Living in It, Living With It, and Moving on: Dimensions of Meaning During Chemotherapy

Marie-Claire Richer

Helene Ezer

ONF 2002, 29(1), 113-119. DOI: 10.1188/02.ONF.113-119

Purpose/Objective: To explore the meanings assigned to the experience of receiving chemotherapy.

Design: Descriptive exploratory.

Setting: An oncology outpatient clinic in a university hospital in Montreal, Quebec, Canada.

Sample: Ten women with breast cancer who experienced chemotherapy for the first time.

Methods: Semistructured interview using a grounded theory approach.

Findings: Women described three dimensions of their experience with breast cancer and chemotherapy: "living in it,™ "living with it,™ and "moving on.™ Existential and situational meanings were an integral part of their experience. The existential meaning seemed to be present in varying degrees of intensity throughout the treatment, whereas the situational meanings were predominant at the beginning of the treatment phase and became less important as the treatment progressed.

Conclusions: The intrapersonal and interpersonal dimensions of the chemotherapy experience as well as the capacity to move on evolve within a context of both situational and existential meanings.

Implications for Nursing Practice: The study results suggest the potential value of exploring each woman's inner world of meanings in relation to her sense of self, relationships with others, resources, and coping strategies during treatment for breast cancer. Because existential and situational meanings are an integral part of women's experience, the nurse's role is to create an environment that permits and facilitates dialogue about these dimensions of meaning.

Jump to a section


    American Cancer Society. (2001). Cancer facts and figures2001. Atlanta: Author.

    Burman, M.E., & Weinert, C. (1997). Concerns of rural men and women experiencing cancer. Oncology Nursing Forum, 24, 1593-1600.

    Canadian Cancer Society. (2001). Cancer statistics. Montreal, Quebec: Author.

    Christman, N.J. (1990). Uncertainty and adjustment during radiotherapy. Nursing Research, 39, 17-20.

    Dibble, S.L., Padilla, G.V., Dodd, M.J., & Miaskowski, C. (1998). Gender differences in the dimensions of quality of life. Oncology Nursing Forum, 25, 577-583.

    Ehlke, G. (1988). Symptom distress in breast cancer patients receiving chemotherapy in the outpatient setting. Oncology Nursing Forum, 15, 343-346.

    Fife, B.L. (1994). The conceptualization of meaning in illness. Social Science in Medicine, 38, 309-316.

    Frankl, V.E. (1984). Man's search for meaning. Boston: Beacon Press.

    Gottlieb, L., & Ezer, H. (1997). Perspectives on health, family, learning, and collaborative nursing: A collection of writings on the McGill model of nursing. Montreal, Quebec: McGill University.

    Gottlieb, L., & Rowat, K. (1987). The McGill model of nursing: A practice-derived model. Advances in Nursing Science, 9, 250-259.

    Hilton, B.A. (1993). Issues, problems, and challenges for families coping with breast cancer. Seminars in Oncology Nursing, 9, 88-100.

    Hortobagyi, G.N. (1998). Treatment of breast cancer. New England Journal of Medicine, 339, 974-984.

    Jacobson, D.E. (1986). Types and timing of social support. Journal of Health and Social Behavior, 27, 250-264.

    Koestenbaum, P. (1976). Is there an answer to death? Englewood Cliffs, NJ: Prentice Hall.

    Lazarus, R.S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.

    Lugton, J. (1997). The nature of social support as experienced by women treated for breast cancer. Journal of Advanced Nursing, 25, 1184-1191.

    Marris, P. (1974). Loss and change. New York: Random House.

    McCorkle, R. (1987). The measurement of symptom distress. Seminars in Oncology Nursing, 3, 248-256.

    McCubbin, M.A., & McCubbin, H.I. (1993). Families coping with illness: The resiliency model of family stress, adjustment, and adaptation. In C.B. Danielson, B. Hamel-Bissel, & P. Winstead-Fry (Eds.), Families, health and illness: Perspectives on coping and intervention (pp. 21-63). St. Louis, MO: Mosby.

    Mishel, M.H., & Braden, C.J. (1987). Uncertainty: A mediator between support and adjustment. Western Journal of Nursing Research, 9, 43-57.

    Morse, J.M., & Field, P.A. (1995). Qualitative research methods for health professionals. Thousand Oaks, CA: Sage.

    Nerenz, D., Leventhal, H., & Love, R. (1982). Factors contributing to emotional distress during cancer chemotherapy. Cancer, 50, 1020-1027.

    O'Connor, A.P., Wicker, C.A., & Germino, B.B. (1990). Understanding the cancer patient's search for meaning. Cancer Nursing, 13, 167-175.

    Patterson, J.M. (1988). Families experiencing stress: The family adjustment and adaptation response model. Applying the FAAR model to health-related issues for intervention and research. Family Systems Medicine, 6, 202-237.

    Richer, M.C., & Ezer, H. (2000). Understanding beliefs and meanings in the experience of cancer: A concept analysis. Journal of Advanced Nursing, 32, 1108-1115.

    Rolland, J.S. (1987). Family illness paradigms: Evolution and significance. Family Systems Medicine, 5, 482-503.

    Sandelowski, M. (1986). The problem of rigor in qualitative research. Advances in Nursing Science, 8(3), 27-37.

    Taylor, S.E. (1983). Adjustment to threatening events: A theory of cognitive adaptation. American Psychologist, 38, 1161-1173.

    Thompson, S.C., & Janigian, A.S. (1988). Life schemes: A framework for understanding the search for meaning. Journal of Social and Clinical Psychology, 7, 260-280.

    Weekes, D.P., & Kagan, S.H. (1994). Adolescents completing cancer therapy: Meaning, perception, and coping. Oncology Nursing Forum, 21, 663-670.

    Yalom, I.D. (1980). Existential psychotherapy. New York: Basic Books.