Quality of Living Among Ovarian Germ Cell Cancer Survivors: A Narrative Analysis

Melinda M. Swenson

Jessica S. MacLeod

Stephen D. Williams

Anna M. Miller

Victoria L. Champion
ONF 2003, 30(3), E48-E54. DOI: 10.1188/03.ONF.E48-E54

Purpose/Objectives: To describe and interpret the meaning of experiences that are important to the quality of living of ovarian germ cell cancer survivors.

Research Approach: Qualitative description within a constructivist paradigm.

Setting: 32 member sites of the Gynecologic Oncology Group and the University of Texas M.D. Anderson Cancer Center in Houston.

Participants: 109 women between the ages of 19-64 (median age = 36) who were enrolled on prospective clinical trials of cisplatin-based chemotherapy after surgery and disease-free for at least two years.

Methodologic Approach: As part of a larger study, narrative responses to four semistructured questions were collected at the end of a telephone interview. Using naturalistic inquiry and qualitative description techniques, content labels were assigned to units of text that seemed to encapsulate one complete thought or idea. The labeled groups were collapsed into interpreted subthemes. Finally, four general themes were constructed as representations of shared narrative responses and meanings.

Findings: The four constructed themes are celebrating illness, experiencing empathetic affirmation, mourning losses, and valuing illness.

Interpretation: In addition to measuring physical, psychological, and sexual functioning in women surviving ovarian germ cell cancer, nurses also must understand how these issues fit into their everyday lived experiences. The four themes may help clinicians and researchers to understand issues that are important to the quality of living of ovarian germ cell cancer survivors.

Jump to a section

    References

    Andersen, B.L. (1993). Predicting sexual and psychologic morbidity and improving the quality of life for women with gynecologic cancer. Cancer, 71(Suppl. 4), 1678-1690.

    Andersen, B.L. (1995). Quality of life for women with gynecologic cancer. Current Opinion in Obstetrics and Gynecology, 7, 69-76.

    Auchincloss, S.S. (1995). After treatment: Psychosocial issues in gynecologic cancer survivorship. Cancer, 76(Suppl. 10), 2117-2124.

    Breaden, K. (1997). Cancer and beyond: The question of survivorship. Journal of Advanced Nursing, 26, 978-984.

    Cella, D.F. (1987). Cancer survival: Psychosocial and public issues. Cancer Investigation, 5, 59-67.

    Frank, A.W. (1991). At the will of the body: Reflections on illness. Boston: Houghton Mifflin.

    Gershenson, D.M. (1993). Update on malignant ovarian germ cell tumors. Cancer, 71(Suppl. 4), 1581-1590.

    Gershenson, D.M. (1994). Management of early ovarian cancer: Germ cell and sex-cord-stromal tumors. Gynecologic Oncology, 55(3 Pt. 2), S62-S72.

    Gershenson, D.M., Morris, M., Cangir, A., Kavanagh, J.J., Stringer, C.A., Edwards, C.L., et al. (1990). Treatment of malignant germ cell tumors of the ovary with bleomycin, etoposide, and cisplatin. Journal of Clinical Oncology, 8, 715-720.

    Gobel, U., Schneider, D.T., Calaminus, G., Haas, R.J., Schmidt, P., & Harms, D. (2000). Germ-cell tumors in childhood and adolescence. GPOH MAKEI and the MAHO study groups. Annals of Oncology, 11, 263-271.

    Guba, E.G., & Lincoln, Y.S. (1989). Fourth generation evaluation. Newbury Park, CA: Sage.

    Ironside, P.M. (1997). Preserving reading, writing, thinking, and dialogue: Rethinking doctoral education in nursing. Academic Medicine, 75, 245-251.

    Kleinman, A. (1988). The illness narratives: Suffering, healing, and the human condition. New York: Basic Books.

    Lackner, S., Goldenberg, S., Arrizza, G., & Tjosvold, I. (1994). The contingency of social support. Qualitative Health Research, 4, 224-243.

    Lincoln, Y.S., & Guba, E.G. (1985). Naturalistic inquiry. Beverly Hills, CA: Sage.

    Mitchell, P.L., Al-Nasiri, N., A'Hern, R., Fisher, C., Horwich, A., Pinkerton, C.R., et al. (1999). Treatment of nondysgerminomatous ovarian germ cell tumors: An analysis of 69 cases. Cancer, 85, 2232-2244.

    Sagae, S., & Kudo, R. (2000). Surgery for germ cell tumors. Seminars in Surgical Oncology, 19, 76-81.

    Sandelowski, M. (2000). Focus on research methods. Whatever happened to qualitative description? Research in Nursing and Health, 23, 334-340.

    Schaefer, K.M., Ladd, E.C., Lammers, S.E., & Echenberg, R.J. (1999). In your skin, you are different: Women living with ovarian cancer during childbearing years. Qualitative Health Research, 9, 227-242.

    Wasserman, A.L., Thompson, E.I., Wilimas, J.A., & Fairclough, D.L. (1987). The psychological status of survivors of childhood/adolescent Hodgkin's disease. American Journal of Diseases of Children, 141, 626-631.

    Williams, S., Blessing, J.A., Liao, S., Ball, H., & Hanjani, P. (1994). Adjuvant therapy of ovarian germ cell tumors with cisplatin, etoposide, and bleomycin: A trial of the Gynecologic Oncology Group. Journal of Clinical Oncology, 12, 701-706.

    Williams, S.D., Gershenson, D.M., Champion, V.L., & Cella, D.F. (2001). [Quality of life for ovarian germ cell cancer survivors]. Unpublished raw data.

    Zeltzer, L.K. (1993). Cancer in adolescents and young adults: Psychosocial aspects. Long-term survivors. Cancer, 71(Suppl. 10), 3463-3468.