors: Implications for developing support services. Oncology Nursing Forum, 25, 887-895.

    Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science and Medicine, 45, 1207-1221.

    Fredette, S.L. (1995). Breast cancer survivors: Concerns and coping. Cancer Nursing, 18, 35-46.

    Ganz, P.A., Coscarelli, A., Fred, C., Kahn, B., Polinsky, M.L., & Petersen, L. (1996). Breast cancer survivors: Psychosocial concerns and quality of life. Breast Cancer Research and Treatment, 38, 183-199.

    Germino, B.B., Fife, B.L., & Funk, S.G. (1995). Cancer and the partner relationship: What is its meaning? Seminars in Oncology Nursing, 11, 43-50.

    Given, B., & Given, C.W. (1992). Patient and family caregiver reaction to new and recurrent breast cancer. Journal of the American Medical Women's Association, 47, 201-206, 212.

    Gotay, C.C., & Muraoka, M.Y. (1998). Quality of life in long-term survivors of adult-onset cancers. Journal of the National Cancer Institute, 90, 656-667.

    Hilton, B.A. (1996). Getting back to normal: The family experience during early stage breast cancer. Oncology Nursing Forum, 23, 605-614.

    King, C.R. (1998). Overview of quality of life and controversial issues. In C.R. King & P.S. Hinds (Eds.), Quality of life: From nursing and patient perspectives (pp. 23-34). Boston: Jones and Bartlett.

    King, C.R., Haberman, M., Berry, D.L., Bush, N., Butler, L., Dow, K.H., et al. (1997). Quality of life and the cancer experience: The state-of-the-knowledge. Oncology Nursing Forum, 24, 27-41.

    Kornblith, A.B., Herr, H.W., Ofman, U.S., Scher, H.I., & Holland, J.C. (1994). Quality of life of patients with prostate cancer and their spouses: The value of a database in clinical care. Cancer, 73, 2791-2802.

    Lewis, F.M. (1993). Psychosocial transitions and the family's work in adjusting to cancer. Seminars in Oncology Nursing, 9, 127-129.

    Lewis, F.M., & Deal, L.W. (1995). Balancing our lives: A study of the married couple's experience with breast cancer recurrence. Oncology Nursing Forum, 22, 943-953.

    Lewis, F.M., & Hammond, M.A. (1992). Psychosocial adjustment of the family to breast cancer: A longitudinal analysis. Journal of the American Medical Women's Association, 47, 194-200.

    McCubbin, M.A., & McCubbin, H.I. (1996). Resiliency in families: A conceptual model of family adjustment and adaptation in response to stress and crises. In H.I. McCubbin, A.I. Thompson, & M.A. McCubbin (Eds.), Family assessment: Resiliency, coping, and adaptation-Inventories for research and practice (pp. 1-64). Madison, WI: University of Wisconsin System.

    Mellon, S., & Northouse, L.L. (2001). Family survivorship and quality of life following a cancer diagnosis. Research in Nursing and Health, 24, 446-459.

    Miles, M.B., & Huberman, A.M. (1994). Qualitative data analysis (2nd ed.). Thousand Oaks, CA: Sage.

    Morse, S.R., & Fife, B. (1998). Coping with a partner's cancer: Adjustment at four stages of the illness trajectory. Oncology Nursing Forum, 25, 751-760.

    Mullan, F. (1996). Survivorship: A powerful place. In B. Hoffman (Ed.) & National Coalition for Cancer Survivorship, A cancer survivor's almanac: Charting your journey (pp. xv-xix). Minneapolis, MN: Chronimed.

    Nelson, J.P. (1996). Struggling to gain meaning: Living with the uncertainty of breast cancer. Advances in Nursing Science, 18(3), 59-76.

    Northouse, L. (1989). A longitudinal study of the adjustment of patients and husbands to breast cancer. Oncology Nursing Forum, 16, 511-516.

    Northouse, L.L., Laten, D., & Reddy, P. (1995). Adjustment of women and their husbands to recurrent breast cancer. Research in Nursing and Health, 18, 515-524.

    Northouse, L.L., Mood, D., Templin, T., Mellon, S., & George, T. (2000). Couples' patterns of adjustment to colon cancer. Social Science and Medicine, 50, 271-284.

    Northouse, L.L., Templin, T., Mood, D., & Oberst, M. (1998). Couples' adjustment to breast cancer and benign breast disease: A longitudinal analysis. Psycho-Oncology, 7, 37-48.

    O'Connor, A.P., Wicker, C.A., & Germino, B.B. (1990). Understanding the cancer patient's search for meaning. Cancer Nursing, 13, 167-175.

    Park, C.L., & Folkman, S. (1997). Meaning in the context of stress and coping. Review of General Psychology, 1, 115-144.

    Pelusi, J. (1997). The lived experience of surviving breast cancer. Oncology Nursing Forum, 24, 1343-1353.

    Rolland, J.S. (1999). Commentary. Families and genetic fate: A millennial challenge. Families, Systems and Health, 17, 123-132.

    Stetz, K.M. (1998). Quality of life in families experiencing cancer. In C.R. King & P.S. Hinds (Eds.), Quality of life: From nursing and patient perspectives (pp. 157-175). Boston: Jones and Bartlett.

    Taylor, E.J. (2000). Transformation of tragedy among women surviving breast cancer. Oncology Nursing Forum, 27, 781-788.

    Thorne, S. (1985). The family cancer experience. Cancer Nursing, 8, 285-291.

    Utley, R. (1999). The evolving meaning of cancer for long-term survivors of breast cancer. Oncology Nursing Forum, 26, 1519-1523.

    Williams, J.K., & Schutte, D.L. (1997). Benefits and burdens of genetic carrier identification. Western Journal of Nursing Research, 19, 71-81.

    Wilson, S., & Morse, J.M. (1991). Living with a wife undergoing chemotherapy. IMAGE: Journal of Nursing Scholarship, 23, 78-84.

    Wyatt, G., & Friedman, L.L. (1996). Long-term female cancer survivors: Quality of life issues and clinical implications. Cancer Nursing, 19, 1-7.

    Zacharias, D.R., Gilg, C.A., & Foxall, M.J. (1994). Quality of life and coping in patients with gynecologic cancer and their spouses. Oncology Nursing Forum, 21, 1699-1706.

    Zebrack, B. (2000a). Cancer survivors and quality of life: A critical review of the literature. Oncology Nursing Forum, 27, 1395-1401.

    Zebrack, B. (2000b). Quality of life of long-term survivors of leukemia and lymphoma. Journal of Psychosocial Oncology, 18(4), 39-59.