1. Breast Cancer Patients Post-Traumatic Growth and Positive Change
Integrative Review of Literature
Miranda Delgado & Sidrah Khan
DePaul University
Abstract
Conceptual Model
Results
Nursing Implications
There are many different types of support groups that exist to aid cancer patients. Each patient should be looked at as an individual and therefore, their treatment should be catered to their unique personality. Due to the nature of the job, nurses are in the unique position to spend more quality time with their patients than almost any other healthcare provider. At times, nurses spend more time with patients than even the patient’s own loved ones. These circumstances allow the nurse to develop intimate relationships with their patients. Therefore, it is arguable that the nurse is the most qualified to assess which type of support is needed to facilitate PTG in the patient. Furthermore, the nurse will have access to hospital resources, like the chaplain, that can be used to facilitate PTG.
Breast cancer is extremely common among women in the United States and has affected the lives of many people. Due to this, research regarding improvements and treatment options is vast and extensive. Breast cancer has ever increasing survival rates and so the care of breast cancer survivors’ mental health has become a major focus as cancer is a life altering and oftentimes traumatic experience. The intent of this integrative literature review is to describe the overall effectiveness of implementing Post-Traumatic Growth (PTG) interventions in women surviving breast cancer to facilitate positive change. This was done using the conceptual model: Pamela Reed’s Theory of Self-Transcendence. An integrative literature review was conducted because there is a gap in the literature in terms of PTG and breast cancer patients. Major trends discovered in the research were divided into two categories: victim/vulnerability and well-being. Limitations found in the assessment included the inability to consistently quantify the qualitative data. To facilitate well-being aspects of the results, women with breast cancer yearned for a sense of empowerment and control over other aspects in their lives since the diagnosis is out of their control. There are a vast number of implications for nurses working with this population. PTG can be encouraged by enhancing and promoting factors that aid in positive change and transcendence.
Pamela Reed’s Theory of Self-Transcendence addresses factors of PTG. This theory emcompasses three components: vulnurability, self-transcendence, and well-being. Vulnerability is defined as the awareness of one’s own mortality. This awareness can occur with aging, other life phases, or during a health/life crises (like being diagnosed with breast cancer). Reed uses self-transcendence to describe the changes that occur in one’s own view of themselves and the world. These fluctuations are multidimensional, encompassing different components including: outward (changes in one’s relationship with others), inward (a greater insight into one’s own beliefs, values, and dreams), temporal (understanding and integrating the past and future in a way that enhances the relative present), and transpersonal (achieving a spiritual awareness of dimensions beyond the physical world) (Coward, 2017). Finally, well-being is a feeling of being whole and healthy, in accord with one’s own criteria for wholeness and well-being (Coward, 2017).
Future Implications
PTG in one patient will look different from the next. Each individual patient will require a different set of professionals to assist in their care. To determine which team members to choose when planning for the care of the patient, it is important to begin with a thorough assessment of the patient themselves. This assessment should involve a complete work-up by a psychologist to see which factors of Reed’s theory of self-transcendence need to be encouraged. With every patient receiving such an assessment, the mental health team will be given an opportunity to truly create impactful change in the patient’s care and therefore, in the potential trajectory of the disease itself.
Furthermore, with continuous therapy sessions throughout the patient’s fight with cancer, the psychologists will be able to measure how effective therapy is in helping the patient achieve a new sense of normal. This new sense of normal plays a pivotal role in the patient’s sense of well-being and hope. Additionally, since cancer is such a life-changing event - therapy should be continued after the cancer has been removed so that the patient can again, adjust to their changed sense of self.
Correlations
Acknowledgements
Special Thanks to:
Dr. Kim Amer
Dr. Barbara Harris
Dr. Karen Larimer