1

A PHENOMENOLOGICAL ANALYSIS ON THE LIVED EXPERIENCES OF

WORKING SENIOR HIGH SCHOOL STUDENTS

A Thesis
Presented to
the Faculty of Senior High Department
Subsidized Technical Education Program (STEP) Inc.
Crossing, Calamba City

In Partial Fulfillment
of the Course Requirements for the Program
Technical Vocational Strand
Mechatronics Servicing

(Name of Leader and Members

Format: Surname, First Name, Middle Initial)

October 2017
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APPROVAL SHEET

This thesis entitled “A PHENOMENOLOGICAL ANALYSIS ON

LIVED EXPERIENCES OF FAMILY MEMBERS WITH CANCER

PATIENT” prepared and submitted by Shane P. San Juan, Danica M. Solomon

and Mirasol D. Tosino, in partial fulfillment of the requirements for the Degree of

Bachelor of Science in Psychology, has been examined and is recommended for

acceptance and approval for Oral Examination.

FLORINA P. SANTIAGO, RPm

Adviser

PANEL OF EXAMINERS
Approved by the Committee on Oral Examination with a grade of

LOIDA F. TUNGAO, Ph.D.

Chairperson

AR-JAY D. PEREZ, RPm, M.A. Ed. MOLINA G. RIZO

Member Member

Accepted and approved in partial fulfillment of the requirements for the

Degree of Bachelor of Science in Psychology.

Date: AMADO C. GEQUINTO, Ph.D.

Dean of Colleges
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ACKNOWLEDGEMENT

After restless weeks of hard work, this study has finally come to an end.
The researchers would like to extend their sincerest gratitude to the following who
contributed much in the development and success of the study:

To Mrs. Florina Padilla-Santiago, thesis adviser, for the guidance, time as

well as unlimited patience and for the ideas shared throughout the conduct of this
research;

To the panelists Dr. Loida F. Tungao, Mr. Ar-Jay D. Perez, and Ms.
Molina G. Rizo, for sharing their knowledge, suggestions, time and insights for
the improvement of the study;

To Ms. Jean O. Bolanos, the grammarian, for exerting her time and effort
to check and improve this research;

To the participants, for allowing us to gain insight to their lived

experiences while experiencing the complex phenomenon;

To the librarians of Batangas State University, Lyceum of the Philippines-

Laguna, National Library of the Philippines for the use of documents and materials
needed to form the concepts of the study;

To the instructors, classmates, family members and friends, for their

ultimate support and encouragement throughout the period;

And most of all, to ALMIGHTY GOD, for giving the researchers the
strength, courage, wisdom, guidance and blessings He gave throughout the process
of this study.
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- The Researchers

DEDICATION

This research study was dedicated to all people who helped the researchers
to produce useful, comprehensive, and informative research study;

To our family members, thank you for your unending support, morally and
financially;

To all the families who have a family member diagnosed with cancer and
any terminal diseases. Remember that you are not alone;

To Mr. Montano L. Tosino, for being the inspiration of this study. May you
rest in peace, you will never be forgotten.

- Shane
- Danica
- Mirasol
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CHAPTER I

THE PROBLEM

Introduction

Unlike all other illnesses, cancer continues to maintain a widespread fear

over people. It becomes synonymous with pain and death. Cancer is insidious,

generally pain-free in the initial stages, and frequently deadly by the time it is

detectable. It has been described as savage cells which somehow evade the laws of

the body; corrupt the forces which normally protect the body; invade the well-

ordered society of cells that surround it; colonize distant areas; and as a finale to

this cannibalistic orgy of flesh consuming flesh, commit suicide by destroying the

host.

Cancer as one of the deadly diseases may also result to a series of

experiences that profoundly affect the person who has the cancer and those who

share the experiences. It does not only affect the individual’s mental and physical

integrity but as well as the functionality of the family system. The way the patients

cope with their disease, the way they adapt to their treatment, and whether or not

they develop psychopathology interact with the coping methods of the family,

family dynamics and support systems.

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Cancer causes changes in the family’s identity, roles, and daily functioning.

The family plays a major role because they are the ones that provide the context of

adjustment in which the person with cancer responds to his or her disease. They

are the most important physical and emotional care providers.

