title: Patients' experience with cancer recurrence: a meta-ethnography.
abstract: OBJECTIVE
  Recurrence is a difficult stage in the cancer journey as it brings to the fore the life-threatening nature of the illness. This meta-ethnography examines and synthesises the findings of qualitative research regarding patients' experience of cancer recurrence.
  
  
  METHODS
  A systematic search of the qualitative studies published between January 1994 to April 2014 was undertaken. Seventeen relevant papers were identified, and a meta-ethnography was conducted.
  
  
  RESULTS
  Six third-order concepts were developed to capture patients' experiences: experiencing emotional turmoil following diagnosis, which described the emotional impact of diagnosis and the influence of previous experiences on how the news were received; experiencing otherness, encompassing changed relationships; seeking support in the health care system, describing the extent of information needs and the importance of the relationship with health care professionals; adjusting to a new prognosis and uncertain future, highlighting the changes associated with uncertainty; finding strategies to deal with recurrence, describing ways of maintaining emotional well-being and regaining a sense of control over cancer; and facing mortality, describing the difficulties in facing death-related concerns and associated consequences.
  
  
  CONCLUSIONS
  This meta-ethnography clarifies the fundamental aspects of patients' experience of recurrence. It suggests that health care professionals can promote a positive experience of care and help lessen the psychosocial impact of recurrence by providing information in an approachable way and being sensitive to their changing needs. It also points to the importance of supporting patients in adopting strategies to regain a sense of control and to address their potential mortality and its impact on loved ones.
authors.affiliation: Clinical Health Care Department, Oxford Brookes University, Jack Straws Lane, Oxford, UK.
authors.forename: Marta
authors.initials: M
authors.lastname: Wanat
authors.affiliation: Clinical Health Care Department, Oxford Brookes University, Jack Straws Lane, Oxford, UK.
authors.forename: Mary
authors.initials: M
authors.lastname: Boulton
authors.affiliation: Clinical Health Care Department, Oxford Brookes University, Jack Straws Lane, Oxford, UK.
authors.forename: Eila
authors.initials: E
authors.lastname: Watson
mesh_terms: D000223:Adaptation, Psychological; D000884:Anthropology, Cultural; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000523:psychology*; D009369:Neoplasms / Q000473:pathology / Q000523:psychology*; D036301:Qualitative Research; D012008:Recurrence; D013315:Stress, Psychological / Q000523:psychology*
keywords: cancer; meta-ethnography; oncology; qualitative; recurrence