The Perceptions of Women with Gynecological Cancer after Radiotherapy Treatment: A Gender-Based Qualitative Study
Abstract
:1. Introduction
2. Material and Method
2.1. Research Design
2.2. Participants, Sampling and Recruitment
2.3. Data Collection
3. Results
3.1. Description of the Participants
3.2. Analysis Categories
3.2.1. Feelings
“Well, absolutely fine, because what I wanted was to get well…”[P6]
“I really deal with this fine.”[P4]
“I feel somehow calm. I mean, everything’s OK. In my country…I would’ve been operated on and just go home. …Here they treat me as they should and they follow me up by telephone and with the scanner. …I’m in good hands.”[P2]
“Pretty average…. As if they were telling YOU.”[P3]
“In terms of mood…. I’m not OK.”[P5]
“Bad, I felt really bad.”[P2]
“Fear and sorrow.”[P2]
“Yes, I was afraid.”[P5]
“…now I’m concerned about dying…”[P8]
“I wasn’t afraid, as I’d already undergone chemotherapy, it was not that there was going to be anything puncturing me or that my hair would fall.”[P1]
“Of course not, of course not. It’s kind of that I don’t believe it… I don’t believe what is happening to my sister. But I had it operated on on time…I’m living it kind of relaxed.”[P4]
“Yes, quite a lot. Really bad at the beginning. It’s only sometimes now.”[P8]
“Yes, and I got very upset.”[P1]
“Well… I think no. I believe that I’ve never been anxious, but never in my life, I think that not during this process either.”[P7]
“Nothing, I’m pretty fearful, but I saw everything perfect.”[P6]
“Ah, how much I want for all of this to end and get better. And be able to live in peace, I’ll have my reviews, but getting better, because now I’m almost always a wreck.”[P7]
“I want to go out again, practice some sport, lead a normal life.”[P2]
3.2.2. Instrumental Activities of Daily Living (IADLs)
“I used to work, I’m on leave now. I went out a whole lot more before and we traveled...”[P7]
“Very limited, my life pace has changed”[P4]
“I do almost the same things, but I’m very tired. Well, not the same things.”[P6]
“Not the same, same things; because it hurts me down there.”[P9]
3.2.3. Role in the Couple/Family
“It’s harder to tell your children… really hard… because when you’re a mother you think one way, but differently when you’re a daughter. And when you’re both you understand these things… One of them is 50 years old and the other is 48, no kids at all, but you go tell them that their mother, who is the one that’s going to live forever, the one to always be there… Well, what I have is cancer. For me, this word didn’t come out… but I hinted it to them and… that it was very hard for me to tell my children. Those around can see that I… that I can’t… That I don’t go shopping… when I lay down in bed all day, they’ve never seen this before.”[P3]
“I don’t see it…I’ve always wanted to be a mother, having children…but with this, I don’t even know if after this… come on, sure thing that I won’t be able to, so, well, it seems that I won’t have biological children. I’ve dealt really bad with this, but now there’s nothing else I can do, so I’ll fight for my own health. Being alive is enough for me.”[P7]
“I live alone, well, I’ve had my partners, but now like this....who’s going to put up with me. My sister really keeps an eye on me. I haven’t had children and now...no way...”[P8]
“It has changed it altogether, there’s no… it’s a difficult situation…as most of the days I don’t feel like it because I’m not OK, it’s not as before for me either… well you already know… kind of no in the state I’m in.”[P7]
3.2.4. Coping
“It overwhelms me at some moments. Sometimes I cry and others I laugh, like everyone else.”[P3]
- -
- Coping using resignation.
“Well look, it had to be me and that’s it, and I’m going to put it on and I’m going to get well, and that’s it. Not with optimism but with resignation, kind of saying ‘Come on, it’s fine’.”[P3]
- -
- Coping using emotional avoidance.
“I get up, do my things and don’t think.”[P6]
- -
- Coping using spirituality.