In the Philippines, family members are the most important physical and

emotional care providers. They are the ones who help the patient perform activities

such as self-care, movement, transport, communication, household chores,

shopping, cooking, financing, organization of appointments, and social activities.

In addition, they need to perform other various activities such as helping the

patient cope with symptoms and coordination of medical care. Like physical care,

they also take on emotional care such as enabling social support, helping the

patients make decisions and searching for or obtaining information.

As stated by The Freeman (2015), cancers can occur at any age. Seventy-

five percent of cancer patients in the Philippines are 50 years old and above while

3.2% belong to the pediatric age bracket (0 to 14 years). In February 2010,

the World Health Organization predicted that the number of cancer deaths

worldwide would increase from 7.6 million to 17 million deaths in 2030. In the

Philippines, cancer ranked third in the list of leading  causes of death  in the

country in 2010, with the following as the ten top causes of cancer deaths in the

country for that same year: breast cancer, lung, liver, cervical, colon, thyroid,
 7

rectal, ovarian, prostate, and Non-Hodgkin’s lymphoma. The statistics discussed is

very alarming that merits careful considerations.

Coping and issues concerning adjustment or adaptation to chronic illness

have been typically studied on an individual level, rather than within the context of

the family. Coping is a stabilizing factor that can help individuals achieve and

maintain psychological stability during stressful periods, and it involves cognitive

and behavioral efforts to reduce or eliminate stressful conditions and emotional

distress.

People diagnosed with cancer experience various problems regarding both

their disease and their treatment methods. Families are directly affected by the

change, the physical capability, body functions, appearance, job status, sexual

functions, and roles within the family and society of the patients. The family also

experiences stress when patients cannot cope with the symptoms they are

experiencing. The stress experienced by the family gives rise to the psychological

symptoms such as stress, depression, anxiety, fear, loneliness, psychosomatic

symptoms and marital problems, and physical symptoms such as tiredness,

anorexia, indigestion, constipation, serious sleeping disorders, and pain.

However, at this time, very little is known about the impact of cancer on the

family members of patients with respect to how they cope and perceive their

family environment and family coping styles. Medical and mental health

professionals have begun to realize that cancer impacts not only on patients but
 8

their family members. The impact of cancer on the family members remains a

relatively understudied phenomenon of the little research that has been conducted

examining the families of cancer patients; the majority has focused on the patient

themselves.

The researchers chose to investigate and know the different coping

strategies that the family members use. By exploring these strategies, researchers

may gain greater insight about the ways families are changed through having a

member diagnosed with cancer, difficulties they encounter, stress they experience,

and the coping strategies they employ in dealing with the situation. This

knowledge may then be utilized to promote successful family functioning and

coping throughout the course of the disease.

Researchers focused on the lived experiences in coping of family member

with cancer patients. To have a deep understanding of the lived experiences in

coping among family members with cancer patients, Interpretative

Phenomenological Analysis (IPA) seemed appropriate in identifying the individual

phenomenology. This investigation sought to add literature by examining lived

experiences and coping issues in family members with cancer patients to

determine the problems, stress, and adjustment they encounter throughout the

crisis. This study will be one of the instruments for the people to become aware,

understand, and help those families who have family members diagnosed with

cancer.
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Statement of the Problem

The study aims to add knowledge and understanding about the

phenomenology of the family with cancer patients. Specifically, it sought to

answer the question:

“What are the lived experiences of the family in coping with the situation of

the family member diagnosed with cancer?”

Scope, Delimitation and Limitation of the Study

The purpose of this study was to determine the coping strategies used by

the family members by knowing their lived experiences while the member was

struggling from cancer. The study used a qualitative research design in which the

researchers conducted observations and interviews. The researchers included five

(5) immediate family members from purposively selected families who are taking

care of the cancer patients residing in Batangas.

The scope of this study covered the families who have members that were

diagnosed with cancer and are currently undergoing medical treatments. This

study was delimited to the family having a cancer survivor member and died

because of cancer. This study is limited for those families having a member that is

still undergoing treatment within the area of Batangas province.

