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The Experience of Cancer Survivor's Return to Everyday Life

암 생존자의 일상생활 복귀 경험

  • Received : 2020.02.10
  • Accepted : 2020.05.08
  • Published : 2020.05.31

Abstract

This study was undertaken to identify ways that enable a successful comeback to everyday life and improvement in the quality of life, by understanding the experiences of cancer survivors in returning to everyday life. Totally, 19 people diagnosed with complete cure after 5 years of cancer treatment, were recruited for the study. Data was collected through in-depth interviews from January 18 to February 25, 2017. One-time interviews took 90 to 120 minutes, and data analysis was achieved by applying the grounded theory. The central phenomenon of 'reality that cannot be escaped' and 'uncertain reality that cannot know tomorrow' was attributed to the causal conditions 'hard reality', 'physical exhaustion', 'psychological exhaustion' and 'economic exhaustion'. Depending on context conditions such as 'lack of family support', 'shift to a vulnerable working class', 'insufficient support system', 'hope for the societal support system', 'daunted gender', 'prejudice against cancer/cancer patients', 'information on life after rare full healing'. The strategy for a successful return was influenced by intervention conditions such as 'robust family fence' and 'effective cancer insurance', which resulted in 'building a new life' or 'enduring'. We conclude that for a successful return to daily lives, cancer survivors require comprehensive information, health and social-welfare interventions.

본 연구는 암 생존자의 일상생활 복귀 경험의 이해를 통해 성공적인 일상생활 복귀와 삶의 질 향상 방안을 모색하고자 시도되었다. 암 치료 후 5년이 경과되어 완치 판정을 받은 19명을 암 생존자 환우회 및 인터넷 카페에 연구목적과 방법을 공지하여 모집하였다. 자료 수집은 2017년 1월 18일부터 2월 25일까지로 심층면담을 통해 실시되었으며, 자료가 포화될 때까지 이론적 표출을 시도하였다. 1회 면담 시간은 90분에서 120분 정도 소요되었으며, 인터뷰 이후 불충분한 내용은 추가 면담을 통해 내용을 확인 받았다. 면담 횟수는 1~3회였다. 근거이론에 따른 자료 분석을 실시하였으며, 암 생존자의 일상생활복귀 경험은 '고달픈 현실', '육체적 소진', '심리적 소진', '경제적 소진'이라는 인과적 조건으로 인해 '벗어날 수 없는 현실', '내일을 알 수 없는 불확실한 현실'이라는 중심현상이 발견되었다. '가족의 지지부족', '노동 취약계층으로의 이동', '미비한 지원시스템', '사회적 지원체계 희망', '위축된 성', '암/암환자에 대한 편견', '찾기 힘든 완치 이후 삶에 대한 정보' 등의 맥락적 조건에 따라 '적극적 건강관리', '긍정적 경험', '절대적 존재에 의지하기' 전략을 선택적으로 수행하였다. 이러한 전략 수행 과정은 중재적 조건인 '든든한 울타리', '효과적인 암보험'의 영향을 받았다. 그 결과는 '새로운 삶 구축하기' 또는 '견디기'로 나타났다. 암 생존자의 성공적인 일상생활 복귀를 위해서는 일상생활 복귀 과정에서 경험할 수 있는 문제들과 관련된 포괄적인 정보 제공 및 보건·복지적 개입이 필요하며, 향후 암 생존자 관리를 위한 시스템 구축 시 암 생존자의 요구를 반영한 지원 프로그램 개발이 필요하다.