“Nothing, I’m pretty fearful, but I saw everything perfect, I believe it’s in God’s hands.”[P6]
“I haven’t thought about how I’ve dealt with this, but… I believe that not very bad. I mean, this is tough both for me and for those around me…. They’ve helped me a lot, my family has helped all the time. They’ve let me fall down little, but I did have big relapses sometimes, especially at the beginning. Perhaps I’m stronger now.”[P7]
3.2.5. Knowledge and Uncertainties
“Very well informed about everything; in fact, when the belly thing started, a little bad, we didn’t even scare because I already knew. And everything went really well, everything.”[P1]
“They told me that I had to do radio, as far as I can remember, they didn’t explain much to me.”[P6]
“I always think, well, that if they hide something from me…. And I say, well, if you don’t tell me the truth. And also, if I feel something, I mean if it’s not normal, if anything hurts, to see if I gave something and they don’t want to tell me…. I search in the Internet. I like to search because I research a lot, but I see bad things.”[P2]
“I search because it’s an addiction. I mean, they’ve explained everything perfectly to me.”[P9]
3.2.6. Emerging Category: Embarrassment and Effects of Toxicity
“I used to get up really willing to do my things. I’m going to do this in the morning and that other thing… that’s over now. No lunch, because I say ‘What if then the belly swells before getting there.’”[P1]
“Of course that my life pace has changed because I don’t feel like going to the beach…”[P4]
“Last week I only didn’t have diarrhea on Sunday, this week so far it’s been every day…”[P3]
“It’s hurting me a little for the belly. No lunch, because I say ‘What if then the belly swells before getting there.’”[P1]
“The worst thing is tiredness…”[P6]
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Sociedad Española de Oncología Médica (SEOM); Red Española de Registros del Cáncer (REDECAN). Las Cifras del Cáncer en España. 2022, pp. 1–38. Available online: https://seom.org/images/las_cifras_del_cancer_en_Espana_2022.pdf (accessed on 10 September 2022).
- American Cancer Society. Statistics. 2022. Available online: https://cancerstatisticscenter.cancer.org/?_ga=2.75899478.2108943270.1670950183-1483158133.1670950183#!/ (accessed on 18 December 2022).
- Centro para el Control y la Prevención de las Enfermedades (CDC). Infórmese Sobre los Cánceres Ginecológicos. Centros para el Control y la Prevención de Enfermedades. 2021. Available online: www.cdc.gov/spanish/cancer/knowledge (accessed on 7 February 2022).
- SEOR. Manual Practico de Oncología Radioterápica. 2013. Available online: https://seor.es/wp-content/uploads/2020/03/Manual-Practico-de-Oncologia-Radioterapica.pdf (accessed on 4 April 2022).
- Borobia, A. Ejercicios de Tonificación del Suelo Pélvico [Internet]. 2021. Available online: https://www.todostui.es/wp-content/uploads/2022/06/2202600_Ejercicio_SP_Mujer_A5.pdf.
- Sánchez Lorenzo, L.; SEOM. Cáncer de Cérvix. Sociedad Española de Oncología Medica. 2020. Available online: https://seom.org/174-Informaci%C3%B3nalP%C3%BAblico-Patolog%C3%ADas/cancer-de-cervix (accessed on 7 March 2022).
- Cabezas, M.L.; de Mingo, M.D.M.; Zamorano, M.R.; Valverde, F.P.; Arranz, C.R.; Montero, P.M.; de la Torre Tomás, A.; Sancho, F.V.; Mancebo, R.M. Guía de Cuidados de Pacientes en Oncología Radioterápica. 2007. Available online: www.seor.es/wp-content/uploads/Gu%C3%ADa-de-cuidados-a-pacientes-en-Oncolog%C3%ADa-Radioter%C3%A1pica.pdf (accessed on 1 April 2022).
- American Cancer Society. Quimioterapia para el Cáncer de Ovario. 2018. Available online: https://www.cancer.org/es/cancer/cancer-de-ovario/tratamiento/quimioterapia.html (accessed on 8 March 2022).
- Instituto Nacional del Cáncer. Hacer Frente. Los Sentimientos y el Cáncer. 2018. Available online: https://www.cancer.gov/espanol/cancer/sobrellevar/sentimientos (accessed on 8 March 2022).
- Instituto Nacional del Cáncer. Cáncer de Útero. Versión para Pacientes. Available online: https://www.cancer.gov/espanol/tipos/uterino (accessed on 7 March 2022).
- Olivares Crespo, M.E. Aspectos Psicológicos en el Cáncer Ginecológico. Av. En Psicol. Latinoam. 2004, 22, 29–48. Available online: https://dialnet.unirioja.es/servlet/extart?codigo=2741881 (accessed on 18 August 2021).
- RAE RAE. Ansiedad. Definición. 2021. Available online: https://dle.rae.es/ansiedad (accessed on 18 August 2022).
- Española. RD de la Lengua. Miedo. Definición. 2022. Available online: https://dle.rae.es/miedo (accessed on 14 January 2023).