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Significance of the Study

The results and findings of this paper are considered significant and will

contribute to the following:

To Batangas State University, the result of the study will help produce

students that will be knowledgeable about the coping strategies that the family of a

cancer survivor used and the life experiences they encountered. This can be done

by making this study accessible in the library.

To the College of Arts and Sciences, this study can be a medium in

conducting extension programs that will help others especially the families who

have cancer patients that do not have enough understanding about coping with the

situation. This study will open the mind of the community on the difficulties they

will encounter and the importance of coping with them.

To health professionals and practitioners, this study will help them be more

aware of what the person with cancer and the family are going through. It will give

more knowledge about the experiences of the family members that can help them

become more effective in dealing with cancer patients and their family.

To the professors and instructors, this kind of study can help them inform

students about the challenges and experiences of the family members regarding

stress they experience that gives psychological symptoms, the crisis they
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encounter in many aspects of their life and how they cope with this situation. They

can be a medium to impart additional knowledge to the students in understanding

of the real situation of a family with cancer patients and how to cope with the

situation.

To the families, this study is a big help to inform them on what is

happening in the family that has this kind of complex human phenomenon. Having

known the difficulty and negative experiences of family with cancer patients, this

study will enlighten their minds on how to deal with, cope with and face the

challenges and have a positive outlook in their lives.

To cancer patients, this kind of situation is hard to deal with but, by means

of this research it will help them enlighten their mind about the importance of

surviving not only for themselves but also for their family.

To Psychology students, this study will be a big help to better understand

the situation of the family while experiencing the struggle and challenges of

having this kind of phenomenon. This study will help them to be more aware and

fully understand the condition of the family that can be an instrument to help them

cope and develop again the family dynamics. This study will help them in their

future practice as a clinical or counseling psychologist.

To future researchers and students, this study will help them be more aware

about the coping strategies that the family uses in order to live well and be the
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strength of the cancer patients. This will help them be prepared in helping others

when they experience the said phenomenon by giving some advice and by

imparting knowledge on how they will cope in this kind of situation.

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CHAPTER II

REVIEW OF RELATED LITERATURE

This chapter presents different authoritative views and research studies

related to the present study. It includes the conceptual literature, research

literature, synthesis, conceptual framework, conceptual paradigm and definition of

terms. These studies gave the researchers more insights, knowledge, and learning

for the expansion and completion of the present study.

The researchers have read and reviewed previous studies and literatures to

have an in-depth knowledge of the coping strategies used by the families with

member diagnosed with cancer.

Conceptual Literature

The researchers sought writings from books, journals, and electronic

sources that helped them understand and finish the study.

Cancer. It is a group of disease characterized by uncontrolled growth and

spread of abnormal cells. If the spread is not controlled, it can result to death.

Cancer is caused by both external factors (tobacco, radiation, and infectious

organisms) and internal factors (inherited mutations, hormones, immune

conditions, and mutations that occur from metabolism). These causal factors may

act together or in sequence to initiate or promote carcinogenesis. The development

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of most cancers requires multiple steps that occur over many years. Certain types

of cancer can be prevented by eliminating exposure to tobacco and other factors

that initiate or accelerate this process. Other potential malignances can be detected

before cells become cancerous or at an early stage, when the disease is most

treatable. Cancer can be treated with surgery, radiation, chemotherapy, hormones,

and immunotherapy (American Cancer Society, 2011).

Cancer as discussed by Freeman (2008) can manifest almost anywhere in

the body, such as the brain, lungs, breast, intestines, bones, liver, stomach, and

skin. Cancer cells grow very fast and take nutrients from surrounding tissue.

Doctors can remove the tumor causing cancer if it has not spread too far. They can

also use drugs, or chemotherapy, and radiation to destroy it. It is difficult to cure

cancer if the cells have spread to the blood or to the lymph nodes that contain

white blood cells or WBC.

Cancer is a disease of abnormal gene function. Genes are segments of DNA

that contain instructions on how to make the proteins that the body needs to

function. They govern hereditary traits, such as hair color, eye color, and height, as

well as susceptibility to certain disease, such as cancer (Calzone, 2004).

