Experiences of Gynecological Cancer through Perspectives of Existential Philosophy: A Qualitative Meta-Synthesis Study

Öz

The aim of this study was to re-interpret qualitative studies that examined life experiences of women with gynecological cancer through the perspective of "existentialist philosophy". In this meta-synthesis study, a theoretical sampling method was used. Thirty-five studies that were accessible in full text, published in Turkish and English, were included in the meta-synthesis. The Joanna Briggs Institute's 2011 Qualitative Assessment and Review Instrument and Weed's meta-interpretation approach was used, respectively, to evaluate and interpret data. In this study, data pertaining to women's experiences with cancer were re-interpreted based on five fundamental concepts of existentialist philosophy: (1)Angst: In cancer's shadow, (2)Despair: I'm sorry for my losses!, (3)Authenticity: Towards a new existence, (4)The Absurd: Lives confined to the short distance between joy of life and existential crisis, (5)The "Other" and the "Look": Cancer: It's so hard to say! In this meta-synthesis study, it was found that women with gynecological cancer continuously bear the heavy burden of uncertainty and the threat of existential angst, and require expert, knowledgeable, and authentic care that focuses on their existence.

Anahtar Kelimeler

• Existentialism, genital neoplasms, qualitative research, life events

Varoluşçu Felsefe Bakış Açısına Göre Jinekolojik Kanser Yaşantıları: Bir Niteliksel Meta-Sentez Çalışması

Öz

Bu çalışmanın amacı, jinekolojik kanseri olan kadınların yaşam deneyimlerini inceleyen niteliksel çalışmaları, "varoluşçu felsefenin" bakış açısıyla yeniden incelemektir. Bu meta-sentez çalışmasında, amaca yönelik örneklem yöntemi kullanılmıştır. Akdeniz Üniversitesi veri tabanından, "gynecological cancer", "qualitative study", "nursing", "care", "patients' perspectives" ve "jinekolojik kanser", "niteliksel araştırma", "hemşirelik", "bakım", "hasta beklentileri" anahtar kelimeleriyle son 10 yıllık literatür sistematik olarak incelenmiştir. Tam metinlerine ulaşılabilen, Türkçe ve İngilizce 35 araştırma çalışmaya dahil edilmiştir. Verilerin değerlendirilme sürecinde Joanna Briggs Enstitünün Niteliksel Değerlendirme Rehberi'nin 2011 versiyonu kullanılmıştır. Verilerin yorumlamasında Weed'in ileri-yorumlama (meta-interpretation) yöntemi kullanılmıştır. Çalışmada kadınların kanser yaşantılarına ilişkin veriler varoluşçu felsefenin beş temel kavramı ile yeniden yorumlanmıştır: (1) Anksiyete; Kanserin gölgesinde, (2) Acı çekme; Üzgünüm, kaybettiklerim için!, (3) Otantiklik; Yeni bir varoluşa doğru, (4) Absürt; Yaşam sevinci ve varlık bunaltısı arasındaki kısa mesafede yaşamlar, ve (5)"Öteki" ve "Bakış"; Kanser: söylemek o kadar zor ki!. Bu meta-sentez çalışmasında, kadınların varoluşun tehdidi ve belirsizliğin ağır yükünü sürekli taşıdıkları ve varoluşlarına odaklanan, ilgili, uzmanca, bilgili ve otantik bir bakıma gereksinim duydukları saptanmıştır.

