Skip to main content
SpringerLink
Log in

Wide-ranging impacts reported by NZ cancer survivors: is supporting cancer survivor resilience a health sector role?

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Cancer survivor numbers are on the rise but little is known about New Zealand (NZ) survivors’ experiences with management of cancer-related impacts and vulnerability. This study explored the experiences and resilience of NZ cancer survivors and the experiences of healthcare practitioners who work with cancer survivors. There is a focus on indigenous Māori survivors.

Methods

This study used qualitative methods to explore survivors and healthcare practitioners’ views on cancer-related impact and management strategies. Two focus groups were conducted with mainly colorectal cancer survivors residing in the central regions of NZ. There was one Māori-only group (n = 6 participants) and one multicultural group (n = 18 participants). The Māori-only focus group was purposefully organised to provide a culturally safe setting for the research. In addition, 12 in-depth interviews were conducted with healthcare practitioners between October 2011 and March 2012.

Results

Wide-ranging survivorship impacts were described by survivors across physical, emotional, spiritual and social domains. Shame resilience and relationships, particularly with healthcare practitioners, were indicated as useful supports. Healthcare practitioners’ time constraints and role priorities were identified as barriers to their ability to provide survivorship support.

Conclusions

This study generated qualitative data on survivorship impacts and components of survivor resilience in NZ. It also provided insights into the need for better strategies and pathways to help the NZ health system be more responsive to both Māori and non-Māori survivors.

Implications for cancer survivors

Survivor impacts create vulnerabilities that are experienced and described differently by individuals and groups in NZ. Tailored survivor support that can enhance resilience and support relationships is needed in NZ.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ministry of Health (2015) Cancer: new registrations and deaths 2012. Ministry of Health, Wellington

    Google Scholar 

  2. Robson B, Purdie G, Cormack D (2010) Unequal impact II: Māori and non-Māori cancer statistics by deprivation and rural–urban status, 2002–2006. Wellington, Ministry of Health

    Google Scholar 

  3. Carter AJR, Nguyen CNA (2012) Comparison of cancer burden and research spending reveals discrepancies in the distribution of research funding. BMC Public Health 12:526

    Article  PubMed  PubMed Central  Google Scholar 

  4. Hewitt M, Greenfield S, Stoval E (2005) From cancer patient to cancer survivor: lost in transition. National Academies Press, Washington DC

    Google Scholar 

  5. Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR (2007) Cancer-related fatigue: the scale of the problem. Oncologist 12(Suppl 1):4–10

    Article  PubMed  Google Scholar 

  6. Jones JM, Olson K, Catton P, Catton CN, Fleshner NE, Krzyzanowska MK, McCready DR, Wong RKS, Jiang H, Howell D (2016) Cancer-related fatigue and associated disability in post-treatment cancer survivors. J Cancer Surviv 10:51–61

    Article  PubMed  Google Scholar 

  7. Hill S, Sarfati D, Blakely T, Robson B, Purdie G, Chen J, Dennett E, Cormack D, Cunningham R, Dew K, McCreanor T, Kawachi I (2010) Survival disparities in indigenous and non-indigenous New Zealanders with colon cancer: the role of patient comorbidity, treatment and health service factors. J Epidemiol Community Health 64:117–123

    Article  PubMed  Google Scholar 

  8. Hill S, Sarfati D, Blakely T, Robson B, Purdie G, Dennett E, Cormack D, Dew K, Ayanian AZ, Kawachi I (2010) Ethnicity and management of colon cancer in New Zealand. Cancer 116:3205–3214

    Article  PubMed  Google Scholar 

  9. Blakely T, Shaw C, Atkinson J, Tobias M, Bastiampillai N, Sloane K, Sarfati D, Cunningham R (2012) Cancer trends: trends in incidence by ethnic and socioeconomic group, New Zealand 1981–2004. University of Otago and Ministry of Health, Wellington

