LITERATURE REVIEW: LIVED EXPERIENCES OF CANCER CAREGIVERS

Running head: LITERATURE REVIEW: LIVED EXPERIENCES OF CAREGIVERS
LITERATURE REVIEW: LIVED EXPERIENCES OF CAREGIVERS OF ADULT PATIENTS
DIAGNOSED WITH CANCER AND DURING ONCOLOGY TREATMENT: AN
INTERPRETATIVE PHENOMENOLOGICAL ANALYSIS
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LITERATURE REVIEW: LIVED EXPERIENCES OF CANCER CAREGIVERS1
Chapter 2: Literature Review
2.1. Introduction
Cancer is a chronic metabolic and inflammatory condition characterized by the excessive
and abnormal growth and development of cells and tissues, which when not mitigated in a
prompt, timely and comprehensive manner, may metastasize to other organs and organ systems
of the body. It is not uncommon to find cancer patients experiencing a range of debilitating
physiological, psychological, emotional and social outcomes as a result of the abnormal
inflammatory changes associated with cancer (O'Toole, Zachariae, Renna, Mennin &
Applebaum, 2017). However, in addition to cancer patients, cancer caregivers have also been
evidenced to experience distressful emotional and social upheavals, which in turn, may often
pave the way for the increased risk of acquiring various mental as well as physical health
disorders (Litzelman, Reblin, McDowell & DuBenske, 2020). While there remains and
abundance of quantitative and objective research, with regards to the experiences and changes in
quality of life encountered across cancer patients and their caregivers during reception of
oncological treatment, there remains limited phenomenological insights into the actual
subjective, subjective experiences prevalent across caregivers caring for adult cancer patients
(Haynes-Maslow, Allicock & Johnson, 2016).
The purpose of a literature review is to provide a detailed and critical insight into the
findings projected by current evidence based literature along with identification of key
limitations which were considered for development of the identified research question
(Christmals & Gross, 2017). With respect to the same, this chapter aims to critically explore
findings ad methodological quality prevalent across current available literature and studies

LITERATURE REVIEW: LIVED EXPERIENCES OF CANCER CAREGIVERS2
exploring the caregiver experiences of adult cancer patients. This chapter also succinctly
expounds upon the observed limitations in the reviewed literature and their role in informing
development of relevant research questions, methodologies and implications in future nursing
practice.
2.2. Theoretical Framework
For the purpose of understanding the nature of relationships and experiences felt by
caregivers when caring for adult cancer patients and with regards to the cancer resources,
symptoms and care burdens, the Transactional Model of Stress and Coping evidenced by Lu,
Liu, Wang & Lou, (2017) can be considered (Figure 1). The first stage of this model is primary
appraisal which is characterized by the way in which the threat to health or the health issue (in
this case cancer), is perceived by the caregiver. The key influencers determining either positive
or negative appraisal of the cancer condition in the patient by the caregiver include: the demands
and daily task responsibilities as well as decision-making activities expected from the caregiver,
the demographic status like age, employment, gender, health conditions of the concerned cancer
caregivers, if the health condition or cancer is perceived as a threat to the caregiver’s personal
values, dreams and goals and finally the availability of supportive resources for the cancer
caregiver such as: healthcare teams, social support, palliative care consultations and
effectiveness of administered oncological interventions (Chu, Tak & Kim, 2018). When the
number of available resources are found to outweigh the allocated demands, it is likely that the
caregiver will perceive the cancer caregiving experience as an acceptable and manageable
burden. When the amount of available resources are lower than the perceived and prevalent
demands, it is likely that the caregiver will perceive the caregiving role as a burden with respect
Figure 1: The Transactional Model of Stress and Coping (Source: Lu, Liu, Wang & Lou,
(2017)

LITERATURE REVIEW: LIVED EXPERIENCES OF CANCER CAREGIVERS3
to caring for the adult cancer patient (DeSteno et al., 2019). In such situations, for the purpose of
coping with the care burden, the cancer caregiver may then revert to the usage of coping
strategies such as emotion focused, meaning focused and problem focused coping strategies,
which in turn, can result the way for either positive or negative psychological consequences
within the cancer caregiver. The transactional model of stress and coping is useful in practical,
professional healthcare practice across palliative and clinical settings, since it informs healthcare
professionals as to why some caregivers perceive the caregiving experience as a fulfilling one,
while some may perceive the same to be emotionally distressful (Toussaint, Webb & Hirsch,
2017). Thus, this model will prove to be useful in interpreting the subjective experiences of the
cancer patient caregivers who will be examined as a part of the interpretive phenomenological
analysis.