Anahtar Kelimeler

• Varoluşçuluk, genital tümörler, niteliksel araştırma, yaşam olayları

Kaynakça

1. Güleç G, Büyükkınacı A. Kanser ve psikiyatrik bozukluklar. Psikiyatride Güncel Yaklaşımlar 2011; 2:343-367.
2. Hallaç S, Öz F. Genital kanser tanı sürecinde varoluşsal kaygı. Psikiyatride Güncel Yaklaşımlar 2011; 3:595-610.
3. İnan FŞ, Üstün B. Meme kanserinde tedavi sonrası dönemde psikosoyal değişimler. Journal of Breast Health 2013; 9:48-51.
4. Sekse RJT, Raaheim M, Blaaka G, Gjengedal E. Cancer as a life-changing process: Women’s experiences five years after treatment for gynaecological cancer. Int J Qual Stud Health Well-being 2009; 4:288-298.
5. Sekse RJT, Raaheim M, Blaaka G, Gjengedal E. Life beyond cancer: women’s experiences 5 years after treatment for gynaecological cancer. Scand J Caring Sci 2010; 24:799-807.
6. Sekse RJT, Raaheim M, Blaaka G, Gjengedal E. Living through gynaecological cancer: three typologies. J Clin Nurs 2012; 21:2626-2635.
7. Burns M, Costello J, Ryan-Woolley B, Davidson S. Assessing the impact of late treatment effects in cervical cancer: an exploratory study of women’s sexuality. Eur J Cancer Care 2007; 16:364-372.
8. Juraskova I, Butow P, Robertson R, Sharpe L, McLeod C, Hacker N. Post-treatment sexual adjustment following cervical and endometrial cancer: A qualitative insight. Psychooncology 2003; 12:267-279.

