The purpose of this cross-sectional ethnography was to develop theory and knowledge
about how women in Canada live with breast cancer. Cross-sectional ethnography
describes a number of individuals from a cross-section of a culture or subculture for a
unit of study (Boyle, 1994). A cross-section of women with breast cancer were studied,
not an interacting group of women with breast cancer (Werner & Schoepfle, 1987 ). As a
result of counselling women with breast cancer over a period of two years, I have learned
that despite the differing treatment protocols and differing kinds and stages of breast
cancer, women with breast cancer are members integrated into a subculture which has
many common words, phrases, images, and themes. Thirteen women with breast cancer
form the unit of study for this research. Cancer is a complex array of diseases which
develop in 25% of the population; one woman in nine is diagnosed with breast cancer in
Canada (Holland, 1989), and one woman in three with breast cancer will die of
metastases (Elliott, Rahimi, Tremblay, Shenoy, Rossiter, & Saulnier, 1997). The
incidence of breast cancer is increasing annually (O’Donnell, Coughlin, & LeMarbre,
1992); breast cancer is the most frequent cancer in women and is the leading cause of
death in women between the ages of 35 and 55 (Andrulis, 1997). Secondary goals of this
research were to have the emergent knowledge published to provide increased choices
and actions for those newly diagnosed with breast cancer, and to provide data, facts and
information to counsellors, professionals and others working and living with breast
cancer. Psychological distress in women with breast cancer is often translated into
psychopathology by those following the medical model in breast cancer treatment
(Mathieson, 1991). Depression and anxiety diagnoses are predominant in women with
breast cancer, with rates of depression diagnoses as high as 75% (Massie & Holland,
1989). A study by Garcia, Cristal-Luna, Li, Uai, Gonzalez, Tarmayo, Masadao, Lola, and Matumog (1997) concluded that the presence of cancer disrupts almost every aspect of an individual’s life and that depressive symptoms were experienced throughout the course of chemotherapy. Symptoms experienced by breast cancer patients are often translated by DSM IV criteria into psychiatric disorders, most often depression and anxiety (Derogatis,
Abeloff, & Melisaratos, 1983). After counselling women in two cancer Clinics, I began to
understand that the experience of having breast cancer imposes many stresses which are
in fact, normal, given the context of the cultural stigmata and traumata which result from
the diagnosis and treatment o f this disease. Women caught up in the shock of diagnosis
and the invasive treatments alluded to colloquially as “slash, burn, and poison” blamed
themselves. Most of all they asked: “How do other women live with breast cancer?" This
study is an initial response to that question.
Thirteen women who had been diagnosed with breast cancer participated in this
study. A cross-sectional ethnography was the research method. Ethnographic questioning
(Spradley, 1979) is used to organize and analyse data. Using the North American culture
as background, and the subculture of those with breast cancer as foreground,
ethnographic questioning elicited the shared contexts of 13 women’s life worlds as they
described their experiences after a diagnosis of breast cancer. This ethnographic method
facilitated the analysis of the women’s experiences by searching for cognitive and
behavioural themes of meaning in the women’s verbal descriptions. Dominant themes
which emerged and recurred through the 13 interviews were: 1) adaptation to ambiguity
and stress; 2) sadness and anger; 3) fear and terror; 4) lack of support;
5) dehumanization; 6) disempowerment and trivialization; 7) shame and stigma;
8) coping; 9) minimization and denial; 10) it (cancer) changes everything; 11) the game of survival; 12) the doctor is God; and 13) metaphors, images, and other cultural symbols specific to those with a diagnosis of breast cancer. Conclusions recommend the inclusion of these and other themes in the psychotherapeutic frameworks utilized by those counselling individuals with a diagnosis of breast cancer. / Graduate
| Identifer | oai:union.ndltd.org:uvic.ca/oai:dspace.library.uvic.ca:1828/8277 |
| Date | 14 June 2017 |
| Creators | Dunlop, Alicia Anne |
| Contributors | Peavy, Vance |
| Source Sets | University of Victoria |
| Language | English, English |
| Detected Language | English |
| Type | Thesis |
| Rights | Available to the World Wide Web |
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