Individuals who survive cancer face a variety of challenges and risks throughout their lives. Therefore, it is necessary to develop an effective understanding of the different issues of cancer survivors, particularly in different cultures. For example, the Filipino population has its own issues of interest and concern that must be addressed after a diagnosis and treatment for cancer. Therefore, it is important to identify the specific factors that are associated with cancer survivorship within this population and the creation of research-based approaches to examine this population further to determine their specific needs and considerations with respect to cancer survivorship. This process is important in order to determine the different stages that are experienced when an individual survives cancer over a period of time.
The qualitative research article entitled “This Too Shall Pass: A Grounded Theory Study of Filipino Cancer Survivorship” by de Guzman et.al (2013) represents a means of exploring the different dimensions of cancer survivorship within the Filipino community. There are a number of critical appraisal techniques that must be included in the evaluation of a qualitative research study to determine its efficacy and impact on the subject area of interest (Burns and Grove, 2011). From a qualitative point of view, this article provides a discussion of grounded theory using the Glaserian method and its impact on cancer survivorship within this population group (de Guzman et.al, 2013). Based upon this discussion, cancer survivors experience several stages, better known as the Ribbon of Cancer Survivorship, whereby trifling, transfusing, transforming, and transcending are key components of cancer adaptation and survival across a variety of populations (de Guzman et.al, 2013).
The research study explored the different dimensions of survival as related to a cancer diagnosis and how these are reflected in the development of specific emotional responses to cancer diagnoses, treatment, and ongoing survival (de Guzman et.al, 2013). In this capacity, the chosen model has been largely successful in its application to the Filipino population due to the wide range of emotional responses and transitional stages that are relevant to this experience (de Guzman et.al, 2013). The model attempts to demonstrate that there are significant benefits to the utilization of cancer survivor techniques which describe some of the most relevant emotional responses and challenges of this experience (de Guzman et.al, 2013).
The grounded theory approach is explored as a means of identifying key points of analysis and coinciding conceptual factors that are coded and grouped accordingly to establish a theoretical basis for the subject at hand (de Guzman et.al, 2013). The diagnosis and treatment of cancer leads to many important questions regarding the ability of individuals to manage the emotional and psychological impacts of the disease, and for those who survive cancer, they face significant challenges in their daily lives during the recovery period and beyond (de Guzman et.al, 2013). Therefore, it is necessary to develop strategies to support these individuals as survivors and its impact on their lives (de Guzman et.al, 2013).
For the purposes of this study, the researchers sought to recruit subjects of Filipino descent who were survivors of cancer and who faced critical and emotional challenges, using the grounded theory design in order to capture the critical concepts associated with cancer survivorship (de Guzman et.al, 2013). The researchers established criteria for the selection of study participants which included the following: 1) participants were over 40 years of age; 2) they were survivors of cancer for at least a six-month period; 3) they were able to follow simple instructions as necessary; and 4) they had been previously diagnosed with a chronic condition (de Guzman et.al, 2013). The study instruments that were used were designed to determine how participants responded to fortitude, acceptance, and the ability to recover from cancer (de Guzman et.al, 2013). In addition, a focus group method was utilized to address their personal experiences with cancer and the recovery process (de Guzman et.al, 2013). The data collection process utilized informed consent and individual participant-chosen locations to increase the level of comfort for the focus group interviews (de Guzman et.al, 2013). The interview method was somewhat informal to increase the flow of communication without hesitation or disruptions, and all interviews were recorded on video (de Guzman et.al, 2013).
In order to accomplish the objectives of the grounded theory method, transcription of the interviews was conducted (de Guzman et.al, 2013). This process also led to the classification of different forms of data into specific codes that were utilized to achieve the grounded theory method (de Guzman et.al, 2013). Based upon the participant interviews and the data collection process, the study findings indicated that there was a distinct pattern of responses that fell under what is known as the Ribbon of Cancer Survivorship, whereby this group of cancer survivors was largely dependent on the ability to explore and transform their experiences into a positive form of recovery (de Guzman et.al, 2013). The study findings demonstrated that participants experienced a variety of responses to their health prior to their cancer diagnosis, with some participants lacking the level of attention that was necessary to care for themselves in the desired manner (de Guzman et.al, 2013). However, upon hearing of the cancer diagnosis, participants generally experienced an overwhelming sense of shock and fear that was very difficult to overcome (de Guzman et.al, 2013). Participants began to realize that they were not invincible and that their lives could be taken from them at any moment (de Guzman et.al, 2013).
In response to the different phases of cancer from diagnosis to recovery, participant survivors recognized the importance of healing and what it meant to them to experience a fully recovery (de Guzman et.al, 2013). The study participants recognized that they had been given a gift of survival, yet they felt most comfortable with those who could best understand their situation, i.e. other cancer survivors (de Guzman, 2013). This was an important step towards the development of new perspectives regarding life and the ability to survive a cancer diagnosis and to once again improve their health (de Guzman, 2013). The grounded theory method was critical to this study because it captured an understanding of the significant challenges associated with a cancer diagnosis and how this impacts one’s life in many important and meaningful ways (de Guzman et.al, 2013).
The study also reflected on the ability to create an environment that enabled study participants to embrace their diagnoses and to determine how to effectively cope with the treatment and recovery processes in order to promote greater health and wellbeing (de Guzman et.al, 2013). There are a number of theories of cancer survivorship that exist, with some emphasizing female experiences with breast cancer (Sherman et.al, 2012), with others considering other types of cancer. Therefore, it is essential to consider the development and application of theoretical perspectives that are applicable to different population groups, such as Filipinos (de Guzman et. al, 2013). Under these conditions, it is important to recognize the value of theory-based approaches to managing cancer diagnoses in an effective manner that allows for greater support and encouragement during a particularly difficult period of time (de Guzman et.al, 2013).
The study by de Guzman et.al (2013) facilitated an important discussion regarding the fragility of life and the understanding of cancer survivorship. Grounded theory was utilized in the study as a means of evaluating the different conditions under which cancer survivors might develop effective coping skills in managing this condition (de Guzman et.al, 2013). The study results indicate that many cancer survivors within the Filipino community follow a specific patter that reflects their ability to recognize the importance of cancer management and survival in a context that includes widespread support and recognition of the disease (de Guzman et.al, 2013). This reflects the ability of grounded theory to be an effective promoter of data analysis to support theoretical perspectives regarding cancer survivorship in a manner that is consistent with the necessity to obtain sufficient emotional and psychological support with this condition (de Guzman et.al, 2013).
Burns, N., and Grove, S.K. (2011). Understanding Nursing Research. Maryland Heights: Elsevier Saunders.
De Guzman, A.B., Jimenez, BCB, Jocson, K.P., Junio, A.R., Junio, D.E., Jurado, JBN, And Justiniano, ABF. (2013). This too shall pass: a grounded theory study of Filipino cancer survivorship. Journal of Holistic Nursing, 31(1), 35-46.
Sherman, D.W., Rosedale, M., and Haber, J. (2012). Reclaiming life on one’s own terms: a grounded theory study of the process of breast cancer survivorship. Oncology Nursing Forum, 39(3), E258-E268.