Congress Abstracts 2003

9

TRANSCENDING BREAST CANCER. Doris Coward, RN, PhD, University of Texas at Austin, Austin, TX

The diagnosis of cancer initiates a period of spiritual disequilibrium for most women undergoing breast cancer treatment. Previous research in women with both early stage and advanced breast cancer revealed that their sense of aloneness and loss triggered new perspectives and behaviors characteristic of self-transcendence. The purpose of this phenomenological study was to describe how the process of self-transcendence might be facilitated in women following initial diagnosis of breast cancer. Self-transcendence as conceptualized by Viktor Frankl and Pamela Reed involves expansion of self-conceptual boundaries inwardly, outwardly toward others and new experiences, and temporally by using past memories and future hopes to enhance a present situation. The 14 study participants were a subset of 161 women recruited for a cancer support group study. Seven participants attending various community cancer support groups were compared over time with seven others participating in an eight-session breast cancer support group intervention in which self-transcendence views and behaviors were consciously promoted. Audiotaped interviews (obtained at baseline, and three and eight months later) were transcribed verbatim and analyzed using Colaizzi’s phenomenological analysis techniques. Standard procedures to assure trustworthiness were implemented. Women described experiences that facilitated maintenance/restoration of emotional, physical, and spiritual well-being. At first, they struggled to maintain their “normal” self-identity. Through reaching out to others for information and support, and using faith resources for support and hope, most women realized they had developed beyond their previously “normal” selves. Later, they accepted their breast cancer experience and described the newly found relationships with themselves and with others as helping them to heal emotionally and spiritually. Women in the intervention support groups developed new perspectives and behaviors earlier than other participants, but all women described reaching beyond previous self-conceptual boundaries to achieve a more positive view of themselves and their life purpose. This process of self-transcendence may be how women who believe they are cancer victims are transformed to find positive meaning as cancer survivors. Oncology nurses can assist in the process by encouraging women with newly diagnosed breast cancer to obtain resources that help them to expand previous self-conceptual boundaries. (Funded by NIH {NINR & NCCAM}).