- Gamel, C.; Hengeveld, M.; Davis, B. Informational needs about the effects of gynaecological cancer on sexuality: A review of the literature. J. Clin. Nurs. 2000, 9, 678–688. [Google Scholar] [CrossRef]
- Rezaei, Z. Quality of life of mothers of children with cancer in Iran. J. Seman Univ. Med. Sci. 2018, 20, 425–431. [Google Scholar]
- Instituto Nacional del Cáncer. Definición de Actividades de la Vida Diaria. 2022. Available online: https://www.cancer.gov/espanol/publicaciones/diccionarios/diccionario-cancer/def/actividades-de-la-vida-diaria (accessed on 5 September 2022).
- Sopena, R.B. Psicología Oncológica: Prevención y Terapeútica Psicológicas del Cáncer; Martínez, R., Ed.; Universudad de la Rioja: Barcelona, Spain, 1985. [Google Scholar]
- Holland, J.C. Psycho-oncology: Overview, obstacles and opportunities. Psychooncology 2018, 27, 1364–1376. Available online: https://onlinelibrary.wiley.com/doi/10.1002/pon.4692 (accessed on 14 March 2022). [CrossRef]
- Kübler-Ross, E.; Kessler, D.; Guiu, S. Sobre el Duelo y el Dolor; Luciernaga: Malaga, Spain, 2015. [Google Scholar]
- Peláez, J.L.; Aguirre-Loaiza, H.; Ortiz, A.; Caballo, V.E.; Núñez, C. Quality of life and coping strategies in patients with gynecological cancer. Suma. Psicol. 2021, 28, 88–96. Available online: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0121-43812021000200088&lng=en&nrm=iso&tlng=es (accessed on 7 February 2022).
- Rodríguez Fernández, M.I. Afrontamiento Del Cancer Y Sentido De La Vida: Un Estudio. Ph.D. Thesis, Universidad Autónoma de Madrid, Madrid, Spain, 2007. Available online: http://hdl.handle.net/10486/2516 (accessed on 8 March 2022).
- Gala León, F.; Lupiani Jiménez, M.; Raja Hernández, R.; Guillén Gestoso, C.; González Infante, J.; Villaverde Gutiérrez, M.C.; Alba Sánchez, I. Actitudes psicológicas ante la muerte y el duelo. Una Revisión. Conceptual. Cuad. Med. Forense. 2002, 30, 39–50. [Google Scholar]
- RAE RAE. Resignación. Definición. 2021. Available online: https://dle.rae.es/resignaci%C3%B3n (accessed on 20 August 2022).
- Enríquez Villota, M.F. Estrategias de afrontamiento psicológico en cáncer de seno. Unid. Salud. 2010, 2, 7–19. Available online: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0124-71072010000100002 (accessed on 7 September 2022).
- RAE D de la Lengua Española. Conocimiento. Definición. 2022. Available online: https://dle.rae.es/conocimiento (accessed on 15 January 2023).
- RAE D de la Lengua Española. Incertidumbre. Definición. 2022. Available online: https://dle.rae.es/incertidumbre (accessed on 15 January 2023).
- Caro, D.F.V.; Cano, G.S. Cáncer de Cuello Uterino: Una Mirada Integral con Perspectiva de Género. Rev. Colomb. Enfermería. 2016, 11, 97. Available online: http://revistas.unbosque.edu.co/index.php/RCE/article/view/1690 (accessed on 5 April 2022). [CrossRef]
- Williams, N.; Griffin, G.; Farrell, V.; Hauck, Y.L. Gaining insight into the supportive care needs of women experiencing gynaecological cancer: A qualitative study. J. Clin. Nurs. 2020, 29, 1684–1694. Available online: https://onlinelibrary.wiley.com/doi/10.1111/jocn.15221 (accessed on 24 February 2022). [CrossRef] [PubMed]
- Lopez, A.-L.J.; Butow, P.N.; Philp, S.; Hobbs, K.; Phillips, E.; Robertson, R.; Juraskova, I. Age-related supportive care needs of women with gynaecological cancer: A qualitative exploration. Eur. J. Cancer Care 2019, 28, e13070. Available online: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85065330874&doi=10.1111%2Fecc.13070&partnerID=40&md5=6f8a93f7643150b66fb107cb0650b792 (accessed on 15 September 2021). [CrossRef]
- Cara Rodríguez, R.; Avilés Sáez, Z.; López Trinidad, L.M. Comunicación y escucha activa por parte del profesional de Enfermería a pacientes con cáncer ginecológico: Una revisión bibliográfica. Rev. Española Comun. Salud. 2018, 9, 221. [Google Scholar] [CrossRef]
- RAE D de la Lengua Española. Deseo. Definición. 2022. Available online: https://dle.rae.es/deseo (accessed on 15 January 2023).
