Spiritual Survivors: Strategies for Coping with Breast Cancer

Öz

Breast cancer (BC), a life-threatening illness, is the most widespread cancer affecting women in the world. Women may experience a number of physical and psychological problems after being diagnosed with breast cancer. To deal with these problems, women use different strategies. This study was used netnography method to examine the strategies used by women with cancer to deal with their problems. The strategies examined were based on the COPE scale developed by Carver et al. (1989) and used by Kershaw et al. (2004). This study examines coping strategies under two headings: active strategies and avoidance strategies. The study was analyzed close to 1000 consumer (patient) comments, posted on five different message boards for consumers. Patients in the group were observed to tell their own stories, ask for help from others in the group, and use different coping strategies in their fight against cancer. In particular, cancer patients were found to use multiple strategies together rather than using a single one. In addition, patients using active coping strategies were observed to be more optimistic, happier, and more appreciative of life, whereas patients using avoidance strategies were observed to avoid taking responsibility, ignore their illness, and blame others for the illness.

Anahtar Kelimeler

• Breast Cancer
• Coping
• Qualitative Research
• Netnography

Manevi Olarak Hayatta Kalanlar: Meme Kanseri ile Başa Çıkma Stratejileri

Öz

Yaşamı tehdit eden bir hastalık olan meme kanseri (BC) dünyadaki kadınları etkileyen en yaygın kanserdir. Kadınlara meme kanseri tanısı konulduktan sonra fiziksel ve psikolojik problemlerle karşı karşıya kalmaktadırlar. Kadınlar bu problemlerle baş etmek için birbirinden farklı stretejiler kullanmaktadır. Bu çalışmada meme kanserli kadınların yaşadıkları problemler ile baş etmelerinde kullandıkları stratejiler netnografi yöntemi kullanılarak incelenmiştir. Carver vd. (1989) ve Kershaw vd. (2004) tarafından geliştirilen baş etme stratejileri (COPE) temel alınmıştır. Baş etme stratejileri bu çalışmalarda aktif ve kaçınma stratejileri olarak iki başlık altında incelenmiştir. Çalışma kapsamında beş farklı tüketici (hasta) forum sitesinden (5 Türkçe) 1000 tüketici yorumu analiz edilmiştir. Grup içerisinde hastaların kendi hikâyelerini anlatması, gruptakilerden yardım istemesi ve kanserle mücadelelerinde farklı baş etme stratejilerini kullandıkları gözlemlenmiştir. Özellikle kanser hastalarının tek bir strateji değil birçok stratejiyi bir arada kullandığı bulunmuştur. Ayrıca aktif baş etme stratejisini kullanan hastaların daha umutlu, mutlu ve hayatın farkına varan, kaçınma stratejisi kullanan hastaların ise, sorumluluk almayan, hastalığı yok sayan ve hastalıkları konusunda başkalarını suçlayan özelliklere sahip oldukları gözlemlenmiştir.

Anahtar Kelimeler

• Meme Kanseri
• Başa Çıkma
• Nitel Araştırma
• Netnografi

Kaynakça

1. Akyolcu, N. (2008). Sexual Life after Surgery in Breast Cancer. Journal of Breast Health, 4(2), 77-83. http://www.eurjbreasthealth.com/sayilar/12/buyuk/1151.pdf
2. Al-Azri, M., Al‐Awisi, H., & Al‐Moundhri, M. (2009). Coping With a Diagnosis of Breast Cancer‐Literature Review and Implications for Developing Countries. The Breast Journal, 15(6), 615-622. doi: 10.1111/j.1524-4741.2009.00812.x
3. Anderson, J. C., & Gerbing, Akdeniz E. B. (2012). The Analysis of The Relationship Between Marital Adjustment and Coping Strategies in Married Women with Breast Cancer. Journal of Psychiatric Nursing, 3(2), 53-60. doi: 10.5505/phd.2012.08208
4. Aro, H., Hänninen, V., & Paronen, O. (1989). Social Support, Life Events and Psychosomatic Symptoms Among 14–16-Year-Old Adolescents. Social Science & Medicine, 29(9), 1051-1056. https://doi.org/10.1016/0277-9536(89)90015-4
5. Aslan, A., Temiz, M., Yiğit, Y., Can, R., Canbolant, E., & Yiğit, F. (2007). The Knowledge Attitude and Behaviorus of Nursery Students About Breast Cancer.TAF Preventive Medicine Bulletin, 6(3), 193-198. ISSN: 1303-734X
6. Aydın, A. (2005). Nurse and Humor. C.U. Journal of Nursing School, 9(1), 1-5. http://eskidergi.cumhuriyet.edu.tr/makale/1118.pdf
7. Baider, L. E., Cooper, C. L., & Kaplan De-Nour, A. E. (1996). Cancer and the Family. John Wiley & Sons.
8. Balneaves, L. G., Bottorff, J. L., Grewal, S. K., Naidu, P., Johnson, J. L., & Howard, A. F. (2007). Family Support of Immigrant Punjabi Women with Breast Cancer. Family Community Health, 30(1), 16-28.