9. Wilmoth MC, Hatmaker-Flanigan E, LaLoggia V, Nixon T. Ovarian cancer survivors: Qualitative analysis of the symptom of sexuality. Oncol Nurs Forum 2011; 38:699-708.
10. Reis N, Beji NK, Coskun A. Quality of life and sexual functioning in gynecological cancer patients: results from quantitative and qualitative data. Eur J Oncol Nurs 2010; 14:137-146.
11. Bal MD, Yilmaz SD, Beji NK. Sexual health in patients with gynecological cancer: a qualitative study. Sex Disabil 2013; 31:83-92.
12. Pilkington FB, Mitchell GJ. Quality of life for women living with a gynecologic cancer. Nurs Sci Q 2004; 17:147-155.
13. Zeng YC, Li D, Loke AY. Life after cervical cancer: Quality of life among Chinese women. Nurs Health Sci 2011; 13:296-302.
14. Hazewinkel M, Sprangers M, Taminiau-Bloem EF, van der Velden J, Burger MP, Roovers JP. Reasons for not seeking medical help for severe pelvic floor symptoms: a qualitative study in survivors of gynaecological cancer. BJOG 2010; 117:39-46.
15. Lopez V, Copp G, Brunton L, Molassiotis A. Symptom experience in patients with gynecological cancers: the development of symptom clusters through patient narratives. J Support Oncol 2011; 9:64-71.
16. Hammer K, Mogensen O, Hall, EOC. Hope as experienced in women newly diagnosed with gynaecological cancer. Eur J Oncol Nurs 2009; 13:274-9.
17. Reb AM. Transforming the death sentence: elements of hope in women with advanced ovarian cancer. Oncol Nurs Forum 2007; 34:70-81.
18. Molassiotisa A, Chan CW, Yam BM, Chan ES, Lam CS. Life after cancer: adaptation issues faced by chinese gynaecological cancer survivors in Hong Kong. Psychooncology 2002; 11:114-123.
19. Çüçen AK. Heidegger’de Varlık ve Zaman. 3. Baskı. Bursa, Asa Kitapevi, 2003.
20. Sartre JP. Varoluşçuluk. (Ed. A Bezirci). 23. Baskı. İstanbul, Say Yayınları, 2012.
21. Pattison G. Philosophy of Kierkegaard. Canada, McGill-Queen's University Press, 200 Çelebi VS. Kirkegaard ve J.P. Sartre’ın varoluşçuluk anlayışlarının karşılaştırılması (Yüksek lisans tezi). Denizli, Pamukkale Üniversitesi, 2008.
22. Afsaroglu E, Okutur K, Demir G. Beliefs of Turkish cancer patients on the genesis of cancer: "why do I have cancer?". J BUON 2010; 15:303-309.
23. Fawcett J. Parse’s theory of human becoming. In Contemporary Nursing Knowledge and Analysis and Evaluation of Nursing Models and Theories, 2nd ed. (Ed J. Fawcett): 471-500. Philadelphia, Davis Company, 2005.
24. Weed M. "Meta-interpretation": a method for the interpretive synthesis of qualitative research. Forum Qual Soc Res 2005; 6:1-21.
25. Weed M. A potential method for the interpretive synthesis of qualitative research: issues in the development of ‘meta-interpretation’. Int J Soc Res Meth 2008; 11:13-28.
26. McClean S, Shaw A. From schism to continuum? the problematic relationship between expert and lay knowledge-an exploratory conceptual synthesis of two qualitative studies. Qual Health Res 2005; 15:729-749.
27. Streubert HJ, Carpenter DR. Qualitative Research in Nursing, Advancing the Humanistic Imperative. 5nd ed. Philadelphia, Lippincott Williams &Wilkins, 2011.
28. Grunfeld EA, Cooper AF. A longitudinal qualitative study of the experience of working following treatment for gynaecological cancer. Psychooncology 2012; 21:82-89. Jones JM, Ferguson S, Edwards E, Walton T, McCurdy N, Howell D. Experiences of care delivery: endometrial cancer survivors at end of treatment. Gynecol Oncol 2012; 124:458-464.
29. Mabena N, Moodley P. Spiritual meanings of illness in patients with cervical cancer. S Afr J Psychol 2012; 42:301-311.
30. Seibaek L, Petersen LK, Blaakaer J, Hounsgaard L. Hoping for the best, preparing for the worst: the lived experiences of women undergoing ovarian cancer surgery. Eur J Cancer Care 2012; 21:360-371.
31. Thygesen MK, Pedersen BD, Kragstrup J, Wagner L, Mogensen O. Gynecological cancer patients’ differentiated use of help from a nurse navigator: a qualitative study. BMC Health Serv Res 2012; 12:168.
32. Guenther J, Stiles A, Champion JD. The lived experience of ovarian cancer: A phenomenological approach. J Am Acad Nurse Pract 2012; 24:595-603.
