Rethinking the Meaning of "Wellness" for a Person with Cancer: A Qualitative Study to Explore What Elements Constitute "Wellness"

"Life Without Symptoms" or "Being Able to Enjoy Life": What does it Mean to be "Well" After Cancer?

OBJECTIVE

To achieve wellness in cancer survivorship, researchers and clinicians need a better understanding of what it means to live "well", from the perspective of cancer survivors themselves.

METHODS

Australian and UK cancer survivors (N = 376) diagnosed in the previous five years, were asked "What does it mean to be well?", with an open-ended text response. Responses were coded using content analysis. Demographics, time since diagnosis, coping style and symptom level were also assessed.

RESULTS

Descriptions of what it meant to be "well" were coded as absence-focused (living without negative impacts of illness, 32.7%) or presence-focused (living with health, function, or wellbeing, 37.8%). A further 29.5% of responses contained both elements. Lower symptom level and higher use of a fatalism coping style were associated with presence-focused definitions of being well.

CONCLUSIONS

More meaningful conversations with cancer survivors about their goals for care would be facilitated by a better understanding of what it means to them to be "well". As symptoms change over the course of survivorship, it may be necessary to re-examine each survivor's goals of care.

Partnering with Consumers - Why would I do it? What is it? How do I do it?

Health care and research are increasingly mandating consumer involvement in the planning, design and evaluation of services, quality projects and research. The editorial reviews the Australian progress with accreditation processes in research and provides practical direction in an area that is unfamiliar to many researchers and clinicians.

Experiences of Patients in Turkey with Breast Cancer throughout the COVID-19 Pandemic and their Coping Mechanisms: A Qualitative Study

This research was conducted in Turkey to determine the experiences and coping mechanisms of breast cancer patients during the COVID-19 pandemic. The research was conducted using qualitative descriptive phenomenology. Data were collected from ten patients via in-depth interviews through semi-structured questionnaires. Content analysis, incorporating a combination of deductive and inductive approaches, was conducted to determine the themes and subthemes. Interviews were transcribed verbatim, simultaneously with the analysis and collected data. The study data were categorized into 3 contexts, 7 themes and 39 subthemes. The first context titled "Problems accompanying the disease" includes the effects of the pandemic, the fear of being infected with COVID-19 and hospital-related themes. The second context titled "Coping strategies" comprises the themes of coping behaviors and healthy lifestyle behaviors. The last context is titled "Anxiety about being infected, and suggestions for the future". In the study, problems experienced by patients with breast cancer throughout the COVID-19 pandemic were investigated from a broad perspective. Patients treated in chemotherapy units constitute the vulnerable group affected by the pandemic most. Therefore, it is important to investigate the experiences of oncology patients, particularly of patients with breast cancer and their coping strategies, and to take necessary precautions accordingly.

Psychometric Properties of the Chinese Version of Female Self-Advocacy in Cancer Survivorship (FSACS-C) Scale

Objective

To translate Female Self-Advocacy in Cancer Survivorship (FSACS) scale and evaluate the psychometric properties of Chinese version of FSACS scale among female cancer survivors in China.

Methods

This study employed a cross-sectional design. FSACS scale was forward–backward translated and cognitive interviews were conducted for cultural adaptation. The newly translated tool was distributed to female cancer survivors to test psychometric properties, including item analysis, content validity, construct validity, criterion validity, internal consistency, and test-retest reliability.

Results

A total of 436 female cancer survivors were recruited in a Chinese tertiary cancer center from May to August in 2021. Item analysis showed statistical significance (P < 0.05) for each one and no ceiling or floor effect. The item-level content validity index ranged from 0.86 to 1.00 and the scale-level content validity index was 0.98. Three factors were extracted based on parallel analysis, and confirmatory factor analysis proved a good model fit with the original 3-factor structure. Pearson's correlation coefficient showed acceptable criterion validity. The Cronbach's α of 0.880 demonstrated the scale's internal consistency reliability, and the Alpha coefficients were 0.826, 0.763, and 0.859 for its three dimensions, respectively. The interclass correlation coefficients for test-retest reliability was 0.904 (0.870–0.891, P < 0.01) which confirmed the external reliability of the scale.

Conclusions

The Chinese version of FSACS scale proved to be a valid and reliable instrument that can be applied among Chinese female cancer survivors. Further research could be conducted in larger populations or people in different cancer stages.