Abstract

The major objective of this longitudinal, descriptive study was to describe the family transition to living with childhood cancer, from the family's point of view, when a child is diagnosed with cancer with a favorable prognosis. The major research question was: What is the experience of families when a child is diagnosed with cancer with a favorable prognosis? A convenience sample consisted of 40 members of 7 families with a child recently diagnosed with cancer with a favorable prognosis at a northwestern health sciences university hospital. Cancer with a favorable prognosis was defined to be any subtype of cancer with greater than 60% long-term survival rate. At least one child in the family was 5 years old or older. All family members over 5 years of age participated. The study used a grounded theory approach. Data collection consisted of three tape-recorded, semi-structured interviews with family members in the home. During the first two interviews, all family members over the age of five were interviewed individually. During the first interview, parent(s) completed a demographic questionnaire. The third interview was with the entire family together. Interviews occurred at the time of diagnosis, at the time the child went into remission, and three months post remission. A modified grounded theory analysis was used. The major finding was a model of the family transition in response to the diagnosis of childhood cancer. This transition was characterized by a fracturing of reality at the realization of the malignant nature of the illness, a period of limbo following the diagnosis, the utilization of strategies to reconstruct reality, and a "new normal" for the family. The transition process continued for the 4-5 month course of the study and, in all families, extended beyond the study period. Factors limiting generalizability of the findings include the small sample size, single site, and the shortness of time families were followed. Implications for nursing practice include the family's need for continued nursing involvement throughout the illness trajectory, past medically defined remission and a need for nursing care to be family focused. Research implications include further exploration of the transition over a longer period of time, with a variety of illness trajectories and a larger sample.

Description

This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 9214996; ProQuest document ID: 303900569. The author still retains copyright.

Further details on funding: Oregon Health Sciences University, School of Nursing Focal Area III Small Grant; Beta Psi Chapter of Sigma Theta Tau, Research Award; National Center for Nursing Research Public Health Service National Research Service Award # NR06157

Author Details

Laura Clarke-Steffen, PhD, RN

Sigma Membership

Beta Upsilon

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Grounded Theory

Research Approach

Qualitative Research

Keywords:

Childhood Cancer, Family Experiences, Positive Prognosis

Advisors

Kodadek, Sheila

Advisor

Sheila Kodadek

Degree

PhD

Degree Grantor

Oregon Health Sciences University

Degree Year

1990

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2019-04-02

Full Text of Presentation

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