Reintegration for Post-treatment Cancer Survivors: A Concept Analysis

Abstract

Background: Cancer survivors who have completed active treatments experience challenges in the survivorship phase of cancer care. Survivors transitioning through an illness experience negotiate former roles and relationships and reevaluate their self-identity. Reintegration of post-treatment cancer survivors has not been analyzed; however, nurses with a clear understanding of reintegration influence holistic care. Purpose: The goal of this artricle is to provide a theoretical definition of the concept of reintegration for cancer survivors post-treatment. The definition is derived and supported from a multidisciplinary literature review. Method: The discussion was organized using the Walker and Avant approach to concept analysis. Findings: This concept analysis defined reintegration as a dynamic process involving the reorganization of former performance roles concurrent with the reevaluation of personal abilities. Survivors are involved in creating a new normal and post-treatment cancer survivor identity. Reintegration is characterized by transitional phases that may be cyclical and evolve with time. Finally, desired outcomes are based on perceived subjective and objective criteria of importance and are strengthened through multidimensional supportive networks. Conclusion: Incorporating the physical, social, emotional, spiritual, and community/environmental aspects of the cancer survivorship experience enhances reintegration.

What Matters in Cancer Survivorship Research? A Suite of Stakeholder-Relevant Outcomes

“…Similarly, reintegration after cancer treatment, arguably the stakeholders' main priority outcome for future research, is a complex construct that would require multiple measures to assess in a holistic and meaningful way. Ore and Foli [28] recently published a concept analysis on reintegration post-cancer treatment that demonstrated the dynamic and evolving nature of this outcome, which involves a reorganization of roles and personal abilities to create a new normal and post-treatment identity. The authors provide some suggested tools to help assess this concept such as symptom scales as well as the Self-Perception and Relationships Tool [29] and the Reintegration to Normal Living Index [30].…”

Psychosocial interventions that facilitate adult cancer survivors’ reintegration into daily life after active cancer treatment: a scoping review protocol

“…Although measurement tools to assess the outcome are lacking, study authors cited examples, including the Reintegration to Normal Living Index. 19,20 Reintegration in cancer survivor literature is lacking, as sources have primarily focused on individual components related to reintegration, such as return to work for adults or return to school for childhood survivors. There are primary studies [21][22][23][24] and systematic reviews [25][26][27][28] on individual components that may fall within reintegration; for example, interventions addressing return to work, 21,25 exercise interventions for psychological improvement, 22,26 body image and sexual function interventions, 23,27 peer support groups, 24 and self-management regimes.…”

“…Ore and Foli published a concept analysis on reintegration post-cancer treatment 19 . Reintegration is a distinct concept compared with related outcomes, such as quality of life, degree of well-being, post-traumatic growth, resilience, or rehabilitation.…”

“…Reintegration is a distinct concept compared with related outcomes, such as quality of life, degree of well-being, post-traumatic growth, resilience, or rehabilitation. They defined reintegration as “a dynamic process involving the reorganization of former performance roles concurrent with the re-evaluation of personal abilities.” 19 (p.300) They further characterized reintegration as an outcome dependent on the subjective and objective interpretation of the cancer survivors, family/friends, and health care providers. Although measurement tools to assess the outcome are lacking, study authors cited examples, including the Reintegration to Normal Living Index 19,20 .…”

“…They defined reintegration as “a dynamic process involving the reorganization of former performance roles concurrent with the re-evaluation of personal abilities.” 19 (p.300) They further characterized reintegration as an outcome dependent on the subjective and objective interpretation of the cancer survivors, family/friends, and health care providers. Although measurement tools to assess the outcome are lacking, study authors cited examples, including the Reintegration to Normal Living Index 19,20 . Reintegration in cancer survivor literature is lacking, as sources have primarily focused on individual components related to reintegration, such as return to work for adults or return to school for childhood survivors.…”