Cervical cancer: patterns of long-term survival.

PURPOSE/OBJECTIVES: To describe the quality of life (QOL) experienced by long-term survivors of cervical cancer and the factors that promoted their adaptation.

DESIGN: Qualitative.

SETTING: Homes and offices in the northeastern United States.

SAMPLE: 19 women diagnosed with cervical cancer from 1975-1995.

METHODS: Semistructured interviews were tape recorded. Interviewers asked the participants questions regarding their cancer experience, recovery, and long-term survival. Qualitative content analysis was used to identify themes that characterized participants' accounts. Participants varied in regard to how the themes were manifested in their accounts.

MAIN RESEARCH VARIABLES: Meaning, impact on identity, impact on QOL, coping strategies, and future expectations.

FINDINGS: Three distinct patterns of response emerged from participants' accounts of long-term survivorship with cervical cancer. Women categorized in the "moving on" pattern described their cancer as a difficult period taking place in the past, women in the "renewed appreciation of life" pattern focused on the positive outcomes of their cancer experience, and women in the "ongoing struggles" pattern emphasized the continuing negative outcomes of their cancer experience. Despite their overall distinctness, some common qualities in the patterns emerged, including the shock of the diagnosis, the pivotal role of healthcare providers, and the importance of support from family and friends.

CONCLUSIONS: Cervical cancer survival, for most of the study participants, brought with it some degree of long-term complications, with differences in reported QOL attributed to an ability or choice to reframe the cervical cancer experience.

IMPLICATIONS FOR NURSING: QOL and depression measures alone do not uncover embedded meanings of women's experiences with longterm survivorship. Clinicians can use a variety of interview probes and evidence-based psychosocial and educational approaches to assist the target population in the journey. Findings suggest that nurses play a key role in responding to cervical cancer survivors' unique experiences with illness and recovery.