There are around 200 different types of cancer. Two in five people, at some

point in their lives, are susceptible to it. Cancer is the term given to a large group

of disease that varies in type and location. It is the result of a continuous, abnormal

and relatively autonomous cell proliferation, which is due to the permanent

 15

alteration of some cells that get transmitted to the cell family. It is a disease caused

by the loss of control over a cell’s reproduction capacity. Rather than dividing in a

controlled and programmed manner, the cell continues to divide and multiply

abnormally, until a detectable lump or tumor develops (Holistic Cancer Cures,

2012).

The first medical document to describe cancer was the Ebers Papyrus,

written around 1500 B.C. The document did not give detailed descriptions of

cancer, only a description of the swellings that accompany tumors. Hippocrates

gave the disorder the name cancer, and the Greek physician, Galen, first used the

word tumor. These ancient physicians did not know much about cancer because

they did not have microscopes or use dissections, two procedures that greatly

facilitate an understanding of cancer (Brannon, 2007).

According to Almilla (2006), cancer is not a single disease, rather, it is

a group of more than 100 diseases all characterized by abnormal and

excessive cell division. A malignant tumor grows rapidly and destroys

nearby tissues in the body and it gives an impression that it is an incurable

disease.

As stated by Kazemi et al. (2013), nowadays, the word “cancer” is

associated with life threat, death, and even avoidance of the disease’s name.

Patients should consider different methods of treatment such as surgery, radiation

and chemotherapy. Even when the treatment is successful, patients live with the
 16

fear of relapse and complications of the treatment. Different methods of treatment

and providing care for patients with cancer can distress the daily life of patients

and affect their quality of life.

Mandal (2000) stressed that there are several methods of diagnosing cancer.

With advances in technologies that understand cancers better, there is a rise of

number of diagnostic tools that can help detect cancers. If a patient is suspected

with cancer, diagnosis is usually made by pathologists and oncopathologists, and

imaging radiologists. Some types of cancer, particularly lymphomas, can be hard

to classify, even for an expert. Most cancers need a second opinion regarding

diagnosis before being sure of the diagnosis or stage and type.

Cancer is a chronic illness leading to a stressful life. The ability of a person

to cope with a cancer diagnosis depends on the patient’s appraisal of the situation

and of the resources available to him or her once dealing with the situation (Martz,

2007).

Cancer is a major life stressor that can disrupt the lifestyles and routines of

all involved. Preexisting factors within the family unit related to life cycle changes

influence the struggle that families face in adjusting to a cancer diagnosis. Most

family members have some on-going life stressors that relate to their role in the

family. For the patient, physical symptoms, changes in responsibilities, financial

issues, and diminished social interactions are factors that contribute to stress.

Families often need to deal with many disease-related stressors in addition to non-
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illness stressors that are part of the developmental life cycle. These age-related

stressors exist concurrently and affect the family’s ability to adjust to illness

(Eggert, 2010).

According to Mandal (2000), there are several methods of diagnosing

cancer. With advances in technologies that understand cancers better, there is a

rise of number of diagnostic tools that can help detect cancers. Once the patient is

suspected with cancer, diagnosis is usually made by pathologists and

oncopathologists, and imaging radiologists. Some types of cancer, particularly

lymphomas, can be hard to classify, even for an expert. Most cancers need a

second opinion regarding diagnosis before being sure of the diagnosis or stage and

type.

Coping Strategies. Coping strategies are efforts to control, reduce, or

tolerate the threats that lead to stress. Humans habitually use certain coping

responses to deal with stress. Most of the time, they are not aware of these

responses - just as they may be unaware of the minor stressors of life until they

build up to aversive levels (Folkman, 2000).

According to Taylor (1998), coping strategies refer to the specific efforts,

both behavioral and psychological, that people employ to master, tolerate, reduce,

or minimize stressful events. Two general coping strategies distinguished:

problem-solving strategies are efforts to do something active to alleviate stressful

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circumstances, whereas emotion-focused coping strategies involve efforts to

regulate the emotional consequences of stressful or potentially stressful events.

