In search of self : the hospitalisation experiences of children with cancer : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University

Abstract

Cancer is the second most common cause of death in children in the Western world. The diagnosis and treatment process is painful and distressing, and is carried out in the hospital environment. This environment is foreign to most children, and influences children's coping with the experience of having cancer. Research in this area has focussed on assessing coping responses, and designing interventions for the pain, distress and anxiety associated with the medical procedures. There have also been studies which have measured the prevalence of emotional and behavioural difficulties in children with cancer. No studies have been conducted into children's experiences of hospital expressed in their own terms. The aim of the present study was to elicit the hospital experiences of children with cancer. Interviews were conducted with seven children, aged 5 - 15 years, who had completed treatment for cancer within the previous two years. An interpretive phenomenological design was utilised in order to gain and analyse accounts of the participants' perceptions and experiences. Findings suggest that the experiences can be interpreted in terms of two themes underlying the experiences of children with cancer, and their coping responses. The first theme is 'Retaining a sense of self-as-normal', which describes efforts to 'Maintain links with familiar people' and 'Becoming 'at home' in hospital'. The second theme is 'Incorporating multiple selves', which are 'Self-as-body-in-pain', 'Self-as-confined', 'Self-as-patient' and 'Self-as-survivor-living-with-cancer'. Success in retaining a sense of self-as-normal both affects, and is influenced by, the incorporation of multiple selves. Implications of these themes for practice in terms of the assessment of coping responses, design of interventions, and the measurement of outcomes, are suggested.