Dr Bridie McCarthySupervisor: Dr Tom AndrewsCo-supervisor: Professor Josephine Hegarty

Background to study Research methodology The emergent substantive theory

Interest in family members Clinical experience Teaching experience Personal experience Chemotherapy units Colo-rectal cancer Literature on communication

To explore family members’ experiences when their loved ones were undergoing chemotherapy treatment for colo-rectal cancer.

Grounded theory (classical) Data collection – Interviews (n=35)

Analysis: ◦Constant comparative analysis

Field notes and memoing Ethical approval

Main concern: Fear of emotional collapse Core category: “Emotional Resistance Building” (ERB)

Emotional reflecting◦ Time taking◦ Explanation seeking ◦ Comparison making

I 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.

Information seeking◦ Attending medical appointments ◦ Active listening/questioning ◦ Establishing trust in HCPs

I 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

Advance planning◦ Action planning◦ Disclosing the diagnosis ◦ Re-normalising

We are in this together and we will

get through it together

Emotional shielding◦ Emotional hiding ◦ Physical hiding ◦ Emotional containing

It 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

Burden relieving◦ Responsibility taking◦ Openly communicating ◦ Illness fighting

We 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.

Emotional releasing ◦ Externalising emotional displays◦ Externalised burden sharing ◦ Spiritualised burden sharing

God 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

Emotional holding◦ Emotional postponing ◦ Maintaining hope ◦ Illness detachment

No 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

Pragmatic adjusting◦ Planning ◦ Negotiating support ◦ Illness disclosure

I 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

Reality adjusting◦ Getting through each day◦ Letting go◦ Confidence layering

My 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

Reconciliatory adjusting◦ Valuing time ◦ Balancing◦ Accommodating disruption

You 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

Policies 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

Thank you for listening

Bridie