Moreover, Davis (2003) stated that coping strategy is a conscious effort to

solve a personal or interpersonal problem that will help in overcoming,

minimizing, or tolerating stress or conflict. People need ways to calm the minds

and bodies after a stressor has taken its toll. The two main categories of coping

strategies are emotion-focused coping and solution-focused coping. Emotion-

focused coping changes a person's emotional response to the stressor. Emotion-

focused coping techniques focused on reducing the negative emotional responses

one might experience because of stressors. Problem-focused coping is about trying

to deal with the stressor itself to avoid the stress response it is causing. Problem-

focused coping involves finding practical ways to deal with stressful situations.

However, according to McLeod (2015), in general people who used

emotion-focused strategies such as eating, drinking and taking drugs reported

poorer health outcomes, such strategies are ineffective as they ignore the root

cause of the stress. The type of stressor, whether the impact was on physical or

psychological health, explained the strategies between coping strategies and health

outcomes. Emotion-focused coping does not provide a long-term solution and may

have negative side effects as it delays the person dealing with the problem.

However, they can be a good choice if the source of stress is outside the person’s

control. In general problem-focused coping is best, as it removes the stressor, so

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deals with the root cause of the problem, providing a long-term solution. Problem-

focused strategies are successful in dealing with stressors such as discrimination,

HIV infections, and diabetes.

It has been established that dealing with highly stressful and traumatic

events, such as cancer, rape and bereavement, can lead to positive life changes,

including enhanced personal relationships, personal changer within the self, and

changes in life philosophy (Ranchor, 2008).

The diagnosis of cancer evokes a profound emotional response, which

patients express in different ways. Some face difficult reality from the outset of

diagnosis and treatment. Many use denial as a coping mechanism and simply

refuse to accept the truth. As evidence of the tumor becomes inescapable, the

patient may develop clinical depression. Family members may express denial in

attempts to cope by encouraging unproven methods of cancer treatment, which can

delay effective care. Some patients cope by intellectualizing about their disease,

enabling them to obscure the reality of the cancer and regard it as unrelated to

themselves. Generally, intellectualization is a more productive coping behavior

than denial because the patient is receiving treatment (Koteckik, 2006).

According to National Cancer Institute (2015), many patients

with cancer rely on spiritual or religious beliefs and practices to help

them cope with their disease. This strategy is called spiritual coping.

Many caregivers also rely on spiritual coping. Each person may have different

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spiritual needs, depending on cultural and religious traditions. For some seriously

ill patients, spiritual well-being may affect how much anxiety they feel about

death. For others, it may affect what they decide about end-of-life treatments.

Some patients and their family caregivers may want doctors to talk about spiritual

concerns, but may feel unsure about how to bring up the subject.

As stated by Reding et al. (2014), cancer treatment has its own stressors,

including treatment challenges, adverse events, and life changes. Promoting

resilience mechanisms during cancer treatment may encourage better adaptation

and other positive psychosocial outcomes during and after treatment. Studies have

suggested that baseline characteristics and resilience mechanisms can affect

patient’s psychosocial functioning.

Family. The family is the most fundamental social group (Dilipchandra,

2012). It is the basic social institution at the very core of the society. The values

institutionalized in the family have long been regarded as important enough to

warrant strong measures against any behavior that violated them. Not only has the

family been defined as fundamental to the existence of society; it has also been

viewed as a source of morality and decent content. Moreover, it has been defined

as a primary force for controlling and civilizing the human animal.

According to Galkwad (2012), man is a social animal and so it is

impossible for him or her to stay alone for a long period of time. One constantly

needs people who can be with him or her; support him or her during tough times;
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and encourage him or her when he or she strides forward in life. Everyone needs

people who can share their happy as well as sorrowful moments, people whom one

can trust and find solace with. These are the people he or she can go to at any point

in time, love them, fight with them, and yet have faith that they never be left alone

until the very end. These are the people he or she shares his or her bloodline with -

his or her parents, children and siblings. They are his or her family.

A family develops a kind of homeostasis – a normal dynamic and routine –

that is disrupted when a member of that family develops a chronic illness. Indeed,

chronic illness changes family members’ roles, responsibilities and boundaries. It

disrupts their self-images and self-esteem. It results in uncertain and unpredictable

future (Lawrence, 2012).