- Sadler-Gerhardt, C.; Reynolds, C.; Britton, P.; Kruse, S. Women Breast Cancer Survivors: Stories of Change and Meaning. J. Ment. Health Couns. 2010, 32, 265–282. Available online: https://meridian.allenpress.com/jmhc/article/32/3/265/83282/Women-Breast-Cancer-Survivors-Stories-of-Change (accessed on 10 September 2022). [CrossRef]
- Hughes, M.K. Alterations of Sexual Function in Women with Cancer. Semin. Oncol. Nurs. 2008, 24, 91–101. [Google Scholar] [CrossRef] [PubMed]
- Ruiz Merino, D.F. La influencia de los Estereotipos en el Cáncer de Mama. 2020. Available online: http://dspace.uib.es/xmlui/handle/11201/154899 (accessed on 5 September 2022).
- Vivar, C.; Arantzmandi, G.; Lopez Dicastillo, M.; Gordo, C. La teoría fundamental como metodología de la investigación cualitativa en enfermería. Rev. Index De Enferm. 2010, 19, 283–288. [Google Scholar]
- Hernández Sampieri, R.; Fernaández Collado, C.; Baptista Lucio, P. Metodologia de la Investigacion, 6th ed.; McGraw-Hill Interamericana Editores: México City, Mexico, 2014; pp. 355–528. [Google Scholar]
- Botello Hermoso, A. Aproximación a las Creencias Populares Sobre los Ciclos Vitales Femmeninos Desde la Perspectiva de Género; Universidad de Sevilla: Sevilla, Spain, 2012. [Google Scholar]
- Bausela Herrera, E. NUDIST: Vivo Programa Informático para el Análisis de Datos en Investigaciones Cualitativas; Pixel-Bit: Framingham, MA, USA, 2005; pp. 53–59. Available online: https://redined.mecd.gob.es/xmlui/handle/11162/95175 (accessed on 25 July 2022).
- Whitford, H.S.; Olver, I.N.; Peterson, M.J. Spirituality as a core domain in the assessment of quality of life in oncology. Psychooncology 2008, 17, 1121–1128. Available online: https://pubmed.ncbi.nlm.nih.gov/18322902/ (accessed on 18 August 2022). [CrossRef]
- Vermeer, W.M.; Bakker, R.M.; Stiggelbout, A.M.; Creutzberg, C.L.; Kenter, G.G.; ter Kuile, M.M. Psychosexual support for gynecological cancer survivors: Professionals’ current practices and need for assistance. Support Care Cancer 2015, 23, 831–839. Available online: https://pubmed.ncbi.nlm.nih.gov/25218609/ (accessed on 17 August 2022). [CrossRef]
- Instituto Nacional del Cáncer. Adaptación al Cáncer: Ansiedad y Sufrimiento. 2021. Available online: https://www.cancer.gov/espanol/cancer/sobrellevar/sentimientos/ansiedad-sufrimiento-pdq (accessed on 18 August 2022).