Keywords

References

  1. Centers for Disease Control and Prevention. A national action plan for cancer survivorship: advancing public health strategies. CDC.; 2004. Available from: https://www.cdc.gov/cancer/survivors/pdf/plan.pdf
  2. S. A. Leigh, "Defining our destiny. In: Hoffman B, ed. A Cancer survivor's almanac: Charting the journey", Minneapolis, MN: Chronimed Publishing; pp. 261-271, 1996.
  3. CL. Park, I. Zlateva, T. Blank, "Self-identity after cancer: survivor, victim, patient, and person with cancer". Journal of General Internal Medicine, Vol.24, No.2, pp.430-5, 2009. DOI: https://dx.doi.org/10.1007%2Fs11606-009-0993-x
  4. S. H. Kim, "Understanding cancer survivorship and its new perspectives", Asian Oncology Nursing, Vol.10, No.1, pp.19-29, 2010. UCI: G704-SER000008675.2010.10.1.011
  5. K. W. Jung, Y. J. Won, H. J. Kong, C. M. Oh, D. H. Lee, J. S. Lee, "Cancer statistics in korea: incidence, mortality, survival, and prevalence in 2011". Cancer Research and Treatment, Vol.46, No.2, pp.109-123, 2014 DOI: https://doi.org/10.4143/crt.2014.46.2.109
  6. J. S. Kim, Return-to-work experience of breast cancer survivors: A qualitative study based on grounded theory approach, Doctoral dissertation, Yonsei University, Seoul, 2016.
  7. National Cancer Information Center. Available from: http://www.cancer.go.kr
  8. E. L. Cohen, M. Felson, "Social change and crime rate trends: A routine activity approach", American Sociological Review, Vol.44, No.4, pp.588-605, 1979. https://doi.org/10.2307/2094589
  9. Y. H. Noh, Breast cancer survivor's conquest experience", Doctoral dissertation, Chonnam National University, Gwangju, 2003.
  10. M. S. Park, K. S. Kim, "Cancer survivors' life experience", Asian Oncology Nursing, Vol.8, No.2, pp.93-104, 2008. Available from: http://www.dbpia.co.kr/pdf/pdfView.do?nodeId=NODE01057060
  11. J. Y. Yang, "The actual experiences of the living world among cancer patients", Journal of Korean Academy of Nursing, Vol.38, No.1, pp.140-51, 2008. DOI: http://dx.doi.org/10.4040/jkan.2008.38.1.140
  12. J. E. Lee, D. W. Shin, B. L. Cho, "The current status of cancer survivorship care and a consideration of appropriate care model in Korea", Korean Journal of Clinical Oncology, Vol.10, No.2, pp.58-62, 2014. DOI: https://doi.org/10.14216/kjco.14012
  13. Y. M. Bae, Y. A. Kim, S. H. Hong, J. H. Koo, Y. H. Yun, "Pubic attitudes toward development of national program for cancer survivorship", Korean journal of hospice and palliative care, Vol.14, No.4, pp.218-26, 2011. UCI: G704-SER000009021.2011.14.4.003 https://doi.org/10.14475/kjhpc.2011.14.4.218
  14. K. Miller, Medical and psychosocial care of the cancer survivor, Boston, MA: Jones and Bartlett Publishers; 2010.
  15. S. Y. Kwon, K. R. Bae, "A study on the knowledge structure of cancer survivors based on social network analysis", Journal of Korean Academy of Nursing, Vol.46, No.1, pp.50-58, 2016. DOI: http://dx.doi.org/10.4040/jkan.2016.46.1.50
  16. E. K. Heo, H. S. Kang, K. H. Kim, Y. P. Hong, "Return-to-work experiences among breast cancer survivors", Journal of the Korean Society of Maternal and Child Health, Vol.15, No.1, pp.92-102, 2011. DOI: https://doi.org/10.21896/jksmch.2011.15.1.92
  17. M. R. Son, Experience of Return to Work among Officers with Cancer, Doctoral dissertation, Hanyang University, Seoul, 2009.
  18. S. I. Nam, K. H. Choi. "School reintegration, adjustment difficulties, and services for childhood cancer survivors ", Korean journal of social welfare research, Vol.38, pp.181-215, 2013. UCI: G704-002139.2013.38..004
  19. S. S. Hur, A study on the experiences in returning to social activities of the early gastric cancer patients after their surgeries, Master's thesis, Hanyang University, Seoul, 2011.
  20. J. H. Han, An ethnography on joy and sorrow of cancer survivors, Doctoral dissertation, Kyung Hee University, Seoul, 2015.
  21. E. Y. Suh, "The processes of coping with breast cancer among korean women", The Korean Journal of Stress Research, Vol.16, pp.305-15, 2008. UCI: G704-002182.2008.16.4.012
  22. M. H. Seo, K. H. Lim, "The effects of fatigue and distress on self-efficacy among breast cancer survivors", The Journal of Korean Academic Society of Adult Nursing, Vol.28, No.4, pp.378-387, 2016. DOI: http://dx.doi.org/10.7475/kjan.2016.28.4.378
  23. A. Strauss, J. M. Corbin, J. Corbin, Basics of qualitative research. Thousand Oaks: Sage Publications, 1998.
  24. J. A. Park, The survival journey of patients with colorectal cancer surgery, doctoral dissertation, Chungang University, Seoul, 2012.
  25. L. Pedro, "Quality of life for long-term survivors of cancer: influencing variables", Cancer Nursing, Vol.24, No.1, pp.1-11, 2001. DOI: http://dx.doi.org/10.1097/00002820-200102000-00001
  26. J. W. Lim, Y. I. Han, "Comparison of quality of life on the stage of cancer survivorship for breast and gynecological cancer survivors", Korean Journal of Social Welfare Studies, Vol.60, No.1, pp.5-27, 2008. DOI: https://doi.org/10.20970/kasw.2008.60.1.001
  27. P. S. Yu, S. H. Ko, "A study on the relation among uncertainty in illness, hope and spiritual well-being of cancer patients", Korean Journal of Adult Nursing, Vol.18, No.3, pp.479-87, 2006. UCI: G704-000678.2006.18.3.001
  28. M. R. Yun, M. S. Song, "A qualitative study on breast cancer survivors' experiences", Perspectives in Nursing Science, Vol.10, No.1, pp.41-51, 2013. Available from: http://s-space.snu.ac.kr/bitstream/10371/86578/1/10-1-41-%EC%9C%A4%EB%AF%B8%EB%9D%BC-%EC%B5%9C%EC%A2%85.pdf
  29. M. K. Lee, K. M. Lee, J. M. Bae, S. Kim, Y. W. Kim, K. W. Ryu, J. H. Lee et al, "Employment status and work-related difficulties in stomach cancer survivors compared with the general population", British Journal of Cancer, Vol.98, No.4, pp.708-15, 2008. DOI: http://dx.doi.org/10.1038/sj.bjc.6604236
  30. Z. Amir, D. Neary, K. Luker, "Cancer survivors' view of work 3 years post diagnosis: A UK perspective", European Journal of Oncology Nursing, Vol.12, No. 3, pp.190-197, 2008. DOI: https://doi.org/10.1016/j.ejon.2008.01.006