With a cancer diagnosis, Edwards (2004) stated that the whole family is

affected. As family members are likely to be providing care for the patient, family

functioning in providing care for a family member with an illness affects the well-

being not just of the patient, but also of the broader family, including the career.

Nordefeldt (2001) and Schneider (2004) both agree that when one member

of the family is diagnosed with a chronic condition, the family members protect

the sick family member at the expense of their own health. The burden and lack of

freedom in the family member’s everyday lives diminish their chances of realizing

their important goals, which can lead to emotional strain and has the potential to

make them ill. When a family member has to be taken care of, this predisposes the
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family to stress caused by the impact of the illness. Family takes on the

responsibility of caring for the sick member as a task. The family members are not

only the providers, but are also the recipients of care as the patient is in the course

of life.

According to Healthlink British Columbia (2009), caregivers worry about

how they will be able to do all this and how to take care of themselves too. The

caregiver sometimes has to give up social activities and miss work. This can all be

very hard and very tiring in a physical and emotional way for both the caregiver

and the patient. These demands can be especially hard on older caregivers.

People who became caregivers for a sick parent, child or other relative

found that this was likely to take its toll on the relationship with their own partner.

Focusing time and attention on the sick person meant that carers were less

available for the needs of others and less patient than they might have been

otherwise (Health Talk Organization, 2005).

Edwards (2004) emphasized that when someone is diagnosed with a

terminal illness there are likely to be financial implications to cope with. Carers

may give up work to care for their friend or relative, or they may need to pay for

care at home or in a care home. Additional costs of heating bills, food and laundry,

and personal care can all mount up. These extra expenses can create financial

worries and add to the stress that carers and their friend or relative are already

going through.
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Research Literature

This section imparts reviews of related studies from different researchers to

serve as background for the present study.

In the study conducted by Radina (2001), it was found out that families

who are more flexible in modifying daily tasks and who have preexisting

resources for coping with stressors have more positive outcomes than those

families who are rigid and cope with stressors poorly. The Family Adjustment and

Adaptation Response (FAAR) was used to interpret the findings.

Fletcher (2010) identified a number of salient issues that include factors

that assisted or hindered mothers’ abilities to cope. The subthemes of this theme

consist of: (1) support; (2) faith, positive thinking, and hope; (3) taking care of

self; (4) being fearful and protective – keeping family close; and (5) living life –

during and after the diagnosis. This research enabled caregivers of children with

cancer to express their experiences about provision of care and factors that

affected their ability to cope. Health care professionals, particularly pediatric

oncology nurses and social workers, perfectly aligned to help families reduce or

manage the turmoil in families that must cope with diagnosis of pediatric cancer.

In the study of Feyh (2012) found out that pediatric palliative care has

recently become a priority in the health care field. Findings from the data

suggested a process of finding meaning which helps close relatives to let go of

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what they cannot control while holding on to what they can control. Social change

implications of this study may include improving health care programming for

close relatives utilizing supportive – expressive measures.

According to the study conducted by Thastum (2008), it was found that

coping strategies used by the younger generation were helping others,

parentification, distraction, keeping it in the head, and wishful thinking. Both

adaptive and destructive examples of parentification were found. Communication

patterns and parental coping seemed to be highly related to the child’s coping

repertoire. Even though most children seemed to manage rather well, all children

were strongly affected by the illness.

Bjork (2005) found out that families’ lived experience was described as a

two-fold essential theme comprising “a broken life world” and an immediate

“striving to survive.” The families’ secure everyday life disappeared and was

replaced by fear, chaos, and loneliness. When striving to make the child and the

family survive, family members strove to feel hope and have a positive focus, to

gain control, and to feel close to other people.

According to the study of Chan (2016), three main themes emerged from

the data analysis by using convenience and purposive sampling method, which are

Death and Anxiety, Freedom and Responsibility, Meaning and Purpose. Under the

theme Death and Anxiety, Fear of Cancer Recurrence found to be one of the

struggles survivors face. In order to cope with such struggles, the survivors of the
 25

study reported to have a change in lifestyle and preoccupy themselves, which is

under Freedom and Responsibility. Moreover, Positive Thinking, Appreciation of

Life, and Spirituality are the sub themes that emerged from the main theme,

Meaning and Purpose.

