Exploring Meaning of Life in Women With Breast Cancer in Taiwan: A Phenomenological Study

10.1097/jnr.0000000000000514

Fan-Ko SUN；Ann LONG；Yun Shan TSENG；YuChun YAO

breast cancer ； phenomenological study ； the meaning of life ； women's cancers

The Journal of Nursing Research

30卷5期（2022 / 10 / 01）

1 - 9

英文

Background: Globally, breast cancer is the most common cancer type in terms of incidence for women. Women with breast cancer endure higher levels of psychological distress than other types of cancer because many lose their identity as a woman, which is an additional characteristic of their psychological distress. Research using phenomenology to explore ＂the meaning of life＂ is rare among women with breast cancer. Purpose: The purpose of this study was to explore the perspectives of women with breast cancer on ＂the meaning of life.＂ Methods: A phenomenological approach was used. Twenty-six women living with breast cancer drawn from a cancer treatment hospital in Taiwan participated in this study. A semistructured interview was utilized to collect the data, and Colaizzi's seven steps were used to analyze the data. Results: Four themes emerged: (a) value of overcoming suffering, (b) value of reciprocal love, (c) value of self-transcendence, and (d) value of spiritual comfort. This means that the participants defined ＂the meaning of life＂ through the lens of suffering from cancer, reciprocal love from their families and friends, uncovering and discovering creative pathways that transformed their pain while searching for the value of their existence, and seeking spiritual guidance from religion. Conclusions: The participants identified the most pivotal aspect of healing as transforming their pain and accepting value for their suffering. They acknowledged they could not change the fact that they had cancer, but they could learn to accept it as part of their lived experience. Healthcare professionals may use these four themes at a clinically appropriate time on women's journeys toward healing to inspire women with breast cancer to process their own unique ＂meaning of life.＂