9. Baqutayan, S. M. S. (2012). The Effect of Anxiety on Breast Cancer Patients. Indian Journal of Psychological Medicine, 34(2), 119. doi: 10.4103/0253-7176.101774
10. Bloom JR, Stewart SL, Johnston M, Banks P, & Fobair P. (2001). Sources of Support and The Physical and Mental Well-Being of Young Women with Breast Cancer. Social Science & Medicine, 53(11), 1513–1524. doi: 10.1016/S0277-9536(00)00440-8
11. Bozo, Ö., Gündoğdu, E., & Büyükaşik-Çolak, C. (2009). The Moderating Role of Different Sources of Perceived Social Support on The Dispositional Optimism—Posttraumatic Growth Relationship in Postoperative Breast Cancer Patients. Journal of Health Psychology, 14(7), 1009-1020. doi: 10.1177/1359105309342295
12. Canfield, J., Henson, M.V., Aubery, P., & Mitchell, N. (1996). Chicken Soup for The Surviving Soul: 101 Stories of Courage and Inspiration from Those Who Have Survived Cancer. Health Communication, Inc., Deerfield Beach, Florida.
13. Carver, C. S., Pozo, C., Harris, S. D., Noriega, V., Scheier, M. F., Robinson, D. S., & Clark, K. C. (1993). How Coping Mediates the Effect of Optimism on Distress: A Study of Women with Early Stage Breast Cancer. Journal of Personality and Social Psychology, 65(2), 375. doi: 10.1037/0022-3514.65.2.375
14. Carver, C.S. (1997). You Want to Measure Coping but Your Protocol’ Too Long: Consider the Brief Cope. International Journal of Behavioral Medicine, 4(1), 92-100. https://link.springer.com/content/pdf/10.1207%2Fs15327558ijbm0401_6.pdf
15. Carver, C. S., Meyer, B., & Antoni, M. H. (2000). Responsiveness To Threats and Incentives, Expectancy of Recurrence, And Distress and Disengagement: Moderator Effects in Women with Early Stage Breast Cancer. Journal of Consulting and Clinical Psychology, 68(6), 965-975. doi: 10.1037//0022-006X.68.6.965
16. Clement, U., & Schonnesson, L. N. (1998). Subjective HIV Attribution Theories, Coping and Psychological Functioning Among Homosexual Men With HIV. Aids Care, 10(3), 355-363. doi: 10.1080/713612416
17. Compas, B. E., Stoll, M. F., Thomsen, A. H., Oppedisano, G., Epping‐Jordan, J. E., & Krag, D. N. (1999). Adjustment To Breast Cancer: Age‐Related Differences in Coping and Emotional Distress. Breast Cancer Research and Treatment, 54(3), 195-203. https://link.springer.com/content/pdf/10.1023%2FA%3A1006164928474.pdf
18. Coyne, J. C., & Racioppo, M. W. (2000). Never The Twain Shall Meet? Closing The Gap Between Coping Research and Clinical Intervention Research. American Psychologist, 55(6), 655-664. doi: 10.1037/0003-066X.55.6.655
19. Creswell, J.W. (2013). Qualitative, Quantitative, and Mixed Methods Approaches Research Design. 3. Edition, Sage.
20. Czerw, A., Religioni, U., & Deptała, A. (2016). Assessment of Pain, Acceptance of Illness, Adjustment to Life with Cancer and Coping Strategies in Breast Cancer Patients. Breast Cancer, 23(4), 654-661. doi: 10.1007/s12282-015-0620-0
21. Dastan, N. B., & Buzlu, S. (2010). The Effects of Spirituality in Breast Cancer Patients and Spiritual Care. Maltepe University Journal of Nursing Science and Art, 3(1), 73-78. https://hemsirelik.maltepe.edu.tr/dergiler/cilt3sayi1/73-78.pdf
22. Demir, S. T. (2016). Disease and Death in The Modern Culture: On Now and Eternity. Beytulhikme: An International Journal of Philosophy, 6(1), 287-305. Doi: 10.18491/bijop.xxx
23. Dilmac, B. (2009). Psychological Needs as A Predictor of Cyber Bullying: A Preliminary Report on College Students. Educational Sciences: Theory and Practice, 9(3), 1307-1325.