The study conducted by Rufino (2004), identified the themes from the data.

First, the respondents seem to be somewhat confused or rather unsure of what their

illness really is. Second, most of the respondents are religious. Third, all had a

support network of family and friends. Fourth, all had a practical approach to their

illness. Fifth, all found time for recreation. Sixth, all of them see breasts as mere

appendage only. Seventh, because of the side effects, they could not do the things

that they used to do. Eighth, most of the respondents feel that there was a change

in the way they communicated. Ninth, most respondents are worriers. Lastly, all of

them saw a benefit from their illness.

On the other hand, Chan (2011) found out that there were various

challenges encountered by the patients in their physical, emotional, religious,

social support, and religious coping. The whole experience of cancer brought

positive and negative outcomes.

Savella (2010) revealed that a multidimensional coping inventory was

developed to assess the different ways in which people respond to stress. There are

five scales of four items of which measures conceptually distinct aspects of

problem-focused coping: active coping, planning, suppression of competing

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activities, restraint coping, seeking of instrumental social support. There are also

five scales that measure aspects of what might be viewed as emotional focused

coping: seeking of emotional support, positive reinterpretation, acceptance, denial,

turning to religion. Additionally, there are three scales that measure coping

responses that are less useful: focused on venting of emotions, behavioral

disengagement, and mental engagements.

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Synthesis

This part presents an overview of the similarities and differences of the

present study to the above-mentioned studies. It provides support to the studies

that there is a need to recognize the necessary strategies that the families used in

coping with the situation.

In the study of Radina et al. (2001), it was found out that families who are

more flexible in modifying daily tasks and who have preexisting resources for

coping with stressors have more positive outcomes than those families who are

rigid and cope with stressors poorly. The studies were similar in terms of

methodology used, which is qualitative approach; variables and respondents used

which were families; and coping with the stressors like chronic illness. However,

this study focused on a specific type of cancer which is breast cancer while the

present study did not.

The study conducted by Fletcher et al. (2010) was similar to the present

study in terms of using interviews and observation as instruments in gathering data

from the respondents. This study identified the factors that assisted or hindered

mothers’ abilities to cope which consist of five sub themes while the present study

identified six major themes.

While the present study administered an in-depth interview with a semi-

structure questionnaire, Feyh et al. (2012) used Semi-structured interviews and

 28

journaling to collect data. This study found out that pediatric palliative care has

recently become a priority in the health care field.

The study of Thastum (2008) identified five coping strategies used by the

younger generation that are helping others: parentification, distraction, keeping it

in the head, and wishful thinking while the present study identified fivecoping

strategies that are emotional disguise and regulation, stress eating resulting to

weight gain, optimism and intellectualization, belief in spiritual healing and

resiliency. However, this study focused on the children of families with parent

having cancer while the present study focused on any family member with cancer

patient.

The present study and the study of Bjork et al. (2005) were quite similar in

using phenomenology research method in knowing the lived experiences of the

respondent. Both studies gathered data on the families having a cancer patient but

this study particularly focused only to the child diagnosed with cancer while the

present study focused on any member having cancer. This study found out that

families’ lived experience described as a 2-fold essential theme comprising “a

broken life world” and an immediate “striving to survive.” The families’ secure

everyday life disappeared and was replaced by fear, chaos, and loneliness.

Chan (2011) conducted a study that focused on the various challenges

encountered by the patients in their physical, emotional, religious, social support

and religious coping. The present study was similar on the instrument used in
 29

gathering data, which was In-depth interviews using open-ended questions. This

study found out that the whole experience of cancer brought positive and negative

outcomes.

The present study and the study of Rufino et al., (2004) were also similar

on the instrument used in gathering data. They both used semi-structured

questionnaire with an in-depth interview. The previous study analyzed the

gathered data by looking for themes, which the present study also used. This study

identified ten themes that brought them the result of the study while the present

study looked for themes in six cases. However, studies differed in terms of

methodology used; the present study used Interpretative Phenomenological

Analysis while the previous study used descriptive research design.

