Presentation on theme: "Emotional Resistance Building: A grounded theory of how family members of loved ones undergoing chemotherapy deal with fear of emotional collapse Dr Bridie."— Presentation transcript:
1Emotional Resistance Building: A grounded theory of how family members of loved ones undergoing chemotherapy deal with fear of emotional collapseDr Bridie McCarthySupervisor: Dr Tom AndrewsCo-supervisor: Professor Josephine Hegarty
2Outline of Presentation Background to studyResearch methodologyThe emergent substantive theory
3Background Interest in family members Clinical experience Teaching experiencePersonal experienceChemotherapy unitsColo-rectal cancerLiterature on communication
4Aim of StudyTo explore family members’ experiences when their loved ones were undergoing chemotherapy treatment for colo-rectal cancer.
5Methodology Grounded theory (classical) Data collection – Interviews (n=35)Analysis:Constant comparative analysisField notes and memoingEthical approval
6Core Category Main concern: Fear of emotional collapse Core category: “Emotional Resistance Building” (ERB)
7PHASES OF ERBPhase Figuring out Emotional reflecting Information seeking Advanced planning Emotional shieldingPhase Uncertainty adjustment Pragmatic adjusting Reality adjusting Reconciliatory adjustingPhase Getting on with it Burden relieving Emotional releasing Emotional holding
8Phase 1: Figuring out Emotional reflecting Time taking Explanation seekingComparison makingI couldn't believe it. I had to take time to think, was it real or just a bad dream. How could it be real, she is too young.
9Phase 1 – continued Information seeking Attending medical appointments Active listening/questioningEstablishing trust in HCPsI never knew he was so lonely until he told the doctor why he couldn’t sleep at night. I was just thinking it was depression and at him to pick himself up. It was a real wake-up call for me
10We are in this together and we will get through it together Phase 1: ContinuedAdvance planningAction planningDisclosing the diagnosisRe-normalisingWe are in this together and we will get through it together
11Phase 1 continued Emotional shielding Emotional hiding Physical hiding Emotional containingIt was terrible at the start. I didn’t leave the house, I just didn’t want to meet or see anyone. I just wanted to be by myself and have a good cry
12Phase 2: Getting on with it Burden relievingResponsibility takingOpenly communicatingIllness fightingWe have to fight this. We are getting the best treatment and I believe my wife will come through this We are both very positive and I have to believe it. We have small children, my wife is not even 40 yet and we have our whole lives ahead of us.
13Phase 2 continued Emotional releasing Externalising emotional displays Externalised burden sharingSpiritualised burden sharingGod has spared me my husband for which I am most grateful. Now if He will save him for me and my family I will do whatever it takes , anything he wants me to do to save my husband, I will do it
14Phase 2: Continued Emotional holding Emotional postponing Maintaining hopeIllness detachmentNo matter how bad the news I would never cry in front of my partner or HCPs. I would hold back until I get to the first loo or until I got home
15Phase 3: Uncertainty adjustment Pragmatic adjustingPlanningNegotiating supportIllness disclosureI work shift hours so I had to arrange my dad’s chemo around times that suited me. If I couldn’t do that I really don’t know how we’d manage
16Phase 3 – continued Reality adjusting Getting through each day Letting goConfidence layeringMy wife got so sick with the chemo that I had to do everything. It was hard going at the beginning with young children as well, but I just took one day at a time
17Phase 3: Continued Reconciliatory adjusting Valuing time Balancing Accommodating disruptionYou never know from day to day or week to week what is gong to happen. Even if they will have the chemo. So you have to be ready for setbacks
18ConclusionPolicies and reports highlight the need to include and support family members (FMs) of patients with cancer (WHO 2006 & DoH&C 2012).That nurses should have an awareness of the emotional impact of cancer on FMs (DoH&C 2012).This explanatory theory highlights the many concerns that FMs experience and how they process them to avoid emotional collapse.Future - Need to intervene at an earlier stage, to reassure, support and guide FMs during this process