24. Doumit, M. A., El Saghir, N., Huijer, H. A. S., Kelley, J. H., & Nassar, N. (2010). Living with Breast Cancer, A Lebanese Experience. European Journal of Oncology Nursing, 14(1), 42-48. doi:l0.1016fj.ejon.2009.08.003
25. Epping-Jordan, J. E., Compas, B. E., Osowiecki, D. M., Oppedisano, G., Gerhardt, C., Primo, K., & Krag, D. N. (1999). Psychological Adjustment in Breast Cancer: Processes of Emotional Distress. Health Psychology, 18, 315-326. doi: 0278-6133/99/S3.00
26. Felder, B.E. (2004). Hope and Coping in Patients with Cancer Diagnoses. Cancer Nursing, 27(4), 320-324. Ferrell B., Grant, M., Otis-Green, S., Garcia N., & Funk B. (1998). Quality of Life in Breast Cancer Survivors: Implications for Developing Support Services. 5th Annual Conference of the International Society for Quality of Life Research, 7(7), 590-591.
27. Fry, W.F. (1992). The Physiologic Effects of Humor, Mirth, And Laughter. JAMA, 267, 1857–1858. doi: 10.1001/jama.267.13.1857
28. Folkman, S., & Lazarus, R. S. (1980). An Analysis of Coping in A Middle-Aged Community Sample. Journal of Health and Social Behavior, 21(3), 219-239.
29. Glanz, K., & Lerman, C. (1992). Psychosocial Impact of Breast Cancer: A Critical Review. Annals of Behavioral Medicine, 14(3), 204-212. doi: abm/article/14/3/204/4616962
30. Gümüs, A. B. (2006). Psychosocial Problems and Supportive Interventions in Breast Cancer. Journal of Breast Health, 2(3), 108-114, E-ISSN 2587-0831
31. Hackett T.P. and Cassem, N.H. (1974). Development of a Quantitative Rating Scale to Assess Denial. Journal of Psychosomatic Research, 18(2), 93-100. doi.org/10.1016/0022-3999(74)90072-5
32. Hammoudeh, W., Hogan, D., & Giacaman, R. (2017). From A Death Sentence to A Disrupted Life Palestinian Women’s Experiences and Coping with Breast Cancer. Qualitative Health Research, 27(4), 487-496. doi: 1049732316628833.
33. Hamdy, S. (2009). Islam, Fatalism, And Medical Intervention: Lessons from Egypt on The Cultivation of Forbearance (Sabr) And Reliance on God (Tawakkul). Anthropological Quarterly, 82(1), 173–196. doi: 10.1353/anq.0.0053
34. Holland Dukes, K., & Holahan, C. K. (2003). The Relation of Social Support and Coping to Positive Adaptation to Breast Cancer. Psychology and Health, 18(1), 15-29. doi: 10.1080/0887044031000080656
35. Holmes, J. A., & Stevenson, C. A. (1990). Differential Effects of Avoidant and Attentional Coping Strategies on Adaptation to Chronic and Recent-Onset Pain. Health Psychology, 9(5), 577. doi: 10.1037/0278-6133.9.5.577
36. Irwin, M., Daniels, M., Bloom, E. T., Smith, T. L., & Weiner, H. (1987). Life Events, Depressive Symptoms, And Immune Function. The American Journal of Psychiatry, 144(4), 437-441. doi: 10.1176/ajp.144.4.437
37. Israel, B. A., & Schurman, S. J. (1990). Social Support, Control, and The Stress Process. In K. Glanz, F. M. Lewis, & B. K. Rimer (Eds.), The Jossey-Bass health series. Health behavior and health education: Theory, research, and practice (pp. 187-215). San Francisco: Jossey-Bass.
38. Johnson, P. (2002). The Use of Humor and Its Influences on Spirituality and Coping in Breast Cancer Survivors. In Oncology Nursing Forum, 29(4), 691-695. doi: 10.1188/02.ONF.691-695
39. Kavas, E. (2015). The Relationship between Religious Attitude and Coping with Stress. Dumlupınar University Journal of Social Sciences, 37, 143-165. http://manevibakim.com/bilim_alanlari/manevi_bakim/makale_16.pdf
40. Kernan, W. D., & Lepore, S. J. (2009). Searching for and Making Meaning After Breast Cancer: Prevalence, Patterns, And Negative Affect. Social Science & Medicine, 68(6), 1176-1182. doi: 10.1016/j.socscimed.2008.12.038 Kershaw, T., Northouse, L., Kritpracha, C., Schafenacker, A., & Mood, D. (2004). Coping Strategies and Quality of Life in Women with Advanced Breast Cancer and Their Family Caregivers. Psychology & Health, 19(2), 139-155. doi: 10.1080/08870440310001652687