    Google Scholar 

  10. Soeberg M, Blakely T, Sarfati D, Tobias M, Costilla R, Carter K, Atkinson J (2012) Cancer trends: trends in cancer survival by ethnic and socioeconomic group, New Zealand 1991–2004. University of Otago and Ministry of Health, Wellington

    Google Scholar 

  11. Walker T, Signal L, Russel M, Smiler K, Tuhiwai-Ruru R, Otaki Community Health Centre, Te Wakahuia Hauora (2008) The road we travel: Maori experiences of cancer. N Z Med J 121:27–35

    PubMed  Google Scholar 

  12. O’Brien I, Britton E, Sarfati D, Naylor W, Borman B, Ellison-Loschmann L, Simpson A, Tamblyn C, Atkinson C (2010) The voice of experience: results from cancer control New Zealand’s first national cancer care survey. N Z Med J 123:10–19

    PubMed  Google Scholar 

  13. Slater T, Matheson A, Davies C, Tavite H, Ruhe T, Holdaway M, Ellison-Loschmann L (2013) ‘It’s whanaungatanga and all that kind of stuff’: Maori cancer patients’ experiences of health services. J Prim Health Care 5:308–314

    PubMed  Google Scholar 

  14. Dew K, Signal L, Davies C, Tavite H, Hooper C, Sarfati D, Stairmand J, Cunningham C (2015) Dissonant roles: the experience of Māori in cancer care. Soc Sci Med 138:144–151

    Article  PubMed  Google Scholar 

  15. Dew K, Stubbe M, Signal L, Stairmand J, Dennett E, Koea J, Simpson A, Sarfati D, Cunningham C, Batten L, Ellison-Loschmann L, Barton J, Holdaway M (2015) Cancer care decision making in multidisciplinary meetings. Qual Health Res 25:397–407

    Article  PubMed  Google Scholar 

  16. Ministry of Health and University of Otago (2010) The burden of cancer: New Zealand 2006. Ministry of Health, Wellington

    Google Scholar 

  17. Koczwara B (2015) Cancer survivorship —lessons from around the globe. Cancer Forum 33:83–86

    Google Scholar 

  18. Oeffinger KC, Argenbright KE, Levitt GA, McCabe MS, Anderson PR, Berry E, Maher K, Merrill J, Wollins DS (2014) Models of cancer survivorship health care: moving forward. Am Soc Clin Oncol Educ Book:205–213

  19. Brown B (2006) Shame resilience theory: a grounded theory study on women and shame. Fam Soc J Contemp Soc Serv 87:43–52

    Google Scholar 

  20. Windle G, Bennett KM, Noyes J (2011) A methodological review of resilience measurement scales. Health Qual Life Outcomes 9:8

    Article  PubMed  PubMed Central  Google Scholar 

  21. Tedeschi RG, Calhoun LG (2004) Posttraumatic growth: conceptual foundations and empirical evidence. Psychol Inq 15:37–41

    Article  Google Scholar 

  22. Jefford M, Karahalios E, Pollard A, Baravelli C, Carey M, Franklin J, Aranda S, Schofield P (2008) Survivorship issues following treatment completion-results from focus groups with Australian cancer survivors and health professionals. J Cancer Surviv 2:20–32

    Article  PubMed  Google Scholar 

  23. Baravelli C, Krishnasamy M, Pezaro C, Schofield P, Lotfi-Jam K, Rogers M, Milne D, Aranda S, King D, Shaw B, Grogan S, Jefford M (2009) The views of bowel cancer survivors and health care professionals regarding survivorship care plans and post treatment follow up. J Cancer Surviv 3:99–108

    Article  PubMed  Google Scholar 

  24. De Moor JS, Mariotto AB, Parry C, Alfano CM, Padgett L, Kent EE, Forsythe L, Scoppa S, Hachey M, Rowland JH (2013) Cancer survivors in the United States: prevalence across the survivorship trajectory and implications for care. Cancer Epidemiol Biomark Prev 22:561–570

