|Abstract: ||The purposes of this study were to explore the psychological and meaning making processes of lung cancer patients and their spouses and to investigate factors facilitating their resilience and recovery. Three couples while one of the spouses with lung cancer was diagnosed at stage III or IV were invited to participate in this qualitative research. Through narrative interviews, the life stories of lung cancer patients and their spouses were first analyzed from the âholistic-contentâ approach. After that, narrative âcategorical-contentâ analysis was employed in the coding, naming, and classifying processes. The research findings of this study were listed as follows :
1. The psychological processes. Experienced emotions of all participants were astonishment, shock, fear and worry after the cancer diagnosis was confirmed by the doctor. During the period, lung cancer patients not only had anger toward their doctors but also blamed them. While their spouses exhibited anticipatory grief reactions. During the lung cancer recurrence, patients experienced feelings of fearlessness, calmness, panic, and pain while their spouses were in agony and felt startled. All participants were worried and had feelings of self-blame and guilt. Moreover, spouses tended to feel distressed, painful to let go, sad, frustrated and helpless as well as worried about their children.
2. The meaning making of cancer experiences.
A. Making sense of cancer experiences. Patients constructed the meaning of their lung cancer experiences as their fate, the consequence of smoking and/or inhaling secondhand smoke, "why me" questions, karma, reborn, and the test and challenge in life. Spousesâ sense-making of cancer experiences included "why me" questions, reborn and a twisted life path resulting from âa stone falling from skyâ.
B. Finding benefits. Benefits found by lung cancer patients had becoming more sensitive and empathetic to the feelings of others, cherishing life and relationships, being closer to families, letting go of life, living in the moment, valuing the importance of depth rather than the length of life, and becoming more flexible in their thinking. Found benefits narrated by spouses included cherishing life and relationships, being closer to families, living a more fulfilling life, letting go of life, planning for the future, gaining self-recognition and satisfaction from taking care of spouses, becoming more empathetic to the feelings of others, and growing and learning from others.
C. Identity changes. Changes of patients included from being a career woman to a housewife, from being unable to say no to others to living within their means, from being stubborn and opinionated to respecting others, from taking the leads to maintaining the low profile, from being arrogant and complacent to being humble. Spouses voiced their identity changes included from being a workaholic to resuming their balance to live their desired lifestyle, and from being dependent to becoming independent.
3. Protective factors for their resilience and recovery from cancer experiences.
A. Protective factors facilitating patientsâ resilience were adopting proactive problem-solving strategies, having social support, having positive personal qualities, getting inner peace from religion, holding expectations for the future, staying enthusiastic in life, considering oneself as a lucky person, being able to regulate emotions to maintain physical and mental harmony, and having a sense of humor. For spouses, protective factors were positive personal qualities, believing in oneself, considering oneself as a lucky person, getting inner peace from religion, adopting proactive problem-solving strategies, having a sense of humor, having social support, and holding expectations for the future.
B. Risk factors hindering spousesâ resilience were having pessimistic personality trait. One of the spouse mentioned she was inclined to have more negative thinking and received more negative information from her families. .
4. The impacts of cancer.
A. Impacts on individual. The impacts of being diagnosed with having lung cancer on the patient had becoming more willing to offer help, being more acceptive to death, leaving from work involuntarily, turning busy lifestyle to a relaxing one, stopping smoking and persuade others to quit smoking, and experiencing the ups and downs interpersonal relationships. Impacts on spouses included leaving from work involuntarily, burdens from being a caretaker, being more acceptive to death, living a slower paced life, becoming more attached family.
B. Impacts on relationship. The impacts on the relationship narrated by patients were becoming compliant and accommodating to families, wanting to contribute more to families, disrupting the family routines, and increasing the financial burden on spouse and children. For spouses, impacts on relationship included offering support, companionship and encouragement to spouse, being compliant and accommodating to families, helping spouse to become more independent, becoming interdependent in couple relationship, and experiencing negative feelings because of the progress or recurrence of spousesâ cancer.
Recommendations were provided to health professionals of cancer treatment team and psychological services' practitioners to enhance and ensure the efficiency of medical and mental care. Implications for further studies were discussed based on research findings.