41. Khodaveirdyzadeh, R., Rahimi, R., Rahmani, A., Ghahramanian, A., Kodayari, N., & Eivazi, J. (2016). Spiritual/Religious Coping Strategies and Their Relationship with Illness Adjustment Among Iranian Breast Cancer Patients. Asian Pacific Journal of Cancer Prevention, 17(8), 4095-4099. doi: 10.14456/apjcp.2016.220/APJCP.2016.17.8.4095
42. Kim, J., Han, J. Y., Shaw, B., McTavish, F., & Gustafson, D. (2010). The Roles of Social Support and Coping Strategies in Predicting Breast Cancer Patients’ Emotional Well-Being Testing Mediation and Moderation Models. Journal of Health Psychology, 15(4), 543-552. doi: 10.1177/1359105309355338
43. Kissane, D. W., Bloch, S., Smith, G. C., Miach, P., Clarke, D. M., Ikin, J., ... & McKenzie, D. (2003). Cognitive‐Existential Group Psychotherapy for Women with Primary Breast Cancer: A Randomised Controlled Trial. Psycho‐Oncology, 12(6), 532-546. doi: 10.1002/pon.683
44. Koenig, H. G., McCullough, M., & Larson, D. B. (2001). Handbook of Religion and Health: A Century of Research Reviewed. New York: Oxford University Press.
45. Kozinets, R. V. (2002). The Field Behind the Screen: Using Netnography for Marketing Research in Online Communities. Journal of Marketing Research, 39(1), 61-72. doi: 10.1509/jmkr.39.1.61.18935.
46. Kozinets, R. V. (2010). Netnography. Doing Ethnographic Research Online. Sage Publications Ltd.
47. Landmark, B. T., & Wahl, A. (2002). Living With Newly Diagnosed Breast Cancer—The Meaning of Existential Issues: A Qualitative Study of 10 Women with Newly Diagnosed Breast Cancer, Based on Grounded Theory. Cancer Nursing, 24(3), 220-226.
48. Lazarus, R. S., & Folkman, S. (1984). Stress, Appraisal, and Coping. New York: Springer.
49. Levenson, J. L., & Bemis, C. (1991). The Role of Psychological Factors in Cancer Onset and Progression. Psychosomatics, 32(2), 124-132. doi: 10.1016/S0033-3182(91)72083-5
50. Liamputtong, P., & Suwankhong, D. (2015). Therapeutic Landscapes and Living with Breast Cancer: The Lived Experiences of Thai Women. Social Science & Medicine, 128, 263-271. doi: 10.1016/j.socscimed.2015.01.031
51. Luecken, L. J., & Compas, B. E. (2002). Stress, Coping, And Immune Function in Breast Cancer. Annals of Behavioral Medicine, 24(4), 336-344, doi: 10.1207/S15324796ABM2404_10
52. Maly, R. C., Umezawa, Y., Leake, B., & Silliman, R. A. (2005). Mental Health Outcomes in Older Women with Breast Cancer: Impact of Perceived Family Support and Adjustment. Psycho‐Oncology, 14(7), 535-545. doi: 10.1002/pon.869
53. Manne, S., Cleveland, J. P., Gaub, H. E., Stucky, G. D., & Hansma, P. K. (1994). Direct Visualization of Surfactant Hemimicelles by Force Microscopy of The Electrical Double Layer. Langmuir, 10(12), doi: 4409-4413. doi/pdf/10.1021/la00024a003
54. Manning-Walsh, J. (2005). Social Support as A Mediator Between Symptom Distress and Quality of Life in Women with Breast Cancer. Journal of Obstetric, Gynecologic & Neonatal Nursing, 34(4), 482-493. doi: 10.1177/0884217505278310
55. Marieke van den Beuken‐van Everdingen, M. Peters, M. L., de Rijke, J. M., Schouten, H. C., van Kleef, M., & Patijn, J. (2008). Concerns Of Former Breast Cancer Patients About Disease Recurrence: A Validation and Prevalence Study. Psycho‐Oncology, 17(11), 1137-1145. doi: 10.1002/pon.1340
56. Moyer, A., & Salovey, P. (1996). Psychosocial Sequelae of Breast Cancer and Its Treatment. Annals of Behavioral Medicine, 18(2), 110-125. doi: 10.1007/BF02909583
