1877P - Meaning-making in the re-entry phase: A qualitative focus group study with patients with breast cancer and melanoma

Background

After completion of curative cancer treatment patients enter the re-entry phase, which is characterized by the difficult task to pick up life again. In the re-entry patients face existential concerns, besides physical and psychosocial concerns. Finding meaning and purpose in this new situation may help in dealing with existential concerns. More insight is needed in the existential concerns and the meaning-making process in order to support patients in the re-entry phase.

Methods

We conducted 6 focus groups with 16 patients (5 patients with melanoma and 11 with breast cancer) during the re-entry phase, defined as the point from completion of treatment (after surgical treatment and adjuvant systemic treatment, except for hormonal therapy) up to 18 months in remission. A thematic content analysis was performed by two researchers.

Results

In general, patients experienced existential concerns regarding their worldview, inner posture, values and the future. In addition, patients with melanoma struggled with trust and responsibility for their health; patients with breast cancer struggled with relationships and identity. Outcomes of the meaning-making process identified were: meaning is affected and gives distress, existing sources of meaning are helpful, search for meaning or new meaning has been found. These outcomes were found at the beginning as well as further into the re-entry, however during the re-entry the focus of the meaning-making process shifted from the disease to (picking up) life.

Conclusions

The transition from being a patient to picking up daily life in the re-entry phase involves dealing with existential concerns causing distress. Patients use existing sources of meaning, search for new meaning or have found new meaning in order to deal with these existential concerns and distress. A meaning-centered intervention increasing patients awareness of their personal sources of meaning might strengthen their meaning-making process and can help in dealing with existential concerns.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

A. Visser and L. Post.

Funding

Novartis b.v.

Disclosure

All authors have declared no conflicts of interest.