Towards balance and harmony: Process of self reconstruction in adaptation to cancer among Chinese women

Abstract

PURPOSE: Current literatures consider restoring a sense of continuity in personal identity as a survival task for cancer patients. However, there has been a dearth of research exploring experiences of cancer patients in the East. This study addresses the experiences of women with breast cancer in the context of Chinese Hong Kong, with a focus on their process of ‘self’ reconstruction. METHOD: A total of 23 in-depth interviews were conducted with 18 Hong Kong Chinese women with breast cancer selected with purposive sampling. Interviews were transcribed and coded. Procedures of data analysis were informed by Constructivist Grounded Theory approach (Charmaz, 2000, 2003). Member check was conducted to enhance credibility and trustworthiness of findings. RESULTS: Findings reveal a 5 ‘R’ processes of self reconstruction in adaptation to cancer: (1) Experiencing the reality of impermanent and unpredictable nature of life; (2) Reappraising self}appraisal of the taken-forgranted assumptions about self and the world, renewed self awareness and revised fundamental belief system; (3) Redefining life goals}change in core values, life purpose and priorities, and development of alternative perspective in life; (4) Rebalancing self}a dynamic process of gaining balance between the ‘small self’ and ‘larger self’, and harmonizing the ‘egoistic self’, ‘social self’ as well as ‘spiritual self’ in one’s construction of self (5) Rebuilding new relationships}with self, others and the transcendent which are congruent with the renewed conception of self and are harmonized with each other. This pattern echoes Janoff-Bulman (1989)’s notion of rebuilding shattered assumptive world as well as Gillies and Neimeyer (2006)’s idea of identity change in meaning reconstruction after loss. Unique to this sample is the process of ‘Rebalancing self’. Chinese people tend to construct self in the interpersonal domain and are relational oriented (Ho, 1995). Women in this study affirmed their individuality as well as spirituality, and expanded beyond a relational self after experiencing cancer. While constructions of self before cancer are idiosyncratic, the process of adaptation is similar; it commonly leads to a reconstruction which encompasses a more fluid and balanced conception of self. CONCLUSION: Findings of this study suggest that Chinese women experienced reconstruction of meaning and self in the aftermath of cancer through a 5 ‘R’ processes of experiencing reality of impermanence, reappraising self, redefining life goals, rebalancing self and rebuilding new relationships. RESEARCH IMPLICATIONS: This study provides valuable insights into the experiences of Chinese women with breast cancer and their processes of ‘self’ reconstruction. Further researches using quantitative method to confirm the findings are warranted. CLINICAL IMPLICATIONS: As transformation of self is possible in surviving cancer, it is imperative for practitioners to help patient find positive meaning, to rediscover self and to appreciate the positive changes in self in the experience.