- Krause, J.C.; Farthmann, J.; Almstedt, K.; Hasenburg, A. Sexuality after gynecological cancer—What do affected people really need? Gynakologe 2020, 53, 251–258. [Google Scholar] [CrossRef]
- Rodríguez Terrín, C.; López Ramírez, E.; Dengra López, N.; García, J.M.J.; Martínez Ballesteros, C.; Martínez Galán, J.; Hernández García, V. Grado de información de los pacientes remitidos a un servicio de oncología radioterápica. Clínica Salud. 2002, 13, 195–206. [Google Scholar]
- Yarandi, F.; Montazeri, A.; Shirali, E.; Mohseni, M.; Fakehi, M.; Ghaemi, M. Sexual Quality of Life in Gynecological Cancer Survivors in Iran. Asian Pacific J. Cancer Prev. 2021, 22, 2171–2175. [Google Scholar] [CrossRef]
- Jaman-Mewes, P.; Rivera, M.S. Vivir con cáncer: Una experiencia de cambios profundos provocados por la quimioterapia. Aquichan 2014, 14, 20–31. [Google Scholar]
- Kim, Y.; Wellisch, D.K.; Spillers, R.L.; Crammer, C. Psychological distress of female cancer caregivers: Effects of type of cancer and caregivers’ spirituality. Support Care Cancer 2007, 15, 1367–1374. Available online: https://pubmed.ncbi.nlm.nih.gov/17516094/ (accessed on 18 August 2022). [CrossRef] [PubMed]
- Pérez, P.; Romasanta, L.A.P.; Vázquez, M.L.; Alonso, A.; Canteli, M.; Marcos, P.; Caeiro, M.; Carballo, E.; Nieto, I.; Montero, E.; et al. Utilización De Internet Como Vía De Información Médica Para El Paciente Sometido a Radioterapia: Revisión Y Presentación De Un Proyecto De Estudio. Psicooncologia 2005, 2, 91–102. [Google Scholar]
- Miraa, J.J.; Pérez-Joveray, V.; Lorenzo, S. Navegando en Internet en busca de información sanitaria: No es oro todo lo que reluce. Atención Primaria 2004, 33, 391–399. Available online: https://www.elsevier.es/es-revista-atencion-primaria-27-articulo-navegando-internet-busca-informacion-sanitaria-13060754 (accessed on 1 April 2023).
- Yavas, G.; Yavas, C.; Dogan, N.; Ilhan, T.; Dogan, S.; Karabagli, P.; Ata, O.; Yuce, E.; Celik, C. Pelvic radiotherapy does not deteriorate the quality of life of women with gynecologic cancers in long-term follow-up: A 2 years prospective single-center study. J. Cancer Res. Ther. 2017, 13, 524–532. Available online: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85028744957&doi=10.4103%2F0973-1482.187243&partnerID=40&md5=8b017cf845565dee21677551964fe1c8 (accessed on 1 April 2022). [CrossRef] [PubMed]
- Casquero, F. Guía de Tumores Ginecológicos; Oncología Radioterápica; Sociedad Española de Oncología Radioterápica (SEOR): Madrid, Spain, 2013. [Google Scholar]
Code | Age | Pathology | Motherhood | Marital Status | Nationality |
---|---|---|---|---|---|
P1 | 74 | Endometrial cancer | 2 sons | Married | Spanish |
P2 | 49 | Endometrial cancer | No | No partner | Moroccan |
P3 | 76 | Endometrial cancer | 2 sons—1 daughter | Married | Spanish |
P4 | 76 | Endometrial cancer | 2 sons | Widow | Spanish |
P5 | 57 | Cervical cancer | 3 sons—1 daughter | Married | Spanish |
P6 | 66 | Cervical cancer | 2 sons | Married | Spanish |
P7 | 35 | Cervical cancer | No | With a partner | Spanish |
P8 | 40 | Endometrial cancer | No | No partner | Spanish |
P9 | 50 | Endometrial cancer | 1 daughter | Widow | Spanish |
Category | Frequency |
---|---|
1. Feelings | 30 |
2. Daily living activities | 14 |
3. Role in the couple/family | 10 |
4. Coping | 16 |
5. Knowledge and uncertainties | 11 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Uceda-Escobar, A.; Guerra-Martín, M.D.; Botello-Hermosa, A. The Perceptions of Women with Gynecological Cancer after Radiotherapy Treatment: A Gender-Based Qualitative Study. Healthcare 2023, 11, 1580. https://doi.org/10.3390/healthcare11111580
Uceda-Escobar A, Guerra-Martín MD, Botello-Hermosa A. The Perceptions of Women with Gynecological Cancer after Radiotherapy Treatment: A Gender-Based Qualitative Study. Healthcare. 2023; 11(11):1580. https://doi.org/10.3390/healthcare11111580
Chicago/Turabian StyleUceda-Escobar, Alicia, María Dolores Guerra-Martín, and Alicia Botello-Hermosa. 2023. "The Perceptions of Women with Gynecological Cancer after Radiotherapy Treatment: A Gender-Based Qualitative Study" Healthcare 11, no. 11: 1580. https://doi.org/10.3390/healthcare11111580
APA StyleUceda-Escobar, A., Guerra-Martín, M. D., & Botello-Hermosa, A. (2023). The Perceptions of Women with Gynecological Cancer after Radiotherapy Treatment: A Gender-Based Qualitative Study. Healthcare, 11(11), 1580. https://doi.org/10.3390/healthcare11111580