title: Coping with an exulcerated breast carcinoma: an interpretative phenomenological study.
abstract: OBJECTIVE
  To explore how women living at home with a malignant fungating wound (MFW) cope with such wounds.
  
  
  METHODS
  To explore coping through the lived experiences of patients a methodological framework, using Heideggerian hermeneutic phenomenology and semi-structured interviews. Nine patients were interviewed from January until November 2009.
  
  
  RESULTS
  The results are divided into two categories: 'living with a MFW' and 'feeling different'. These categories demonstrate how it is to live with the unpredictability, and uncontrollability of a MFW due to symptoms such as malodour, bleeding, exudate, pain and itching. The loss of control of the body boundary due to uncontrollable symptoms led to significant levels of distress and suffering for the patients. Different coping strategies were used to live with this wound.
  
  
  CONCLUSIONS
  This study demonstrates how difficult it is to live and cope with a malignant fungating wound. Coping strategies, including going into isolation, or denying any issues, were used. When taking care of patients with MFWs, strategies need to integrate a palliative, holistic, empathic approach.
authors.affiliation: Department of Health, Zurich University of Applied Sciences, Winterthur, Switzerland. sebastian.probst@zhaw.ch
authors.forename: S
authors.initials: S
authors.lastname: Probst
authors.forename: A
authors.initials: A
authors.lastname: Arber
authors.forename: S
authors.initials: S
authors.lastname: Faithfull
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications / Q000523:psychology*; D005122:Exudates and Transudates; D005260:Female; D006470:Hemorrhage; D006801:Humans; D008875:Middle Aged; D033262:Narration; D009812:Odorants; D059408:Pain Management; D010166:Palliative Care; D011537:Pruritus; D036301:Qualitative Research; D012883:Skin Ulcer / Q000209:etiology / Q000523:psychology* / Q000628:therapy; D012944:Social Support; D013557:Switzerland