Awaiting Diagnosis of Breast Cancer: Strategies of Enduring for Preserving Self

Abstract

The Praxis Theory of Suffering enables nurses to recognize and respond according to the behaviors of suffering, and to endure with healthy, adaptive, and normalizing behaviors that enable preserving self.

Using qualitative methods to access the pain experience

“…16,17 When enduring, the person suppresses emotion in order to 'keep going', to cognitively suppress the fear of cancer, until able to accept the notion (or 'come to terms') that they may indeed have cancer. 9 This state of emotional suppression is evident behaviourally. When the enduring is 'acute', sufferers walk stiffly and upright, without spontaneous movement.…”

“…I have conducted a large number of qualitative studies with 'distressed' patients, including those undergoing diagnosis for breast cancer and those who were dying from cancer, 9 and conducted qualitative synthesis of interrelated projects, a technique called theoretical coalescence, 15 fitting these studies together, to form the Praxis Theory of Suffering. 16,17 The clinical validity of the Distress Thermometer Recently, there has been a trend towards measuring 'distress' in cancer patients using the Distress Thermometer.…”

“…8 The third example is a discussion of 'distress' using the Distress Thermometer, and I present an alternative theoretical explanation, a theory of suffering behaviour that accounts for the absence of expected distress in women when undergoing the diagnostic procedures for breast cancer. 9 Each of these examples illustrates different perspectives about the expression of pain, the uniqueness of pain and the difficulties we have as caregivers assessing pain.…”

Centres de diagnostic rapide du cancer et conséquences psychologiques : une analyse systématique

“…Des études ont montré que les femmes en processus de dépistage d'un cancer du sein vivent beaucoup d'anxiété et d'incertitude pendant la phase de diagnostic, même lorsque l'affection se révèle bénigne. (Harding, 2014;Liao, Chen, Chen et Chen, 2008;Meechan, Collins, Moss-Morris et Petrie, 2005;Morse et al, 2014). Pendant cette période, le besoin d'information des femmes au sujet du processus d'évaluation diagnostique n'est pas toujours satisfait, ce qui risque d'amplifier le sentiment d'incertitude (Harding et McCrone, 2013;Liao, Chen, Chen et Chen, 2007).…”

The psychological impact of the rapid diagnostic centres in cancer screening: A systematic review

“…Studies have found that women undergoing investigation for breast cancer experience high levels of anxiety and uncertainty during the diagnostic phase, including the many women whose results are benign (Harding, 2013;Liao, Chen, Chen, & Chen, 2008;Meechan, Collins, Moss-Morris, & Petrie, 2005;Morse et al, 2014). Women undergoing investigation also have unmet informational needs about the diagnostic process that may increase this uncertainty (Harding & McCrone, 2013;Liao, Chen, Chen, & Chen, 2007).…”