Struggling with paradoxes: The spiritual experience of women with cancer

Abstract

Spirituality is an important aspect of holistic health for women with cancer. Though extensive research focuses on spirituality, three major areas lack delineation. First, the developmental nature of spirituality requires exploration. Second, minimal systematic research directed at understanding spirituality from the perspective of women with cancer is reported. Finally, research exploring spirituality within specific time frames of the cancer trajectory is nonexistent. The purpose of this grounded theory study was to examine the spiritual experience of women diagnosed with cancer within 5 years of initial treatment. Data from two interviews with 10 Caucasian women, ranging from 40-70 years of age, were analyzed using the constant comparison technique. As the women began to suspect a cancer diagnosis, they questioned how this would affect their lives. The diagnosis posed a threat to the meaning they ascribed to their lives. This problem was resolved through the basic social psychological process of Struggling with Paradoxes, a 3-phase process consisting of deciphering the meaning (Phase I), realizing human limitations (Phase II), and learning to live with uncertainty (Phase III). In Phase I, deciphering the meaning, five paradoxes were uncovered that focused on confronting the possibility of their own death, staggering distress, and vulnerability. The women struggled to maintain coherence in old and new ways by connecting in giving and receiving processes. In Phase II, realizing human limitations, the demands of treatment initiated the women's struggle with three paradoxes. Confronting death, connecting for support, and asking the difficult questions were important dimensions that helped the women move toward letting go of ultimate control over their lives. As they entered Phase III, learning to live with uncertainty, the women attained greater well-being but realized that permanent survival could not be assured. In this phase, as the women struggled with two paradoxes, the dimensions of redefining meaning, identifying spiritual growth, reintegration, and facing the possibility of recurrence emerged. Findings confirm the importance of spirituality for women with cancer. Development of curriculum to enhance nurses' knowledge of spirituality is needed. Based on women's perspectives, development and testing of interventions that support and enhance spiritual growth is crucial for research-based practice.