Labeled as lucky: contradictions between what women and healthcare professionals experience regarding the need for help after the early stages of gynecological cancer

• Published in: Supportive care in cancer 2020-02, Vol.28 (2), p.907-916
• Main Authors: Thisted, Lise Bjerrum, Zoffmann, Vibeke, Olesen, Mette Linnet
• Format: Article
• Language: English
• Subjects: Adult; Analysis; Cancer; Career development; Cervical cancer; Disease management; Female; Genital Neoplasms, Female - psychology; Gynecological cancer; Gynecology; Health Personnel; Health psychology; Humans; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging; Nurses; Nursing; Nursing care; Nursing Research; Oncology; Original Article; Pain Medicine; Patient satisfaction; Patient-centered care; Qualitative Research; Quality of Life - psychology; Rehabilitation; Rehabilitation Medicine; Uterine cancer; Women; Womens health
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-019-04882-2

Purpose To explore how participants perceived a nurse-led, person-centered intervention, Guided Self-Determination Gynecological Cancer (GSD-GYN-C) and how participants felt it influenced the challenges they faced and their rehabilitation after gynecological cancer surgery. Methods Participants were invited from a previously conducted randomized trial where GSD-GYN-C improved physical quality of life in the intervention group. Ten semi-structured interviews were conducted, transcribed, and analyzed using thematic analysis. Results Three central themes were identified: (1) “labeled as the lucky ones,” which describes a contrast between the women’s perceived problems and the healthcare professionals’ tendency to stress their luck in being treated early and cured with no particular problems in sight, leading to an unintended delay in their rehabilitation process; (2) “personal reflections pave the way for change,” which shows how new problem-solving skills were mobilized when reflection sheets and dialogue on GSD-GYN-C provided new insight into their situation and the feeling of being taken seriously; and (3) “emerging relational competence,” which describes the new skills the women developed in interacting with family, friends, colleagues, and healthcare professionals. Conclusions As a supplement to usual care, GSD-GYN-C remedied a tendency among healthcare professionals to underestimate problems in the early stages of gynecological cancer, and GSD-GYN-C involved the women in their rehabilitation process characterized by active problem-solving in relationships with other people.