Exploration and examination of the meaning of resilience in the context of adult cancer care: perspectives of individuals with colorectal cancer
Access status:
Open Access
Type
ThesisThesis type
Doctor of PhilosophyAuthor/s
Luo, DanAbstract
Background
Resilience is a concept that is increasingly used by nurses and other health professionals when discussing management of psychosocial distress for people living with cancer. Empirical studies suggest that low levels of resilience may contribute to high levels of ...
See moreBackground Resilience is a concept that is increasingly used by nurses and other health professionals when discussing management of psychosocial distress for people living with cancer. Empirical studies suggest that low levels of resilience may contribute to high levels of psychological distress in people affected by cancer. Despite often being proffered as a solution, the conceptualisation of resilience for adult cancer patients has not been addressed so far. Aim The overarching aim of this two-phase study was to clarify the meaning of individual resilience in the context of adult cancer care. Specifically, this study aimed to: 1. Conceptualise individual resilience in adult cancer care and developing a preliminary conceptual model of individual resilience; 2. Examine and refine the preliminary conceptual model of individual resilience based on the perspectives and experience of resilience in the population of adults with a certain cancer (i.e. colorectal cancer) in the context of their illness. Methods For the first phase of the study, the concept analysis method recommended by Walker and Avant was employed to conceptualise individual resilience in adult cancer care. Based on the conceptualisation of individual resilience, we developed a preliminary conceptual model of individual resilience in adult cancer care. For the second phase of the study, qualitative inquiry was applied to guide the study. Twelve participants diagnosed with colorectal cancer that had completed treatment were recruited from a tertiary hospital in Australia. The meaning of resilience was explored using in-depth individual interviews. Following thematic analysis, the elements of the preliminary model of individual resilience were mapped against the themes and subthemes to refine the preliminary conceptual model. Results Based on our concept analysis, individual resilience in adult cancer care was defined as “the capacity and dynamic recalibration process of an individual to change their psychological distress level and individual functioning performance through their interaction with the environment when facing cancer-related adversity”. Our refined conceptual model of individual resilience in adults with colorectal cancer comprised five components (themes). When faced with adversity related to diagnosis and treatment for colorectal cancer, participants initially strove to seek motivations to move forward, through identifying and clarifying important things to live for, drawing on mental efforts and strength, and accessing the spiritual self. With the motivation to move forward, participants strove to live as normally as they could during their cancer journey. Meanwhile, they also made efforts to adapt and manage themselves as well as draw on external supports to respond to various illness-related adversities, which was also beneficial for them to achieve the goal of living a normal life. Once the adversity was overcome, individuals were able to reconsider their perception of self by reflecting on the changes they had made in their ability to manage adversity, and to set their values and life priorities. Conclusion This study expanded the body of knowledge on resilience in adult cancer care through clarifying the concept of resilience, developing and refining the conceptual model of resilience based on the perspectives and experience of resilience in adults with colorectal cancer in the context of their illness. This study bridged the gap in the lack of a consistent definition in existing resilience studies in adult cancer care. The concept clarification may contribute to a better understanding of the nature of resilience in people living with cancer for nurses and other health professionals. Understanding the nature of dynamic changes of resilience may be beneficial for improving health professionals’ awareness of regularly assessing psychosocial conditions of people affected by cancer, thereby facilitating early identification and referral to psychosocial support services for patients who may be at risk of developing adaptation difficulties. The refined conceptual model of resilience in adults with colorectal cancer could be used to guide the development of cancer-specific resilience measures as well as interventions that aim to facilitate resilience in individuals living with colorectal cancer.
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See moreBackground Resilience is a concept that is increasingly used by nurses and other health professionals when discussing management of psychosocial distress for people living with cancer. Empirical studies suggest that low levels of resilience may contribute to high levels of psychological distress in people affected by cancer. Despite often being proffered as a solution, the conceptualisation of resilience for adult cancer patients has not been addressed so far. Aim The overarching aim of this two-phase study was to clarify the meaning of individual resilience in the context of adult cancer care. Specifically, this study aimed to: 1. Conceptualise individual resilience in adult cancer care and developing a preliminary conceptual model of individual resilience; 2. Examine and refine the preliminary conceptual model of individual resilience based on the perspectives and experience of resilience in the population of adults with a certain cancer (i.e. colorectal cancer) in the context of their illness. Methods For the first phase of the study, the concept analysis method recommended by Walker and Avant was employed to conceptualise individual resilience in adult cancer care. Based on the conceptualisation of individual resilience, we developed a preliminary conceptual model of individual resilience in adult cancer care. For the second phase of the study, qualitative inquiry was applied to guide the study. Twelve participants diagnosed with colorectal cancer that had completed treatment were recruited from a tertiary hospital in Australia. The meaning of resilience was explored using in-depth individual interviews. Following thematic analysis, the elements of the preliminary model of individual resilience were mapped against the themes and subthemes to refine the preliminary conceptual model. Results Based on our concept analysis, individual resilience in adult cancer care was defined as “the capacity and dynamic recalibration process of an individual to change their psychological distress level and individual functioning performance through their interaction with the environment when facing cancer-related adversity”. Our refined conceptual model of individual resilience in adults with colorectal cancer comprised five components (themes). When faced with adversity related to diagnosis and treatment for colorectal cancer, participants initially strove to seek motivations to move forward, through identifying and clarifying important things to live for, drawing on mental efforts and strength, and accessing the spiritual self. With the motivation to move forward, participants strove to live as normally as they could during their cancer journey. Meanwhile, they also made efforts to adapt and manage themselves as well as draw on external supports to respond to various illness-related adversities, which was also beneficial for them to achieve the goal of living a normal life. Once the adversity was overcome, individuals were able to reconsider their perception of self by reflecting on the changes they had made in their ability to manage adversity, and to set their values and life priorities. Conclusion This study expanded the body of knowledge on resilience in adult cancer care through clarifying the concept of resilience, developing and refining the conceptual model of resilience based on the perspectives and experience of resilience in adults with colorectal cancer in the context of their illness. This study bridged the gap in the lack of a consistent definition in existing resilience studies in adult cancer care. The concept clarification may contribute to a better understanding of the nature of resilience in people living with cancer for nurses and other health professionals. Understanding the nature of dynamic changes of resilience may be beneficial for improving health professionals’ awareness of regularly assessing psychosocial conditions of people affected by cancer, thereby facilitating early identification and referral to psychosocial support services for patients who may be at risk of developing adaptation difficulties. The refined conceptual model of resilience in adults with colorectal cancer could be used to guide the development of cancer-specific resilience measures as well as interventions that aim to facilitate resilience in individuals living with colorectal cancer.
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Date
2022Rights statement
The author retains copyright of this thesis. It may only be used for the purposes of research and study. It must not be used for any other purposes and may not be transmitted or shared with others without prior permission.Faculty/School
Faculty of Medicine and Health, The University of Sydney Susan Wakil School of Nursing and MidwiferyAwarding institution
The University of SydneyShare