1. Liao, F.-Z.,Chang, Y.-S.,Chen, S.-L.(2018).Life of single mother breast cancer survivors.The Journal of Oncology Nursing,18,5-17.
   連結：
2. Peng, H.-L.,Hsueh, H.-W.,Chang, Y.-H.,Li, R.-H.(2021).The mediation and suppression effect of demoralization in breast cancer patients after primary therapy: A structural equation model.The Journal of Nursing Research,29(2),Article e144.
   連結：
3. Wu, P.-H.,Chen, S.-W.,Huang, W.-T.,Chang, S.-C.,Hsu, M.-C.(2018).Effects of a psychoeducational intervention in patients with breast cancer undergoing chemotherapy.The Journal of Nursing Research,26(4),266-279.
   連結：
4. Zhang, Q.,Xiao, S.,Yan, L.,Sun, L.,Wang, Y.,Huang, M.(2019).Psychosocial predictors of adjustment to disability among patients with breast cancer: A cross-sectional descriptive study.The Journal of Nursing Research,27(2),Article e15.
   連結：
5. Ahmadi, F.,Hussin, N. A. M.,Mohammad, M. T.(2019).Religion, culture and meaning-making coping: A study among cancer patients in Malaysia.Journal of Religion and Health,58,1909-1924.
6. Beauchamp, T. L.,Childress, J. F.(2013).Principles of biomedical ethics.Oxford University Press.
7. Busted, L. M.,Nielsen, D. S.,Birkelund, R.(2020)."Sometimes it feels like thinking in syrup"-The experience of losing sense of self in those with young onset dementia.International Journal of Qualitative Studies on Health and Well-Being,15,Article 1734277.
8. Campbell-Enns, H.,Woodgate, R.(2015).The psychosocial experiences of women with breast cancer across the lifespan: A systematic review protocol.JBI Database of Systematic Reviews and Implementation Reports,13(1),112-121.
9. Chen, Y.-C.,Huang, H.-M.,Kao, C.-C.,Sun, C.-K.,Chiang, C.-Y.,Sun, F.-K.(2016).The psychological process of breast cancer patients receiving initial chemotherapy: Rising from the ashes.Cancer Nursing,39(6),E36-E44.
10. Denzin, N. K.,Lincoln, Y. S.(2005).The SAGE handbook of qualitative research.Sage Publications.
11. Duijts, S. F. A.,van Egmond, M. P.,Gits, M.,van der Beek, A. J.,Bleiker, E. M.(2017).Cancer survivors' perspectives and experiences regarding behavioral determinants of return to work and continuation of work.Disability and Rehabilitation,39(21),2164-2172.
12. Ellis, J.,Cobb, M.,O'Connor, T.,Dunn, L.,Irving, G.,Lloyd-Williams, M.(2015).The meaning of suffering in patients with advanced progressive cancer.Chronic Illness,11(3),198-209.
13. Fradelos, E. C.,Papathanasiou, I. V.,Veneti, A.,Daglas, A.,Christodoulou, E.,Zygal, S.,Kourakos, M.(2017).Psychological distress and resilience in women diagnosed with breast cancer in Greece.Asian Pacific Journal of Cancer Prevention,18(9),2545-2550.
14. Frankl, V. E.(2014).The will to meaning: Foundations and applications of logotherapy.Penguin Group.
15. Frankl, V. E.(1967).Logotherapy and existentialism.Psychotherapy: Theory, Research & Practice,4(3),138-142.
16. Gallagher, J.,Parle, M.,Cairns, D.(2002).Appraisal and psychological distress six months after diagnosis of breast cancer.British Journal of Health Psychology,7(3),365-376.
17. Godskesen, T.,Hansson, M. G.,Nygren, P.,Nordin, K.,Kihlbom, U.(2015).Hope for a cure and altruism are the main motives behind participation in phase 3 clinical cancer trials.European Journal of Cancer Care,24(1),133-141.
18. Guedes, T. S. R.,Dantas de Oliveira, N. P.,Holanda, A. M.,Reis, M. A.,Silva, C. P.,Rocha e Silva, B. L.,Cancela, M. C.,de Souza, D. L. B.(2018).Body image of women submitted to breast cancer treatment.Asian Pacific Journal of Cancer Prevention,19(6),1487-1493.
19. Health Promotion Administration. (2022d). The prevention of breast cancer. Ministry of Health and Welfare. https://www.mohw.gov.tw/cp-16-67466-1.html (Original work published in Chinese)
20. Health Promotion Administration. (2022b). The statistical analysis of the cause of death in 2019. Ministry of Health and Welfare. https://www.mohw.gov.tw/cp-5017-61533-1.html (Original work published in Chinese)
21. Health Promotion Administration(2022).Cancer registry annual report in 2019.Ministry of Health and Welfare.
22. Health Promotion Administration. (2021). Statistics of health promotion 2019. Ministry of Health and Welfare. https://www.hpa.gov.tw/File/Attach/14567/File_17245.pdf (Original work published in Chinese)
23. Health Promotion Administration. (2022c). Top 10 cancer incidences in Taiwan. Ministry of Health and Welfare. https://www.gender.ey.gov.tw/gecdb/Stat_Statistics_DetailData.aspx?sn=nLF9GdMD%2B%2Bv41SsobdVgKw%3D%3D&d=x6hHAJy%2F6kd5%2FI2WaRjP4Q%3D%3D (Original work published in Chinese)
24. Isaksson, J.,Wilms, T.,Laurell, G.,Fransson, P.,Ehrsson, Y. T.(2016).Meaning of work and the process of returning after head and neck cancer.Supportive Care in Cancer,24(1),205-213.
25. Kejkornkaew, S.,Sirapo-ngam, Y.,Monkong, S.,Junda, T.,Wallhagen, M. I.(2016).A ground theory study of the quality relationships between family caregivers and persons with head and neck cancer.Pacific Rim International Journal of Nursing Research,20(2),161-173.
26. Kelly, E. P.,Paredes, A. Z.,Tsilimigras, D. I.,Hyer, J. M.,Pawlik, T. M.(2022).The role of religion and spirituality in cancer care: An umbrella review of the literature.Surgical Oncology,42,Article 101389.
27. Lai, M. L.(2002)。Introduction to logotherapy。Taiwan Journal of Hospice Palliative Care，7(2)，153-164。
28. Lapierre, S.,Desjardins, S.,Dube, M.,Marcoux, L.,Miquelon, P.,Boyer, R.(2017)."On the road to a better life": An innovative suicide prevention program based on the realization of meaningful personal goals.Journal of Depression and Therapy,1(2),8-22.
29. Li, Y. H.(Ed.),Ho, M. Y.(Ed.)(2013).Concepts of nursing research.Farseeing.
30. Lincoln, Y. S.,Guba, E. G.(1985).Naturalistic inquiry.Sage Publications.
31. Mu, P.-F.(1996).Phenomenology.Nursing Research,4(2),195-202.
32. Neris, R. R.,Biaggi Leite, A. C. A.,Nascimento, L. C.,García-Vivar, C.,Fontão Zago, M. M.(2020)."What I was and what I am": A qualitative study of survivors' experience of urological cancer.European Journal of Oncology Nursing,44,Article 101692.
33. Noguchi, W.,Morita, S.,Ohno, T.,Aihara, O.,Tsujii, H.,Shimozuma, K.,Matsushima, E.(2006).Spiritual needs in cancer patients and spiritual care based on logotherapy.Supportive Care Cancer,14(1),65-70.
34. Post, L.,Ganzevoort, R. R.,Verdonck-de Leeuw, L. M.(2020).Transcending the suffering in cancer: Impact of a spiritual life review intervention on spiritual re-evaluation, spiritual growth and psycho-spiritual wellbeing.Religions,11(3),Article 142.
35. Sun, F.-K.,Long, A.,Chiang, C.-Y.,Huang, H.-M.,Hou, Y.-C.,Yao, Y.(2018).Rationale underpinning postgraduate student nurses' choice of research methods used for their masters’ theses.Nursing Education in Practice,33,127-132.
36. Tang, P.-L.,Chen, W.-L.,Cheng, S.-F.(2013)。Using logotherapy to relieve death anxiety in a patient with recurrent cancer: A nursing experience。The Journal of Nursing，60(4)，105-110。
37. Valle, R. S.(Ed.),King, M.(Ed.)(1978).Existential phenomenological alternative for psychology.Oxford University Press.
38. Wolvers, M. D. J.,Leensen, M. C. J.,Groeneveld, I. F.,Frings-Dresen, M. H. W.,De Boer, A. G. E. M.(2018).Predictors for earlier return to work of cancer patients.Journal of Cancer Survivorship,12,169-177.
39. Wong, P. T. P.(2012).From logotherapy to meaning-centered counseling and therapy.The human quest for meaning: Theories, research, and applications
40. World Health Organization. (2022). Cancer. Author. https://www.who.int/news-room/fact-sheets/detail/cancer
41. Wu, S. F.,Lin, Y. H.,Lee, L. L.,Kan, Y. Y.(2014)。The relationship between illness uncertainty and depression in gynecologic cancer patients。Journal of Nursing and Healthcare Research，10(2)，83-93。