COPING & SELF-CARE OF CANCER FAMILIES--NURSE PROSPECTUS

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The purpose of this nursing study is to determine the coping strategies and self-care behaviors of patients and family members for a 6-month period during cancer chemotherapy treatment and to compare responses of those receiving chemotherapy for the first time with those receiving chemotherapy for cancer recurrence. Theories of coping and self-care provide the conceptual framework for the proposed study; coping as described for the individual by Lazarus, for the family by McCubbin and Patterson; and self-care as described by Levin and Orem. These theories are complementary in that self-care is a strategy of coping. The focus of self-care for the patient is twofold: management of the side effects of chemotherapy; and management of other concerns (related to chemotherapy and life experiences) that arise. The focus of self-care for the family members centers on management of concerns they have regarding the patient, the family as a whole, and themselves as individual family members. To enhance understanding of patient and family's coping and self-care, a comparative longitudinal design will be used. Coping (dependent variable) will be measured for the individual (patient and adult family members and the family as a unit. Self-care will be measured by logs kept by the patients' and family members. Independent variables include control; interpersonal resources (social support, informal caregiver strain, and dyadic adjustment); intrapersonal resources (chemotherapy knowledge, awareness, and functional status); and affective state. The sample will include 120 families with a family member who has breast, lung, colorectal, gynecological cancer or lymphoma. These patients will constitute two primary groups; those who are initiating either their first protocol of chemotherapy or those who have recurrence of disease and are initiating their second protocol of chemotherapy. The type of cancer will be a stratifying variable. Repeated measures of the dependent and independent variables occur at five data collection points. Semi-structured interviews, self-administered questionnaires and self-report logs are the methods for obtaining data. The study findings will increase understanding of what are currently the coping strategies and self-care behavior practices of patients being treated for cancer and their adult family members and will provide the basis for a future experimental intervention study.