57. Nelson, J. P. (1996). Struggling To Gain Meaning: Living with The Uncertainty of Breast Cancer. Advances in Nursing Science, 18(3), 59-76.
58. Nosarti, C., Roberts, J. V., Crayford, T., McKenzie, K., & David, A. S. (2002). Early Psychological Adjustment in Breast Cancer Patients: A Prospective Study. Journal of Psychosomatic Research, 53(6), 1123-1130. doi:10.1016/S0022-3999(02)00350-1
59. Olgun N., Öntürk Z. K., Aslan F. E., Karabacak Ü. & Serbest S. (2010). Problem Solving Skills of The Nursing Students: Results of the 1-Year Observation Problem Solving Skills of The Students. Acıbadem University Journal of Health Science, 1(4): 188-194.
60. Osowiecki, D., & Compas, B. E. (1998). Psychological Adjustment to Cancer: Control Beliefs and Coping in Adult Cancer Patients. Cognitive Therapy and Research, 22(5), 483-499. doi: 0147-5916/98/1000-0483$
61. Pargament, K. I., Koenig, H. G., Tarakeshwar, N., & Hahn, J. (2004). Religious Coping Methods as Predictors of Psychological, Physical and Spiritual Outcomes Among Medically Ill Elderly Patients: A Two-Year Longitudinal Study. Journal of Health Psychology, 9(6), 713-730. doi: 10.1177/1359105304045366
62. Ross, R., Zeller, R., Srisaeng, P., Yimmee, S., Somchid, S., & Sawatphanit, W. (2005). Depression, Stress, Emotional Support, And Self-Esteem Among Baccalaureate Nursing Students in Thailand. International Journal of Nursing Education Scholarship, 2(1), 1165. doi: 10.2202/1548-923X.1165
63. Royak-Schaler, R., Stanton, A. L., & Danoff-Burg, S. (1997). Breast Cancer: Psychosocial Factors Influencing Risk Perception, Screening, Diagnosis, and Treatment. In S. J. Gallant, G. P. Keita, & R. Royak-Schaler (Eds.), Health care for women: Psychological, social, and behavioral influences (pp. 295-314. doi: 10.1037/10235-018
64. Smith, W. D. (Ed.). (1996). A Portrait of Breast Cancer: Expressions in Words and Art. Project Woman.
65. Stanton, A. L., Danoff-Burg, S., Cameron, C. L., Bishop, M., Collins, C. A., Kirk, S. B., & Twillman, R. (2000). Emotionally Expressive Coping Predicts Psychological and Physical Adjustment to Breast Cancer. Journal of Consulting and Clinical Psychology, 68(5), 875-882. doi: 10.1037//0022-006X.68.5.875
66. Stanton L. Annette, Sharon Danoff-Burg & Melissa E. Huggins (2002). The First Year After Breast Cancer Diagnosis: Hope and Copıng Strategies as Predictors of Adjustment. Psycho-Oncology, 11, 93-102. doi: 10.1002/pon.574
67. Turner, B. S. (1995). Medical Power and Social Knowledge. London, Thousand Oaks and New Delhi: Sage Publications.
68. Cancer Statistics Turkey, (2016). The Ministry of Health, Public Health Agency of Turkey. Retrieved from http://kanser.gov.tr/Dosya/ca_istatistik/ANA_rapor_2013v01_2.pdf
69. Yıldırım İ. (1997). Perceived Social Support Scale Which Is Developed, Reliability. Hacettepe University Journal of Education, 13, 81-87.
70. Watson, M., Greer, S., Blake, S., & Shrapnell, K. (1984). Reaction To a Diagnosis of Breast Cancer Relationship Between Denial, Delay and Rates of Psychological Morbidity. Cancer, 53(9), 2008-2012. doi: 10.1002/1097-0142
71. Wilmoth, M. C., Tulman, L., Coleman, E. A., Stewart, C. B., & Samarel, N. (2006, January). Women's Perceptions of The Effectiveness of Telephone Support and Education on Their Adjustment to Breast Cancer. In Oncology Nursing Forum, 33(1), 138-144. doi: 10.1188/06.ONF.138-144
72. Zwingmann, C., Müller, C., Körber, J., & Murken, S. (2008). Religious Commitment, Religious Coping and Anxiety: A Study in German Patients with Breast Cancer. European Journal of Cancer Care, 17(4), 361-370. doi: 10.1111/j.1365-2354.2007.00867.x