Experiences of psychological distress, uncertainty, and coping amongst people with cancer

Slater, Hayley and Duxbury, Anna and Daiches, Anna and Murray, Craig (2020) Experiences of psychological distress, uncertainty, and coping amongst people with cancer. PhD thesis, Lancaster University.

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Abstract

The thesis entitled ‘Experiences of Psychological Distress, Uncertainty, and Coping Amongst People with Cancer’ explores the psychological experiences of individuals affected by cancer. A systematic literature review of the of the relationship between psychological distress and uncertainty amongst younger adults with cancer is presented in section one. Fifteen eligible studies were identified via database and hand searches. Risk of bias assessments were carried out. Findings demonstrated a highly significant relationship between uncertainty and psychological distress, with a number of studies indicating that uncertainty predicts psychological distress. Inconsistency in findings, however, suggests that other variables may influence this relationship. Risks of bias were identified across studies. A research study exploring patients’ experiences of coping longer-term with cancer of unknown primary (CUP) is presented in section two. Interviews were carried out with ten participants and data was analysed using interpretative phenomenological analysis. Three superordinate themes were identified: (1) ‘“Fuss and Bother”: The Upheaval of Everyday Life’, with subordinate themes of ‘Appointment threats’, and ‘Symptoms and side-effects’; (2) ‘“It’s the Unknowing”: The Enduring Uncertainty of CUP’ with subordinate themes of ‘“What the bloody hell’s that?!”’, ‘An uncertain future’, and ‘Hope’; and (3) ‘“Just Get on With It”: Managing and Moving Forwards’ with subordinate themes of ‘Maintaining normality’, ‘Acceptance’, and ‘Support’. Findings highlighted that the experiences of people living longer-term with CUP are comparable to those of other cancer patient populations, however, they also face a number of distinct challenges. A critical appraisal of the research paper is presented in section three. Within the critical appraisal, consideration is given to the epistemological and ontological assumptions made within the thesis, the position of the researcher and the importance of researcher reflexivity, and the research process. The ethics application and associated documentation are presented in section four.