33. Oshima S, Kisa K, Terashita T, Habara M, Kawabata H, Maezawa M. A qualitative study of Japanese patients’ perspectives on post-treatment care for gynecological cancer. Asian Pac J Cancer Prev 2011; 12:2255-2261.
34. Willis EM, Dwyer J, Owada K, Couzner L, King D, Wainer J. Indigenous women’s expectations of clinical care during treatment for a gynaecological cancer: rural and remote differences in expectations. Aust Health Rev 2011; 35:99-103.
35. Cesario SK, Nelson LS, Broxson A, Cesario AL. Sword of Damocles cutting through the life stages of women with ovarian cancer. Oncol Nurs Forum 2010; 37:609-617. Walton LM, Reeve J, Brown PM, Farquhar CM. Gynaecologic cancer patients’ needs and experiences of supportive health services in New Zealand. Psychooncology 2010; 19:201-208.
36. Akyüz A, Güvenç G, Üstünsöz A, Kaya T. Living with gynecologic cancer: experience of women and their partners. J Nurs Scholarsh 2008; 40:241-247.
37. Baldwin AE. Going the distance-experiences of women with gynaecological cancer residing in rural remote north Queensland. Int J Nurs Pract 2008; 14:322-328.
38. Wray N, Markovic M, Manderson L. Discourses of normality and difference: responses to diagnosis and treatment of gynaecological cancer of Australian women. Soc Sci Med 2007; 64:2260-2271.
39. Ashing-Giwa KT, Padilla GV, Bohorquez DE, Tejero JS, Garcia M, Meyers EA. Survivorship: 1ualitative investigation of Latinas diagnosed with cervical cancer. J Psychosoc Oncol 2006; 24:53-88.
40. Ahlberg K, Nordner A. The importance of participation in support groups for women with ovarian cancer. Oncol Nurs Forum 2006; 33:53-61.
41. Ekwall E, Ternestedt BM, Sorbe B. Important aspects of health care for women with gynecologic cancer. Oncol Nurs Forum 2003; 30:313-319.
42. Ferrell B, Smith S, Cullinane C, Melancon C. Symptom concerns of women with ovarian cancer, J Pain Symptom Manage 2003; 25:528-538.
43. Ferrell BT, Smith SL, Ervin KS Itano J, Melancon C. A qualitative analysis of social concerns of women with ovarian cancer. Psychoocology 2003; 12:647-663.
44. Howell D, Fitch MI, Deane KA. Impact of ovarian cancer perceived by women. Cancer Nurs 2003; 26:1-9.
45. Howell D, Fitch MI, Deane KA. Women’s experiences with recurrent ovarian cancer. Cancer Nurs 2003; 26:10-17.
46. Qualitative Evidence. Joanna Briggs Institute Reviewers’ Manual: 2011 edition. South Australia, University of Adelaide, 2011.
47. Wahl J. Varoluşçuluğun Tarihçesi (Çeviri Ed. B Onaran). İstanbul, Payel Yayınları, 19 Sezer S, Saya P. Gelişimsel açıdan ölüm kavramı. Dicle Üniversitesi Ziya Gökalp Eğitim Fakültesi Dergisi 2009; 13:151-165.
48. Karakuş G, Öztürk Z, Tamam L. Ölüm ve ölüm kaygısı. Arşiv Kaynak Tarama Dergisi 2012; 21:42-79.
49. İnci F, Öz F. Palyatif bakım ve ölüm kaygısı. Psikiyatride Güncel Yaklaşımlar 2012; 4:178-187.
50. Kılıç S. Jean Paul Sartre’in varoluş felsefesinde öteki kavramı (Yüksek lisans tezi). Antalya, Akdeniz Üniversitesi, 2006.
51. Camus A. Uyumsuz Yaşama (Çeviri Ed. T. Yücel). İstanbul, Varlık Yayınları, 1974. Terakye G. Karşıdan bakış. Dokuz Eylül Üniversitesi Hemşirelik Yüksekokulu Elektronik Dergisi 2012; 5:162-170.
52. Watson J. Nursing: Human Science and Human Care. 1nd ed. New York, Jones & Bartlett Learning, 2008. İlkay Arslan Özkan, Öğr.Gör.Dr., Akdeniz Üniversitesi Hemşirelik Fakültesi, Antalya; Gamze Teskereci, Araş Gör., Akdeniz Üniversitesi Hemşirelik Fakültesi, Antalya; Özen Kulakaç, Doç. Dr., Akdeniz Üniversitesi Hemşirelik Fakültesi, Antalya. Yazışma Adresi/Correspondence: İlkay Arslan Özkan, Akdeniz Üniversitesi Hemşirelik Fakültesi, Antalya, Turkey. E-mail: [e-mail] Yazarlar bu makale ile ilgili herhangi bir çıkar çatışması bildirmemişlerdir. The authors reported no conflict of interest related to this article. Bu makale, 7-11 Kasım 2012 tarihleri arasında düzenlenen 13. Ulusal Jinekolojik Onkoloji Kongresi’nde Sözel Bildiri olarak sunulmuş, sözel bildiri birincilik ödülü almıştır. Teşekkür: Bu çalışma, Akdeniz Üniversitesi Bilimsel Araştırma Projeleri Yönetim Birimi tarafından desteklenmiştir. Çevrimiçi adresi / Available online at: www.cappsy.org/archives/vol5/no3/ Çevrimiçi yayım / Published online 04 Eylül/September 04, 2013; doi:10.5455/cap.20130521