    Article  Google Scholar 

  25. Sarfati D, Koczwara B, Jackson C (2016) The impact of comorbidity on cancer and its treatments. CA Cancer J Clin 66:337–350

    Article  PubMed  Google Scholar 

  26. Aziz NM (2007) Cancer survivorship research: state of knowledge, challenges and opportunities. Acta Oncol 46:417–432

    Article  PubMed  Google Scholar 

  27. Gilbert SM, Miller DC, Hollenbeck BK, Montie JE, Wei JT (2008) Cancer survivorship: challenges and changing paradigms. J Urol 179:431–438

    Article  PubMed  PubMed Central  Google Scholar 

  28. Durie M (1994) Waiora: Maori health development. Oxford University Press, Oxford

    Google Scholar 

  29. Metge J (1995) New growth from old: the whanau in the modern world. Victoria University Press, Wellington

    Google Scholar 

  30. Central Cancer Network NZ (2016) He anga whakaahuru: supportive care framework. Central Cancer Network, Palmerston North

    Google Scholar 

  31. Health Research Council of New Zealand (2010) Guidelines for researchers on health research involving Māori. http://www.hrc.govt.nz/news-and-publications/publications/guidelines-researchers-health-research-involving-maori. Accessed 9 Dec 2010

  32. Koea JB (2008) Ghosts in the machine: the experiences of Māori in the New Zealand health system. N Z Med J 121:27–35

    Google Scholar 

  33. Egan R, Doherty J, Albert T, Llewellyn R, Walsh C, Kerslake P, Pihema C, Kramer J, Frost A, Retimanu-Pule M, Atkinson K, Sutcliffe S, Olsen T, Atkinson C, McGrath P, Wood S, Stacy-Baynes S, Daly M (2014) He kahui korero taumahatanga o te mate pukupuku: cancer stories project Aotearoa/New Zealand. University of Otago and Cancer Society of New Zealand, Dunedin

    Google Scholar 

  34. Ohlsson-Nevo E, Andershed B, Nilsson U, Anderzén-Carlsson A (2012) Life is back to normal and yet not—partners’ and patient’s experiences of life of the first year after colorectal cancer surgery. J Clin Nurs 21:555–563

    Article  PubMed  Google Scholar 

  35. Richardson A, Addington-Hall J, Amir Z, Foster C, Stark D, Armes J, Brearley SG, Hodges L, Hook J, Jarrett N, Stamataki Z, Scott I, Walker J, Ziegler L, Sharpe M (2011) Knowledge, ignorance and priorities for research in key areas of cancer survivorship: findings from a scoping review. Br J Cancer 105(Suppl):S82–S94

    Article  PubMed  PubMed Central  Google Scholar 

  36. Klimmek R, Wenzel J (2012) Adaptation of the illness trajectory framework to describe the work of transitional cancer survivorship. Oncol Nurs Forum 39:E499–E510

    Article  PubMed  PubMed Central  Google Scholar 

  37. Murray CJL, Evans DB (2003) Health systems performance assessment: debates, methods and empiricism. World Health Organisation, Geneva

    Google Scholar 

Download references

Funding

This study received funding from Cancer Society Wellington, New Zealand.

Author information

Authors and Affiliations

  1. University of Otago, 23 Mein St, Newtown, Wellington, 6242, New Zealand

    Inga O’Brien, Louise Signal & Diana Sarfati

Authors
  1. Inga O’Brien
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Louise Signal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Diana Sarfati
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Inga O’Brien.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study (NZ Central Health and Disability Ethics Committee 12/CEN/12).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

O’Brien, I., Signal, L. & Sarfati, D. Wide-ranging impacts reported by NZ cancer survivors: is supporting cancer survivor resilience a health sector role?. Support Care Cancer 26, 1207–1213 (2018). https://doi.org/10.1007/s00520-017-3943-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-017-3943-x

Keywords

Search

Navigation