SUBJECTIVE CONSTRUCTS AND FIRST APPRAISAL IN WOMEN WITH BREAST CANCER (ITALY).
Contributors: Case Western Reserve University.
Published: 1995
Number of pages: 259
Subjects: Health Sciences, Nursing.; Psychology, Clinical.; Women's Studies.
Description: The purpose of this study was to describe patterns of personal cognitive constructs and first appraisal in women recently diagnosed with breast cancer. A framework integrating the Folkman and Lazarus coping model (1984) and Kelly's Personal Construct Theory (1955) guided this study.

Sixty-two women from five different Italian regional hospitals participated in the study. Subjects were interviewed just prior to breast surgery. Breast surgery consisted of lumpectomy. Personal cognitive constructs were elicited during in-depth face-to-face interviews using Kelly's Repertory Grid technique (Kelly, 1955). First appraisal was measured using a visual analog scale with an investigator developed self report questionnaire. The basis for the questionnaire was Lazarus' three appraisal categories: Challenge, Threat, and Harm/Loss (Lazarus & Folkman, 1985). First appraisal was assessed both as perceived during the interview and as remembered by the subject immediately after the diagnosis. Demographic data were collected using an investigator designed demographic data form. Subjects were interviewed between 1 to 10 weeks following diagnosis. Fifty-two subjects were interviewed prior to the surgery, 10 were interviewed following surgery.

Many events used by the women to elicit their cognitive constructs were similar. The category "Challenge" was referred to by the majority of the women as the most intense at the time of the interview; based on the participant's memory, "Challenge" was also described by the majority as the most intense immediately following the diagnosis. No relationship was found between the participants' demography and category of appraisal. Some differences in the patterns of constructs characterized the subjects within the three appraisal categories.

Three conclusions were drawn: (a) the women generally used some similar typologies of events in construing the meanings of their disease; (b) the women preferred "Challenge" among the three categories of appraisal of cancer; and (c) there were some distinctive features in the patterns of personal cognitive constructs of women who appraised their breast cancer as Harm/Loss, Threat, or Challenge.

This study used a convenience sample of 62 Italian women, therefore the results are not generalizable beyond the participants. An insufficient number of subjects who had had surgery were accrued to the study to determine differences between those who had had surgery and those who had not. It is possible that women who participated had motives that were different than women who may have declined, and/or the physician had motives in approaching the participants. The majority of interviews were held in clinical settings exposed to environmental noise beyond the control of the interviewers. The translation from Italian to English may have caused modifications within the original meanings assigned by the participants. Lazarus's categories of appraisal may assume a different meaning when translated within Italian culture.

This study can be replicated on comparable samples of women across countries to evaluate the role of national cultures upon appraisal and constructs. Longitudinal research is needed to assess changes within constructs from diagnosis through to surgery, and finally, experimental research is needed to test the study's underlying assumption of a link between constructs and first appraisal of cancer and to evaluate the nursing interventions that could be used to help women with breast cancer.
Notes: Source: Dissertation Abstracts International, Volume: 56-11, Section: B, page: 6041.

Thesis (PH.D.)--CASE WESTERN RESERVE UNIVERSITY, 1995.

School code: 0042.