Adaptation process and psychosocial resources of Chinese colorectal cancer patients undergoing adjuvant treatment: a qualitative analysis.
OBJECTIVE
To examine how Chinese patients with colorectal cancer (CRC) dynamically adapt to diagnosis and treatment and explore how patients evolve and deploy different resources throughout the illness trajectory.


METHODS
Semi-structured interviews were conducted on a purposive sample of 16 histologically diagnosed Chinese CRC patients about to complete or who had very recently completed all treatment without recurrence. Recorded interviews were transcribed verbatim and analyzed by using grounded theory techniques.


RESULTS
Three major adaptation-related themes were identified: (1) utilization of medical resources, (2) transition of resource utilization, and (3) continuous resistance to demands. Initial prevailing fatalistic views of diagnosis associated predominantly with frequent medical surveillance and with respondents' weighting of treatment and expertise of medical professionals. As treatment progressed, there was a shift toward reliance on personal and social resources to field cancer-related demands concurrent with a gradual distancing from medical care. Upon treatment completion, fatalism re-emerged regarding disease recurrence, which, like diagnosis, was seen as not amenable to individual control, even with close adherence to medical follow-ups and dietary adjustment. Maintaining positive states of mind and good relationships with family and friends were cores strategies respondents adopted to preserve psychological well-being.


CONCLUSIONS
Maintenance and enhancement of personal and social resources throughout the CRC trajectory may have considerably more utility than traditional descriptive studies hitherto suggested. Considering personal and social resources within dynamic rather than static models could avoid the pitfall of attributing maladaptive responses to initial dispositions and socioeconomic conditions that are seemingly unalterable and enduring over time.
Hou
Wai Kai
WK
Department of Psychology, Faculty of Social Sciences, The University of Hong Kong, Pokfulam, Hong Kong, China.
Lam
Wendy W T
WW
Fielding
Richard
R
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D044466:Asian People / Q000523:psychology*; D017024:Chemotherapy, Adjuvant / Q000523:psychology; D015179:Colorectal Neoplasms / Q000208:ethnology* / Q000523:psychology* / Q000628:therapy; D003131:Combined Modality Therapy; D003674:Defense Mechanisms; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong; D006801:Humans; D055809:Illness Behavior; D007389:Internal-External Control; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000208:ethnology / Q000523:psychology; D010349:Patient Compliance / Q000208:ethnology / Q000523:psychology; D012929:Psychological Distance; D018714:Radiotherapy, Adjuvant / Q000523:psychology; D012648:Self Care / Q000523:psychology