No One Sees the Fear: Becoming Diseased Before Becoming Ill-Being Diagnosed With Breast Cancer.
Cancer Nurs. 2013 Feb 28. Epub 2013 Feb 28. PMID: 23448954
Author Affiliation: Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany.
BACKGROUND:: Breast cancer patients experience profound life changes that include feelings of fear years after concluding treatment. OBJECTIVE:: The aim of this article was to understand the nature and origin of the persistent worry women experience after breast cancer treatment. METHODS:: Materials from participant observation of an oncology ward and from interviews with 17 first-time breast cancer patients, 4 oncologists, and 10 nurses were analyzed. Interpretation of materials was guided by theoretical concepts such as embodiment and liminality to understand the phenomenological aspects and cultural shaping of the illness experience. RESULTS:: Interviewees felt healthy at the time of diagnosis. It was the physician's word that initiated the illness process through the experience of shock. Nurses' work and therapeutic emplotment were instrumental in guiding the women to overcome the shock and engage in treatment. Study participants' lives were restructured under biomedical conditions. This included mistrust toward their bodies. Because of the mode of diagnosis and the initial shock, long-term fear can be seen as an integral part of the experience of having had breast cancer. CONCLUSIONS:: The study participants' sense of being in the world had changed in that their bodies had become objects unto themselves, dangerous objects. Fear became part of women's lives. To control the fear, women relied on biomedical practices to interpret bodily sensations. IMPLICATIONS FOR PRACTICE:: Therapeutic interventions and practices of care that facilitate a reconnection of trust with the (physical) body should be included in the care of posttreatment patients.