Chan (2016) also conducted a study which was similar to the present study

in terms of respondents. Both used cancer survivors. The study focused on the

struggles, coping, and perception of young cancer survivors that brought three

main themes which are Death and Anxiety, Freedom and Responsibility, Meaning

and Purpose.

The study conducted by Clanor et al. (2013) focused on the families of

cancer patient, which was similar to the present study. However, both studies

differed in the methodology and gathering of data. The present study used a

qualitative approach and an open-ended interview while this study used a

quantitative approach and a written questionnaire on data gathering.

 30

The study of Savella (2010) determined the two categories of coping

mechanisms, which are problem – focused and emotional – focused coping while

the present study identified six coping strategies. This study developed a

multidimensional coping inventory. However, this study determined result by

using a descriptive – correlational research design with 34 respondents by giving

questionnaire checklist while the present study used a qualitative research design

and chose 5 respondents purposively.

Theoretical Framework

Lazarus (2002) classified coping theory into two parameters: (a) trait-

oriented versus state oriented and (b) micro analytic versus macro analytic

approaches (Krohne, 1996). Trait-oriented and state-oriented research strategies

have different objectives. The trait-oriented (or dispositional) strategy aims at

early identification of individuals whose coping resources and tendencies are

inadequate for the demands of a specific stressful encounter. Research that is state

oriented, which centers around actual coping, has a more general objective. This

research investigates the relationships between coping strategies employed by an

individual and outcome variables such as self-reported or objectively registered

coping efficiency, emotional reactions accompanying and following certain coping

efforts, or variables of adaptational outcome (e.g., health status or test

performance). This research strategy intends to lay the foundation for a general

modificatory program to improve coping efficacy. Micro analytic approaches

 31

focus on a large number of specific coping strategies, whereas macro analytic

analysis operates at a higher level of abstraction, thus concentrating on more

fundamental constructs.

One example of state-oriented micro analytic approach was Freud’s classic

defense mechanism. Although Freud distinguished a multitude of defense

mechanisms, in the end, he related these mechanisms to two basic forms:

repression and intellectualization. The trait-oriented correspondence of these basic

defenses is the personality dimension repression–sensitization. The distinction of

the two basic functions of emotion-focused and problem- focused coping proposed

by Lazarus and Folkman (1984) represents another macro analytic state approach.

Lazarus and Folkman distinguished eight groups of coping strategies:

confrontative coping, distancing, self-controlling, seeking social support,

accepting responsibility, escape-avoidance, planful problem-solving and positive

reappraisal. The coping theory of Lazarus seemed appropriate to serve as a basis in

analyzing the experiences of family members with cancer patients in coping with

the situation.
 32

Conceptual Paradigm

This part presents the researchers’ concepts and their ideas about the entire

study. It consists of the input, process and output of the study.

Input Process Output

The lived
000 In-depth interview Recommendations
experiences of
and Interpretative of the study to the
family in coping to
Phenomenological families having a
the situation of the
Analysis used to member diagnosed
member diagnosed
gather information. with cancer
with cancer.

Figure 1
Research Paradigm of the Study
 33

Definition of Terms

The following terms are significantly used in the present study and this

section shows their conceptual and operational definition.

Cancer. Cancer, also called malignancy, is an abnormal growth of cells. There

are more than 100 types of cancer including breast cancer, skin cancer, lung cancer,

colon cancer, prostate cancer, and lymphoma. Symptoms vary depending on the type

(WebMD, 2017). Cancer is the kind of illness the study had focused, specifically, on

how family members cope in dealing with cancer patients.

Cancer Patients. In this study, they are the ones who are currently undergoing

medical treatments to fight their disease. According to Cancer Institute (2005), cancer

patients are the persons who are diagnosed with any kind and stage of cancer.

Coping Techniques. It is the effort to control, reduce, or tolerate the threats

that lead to stress known as coping. People habitually use certain coping responses

to deal with stress. Most of the time, people are not aware of these responses-just

as they may be unaware of the minor stressors of life until they build up to

aversive levels (Folkman, 2000). The coping techniques in this study are

emotional disguise and regulation, stress eating resulting to gaining weight,

optimism and intellectualization, belief in spiritual healing, and resiliency which

the family members used to cope with the situation.

 34

Closer Family Relationship. In this study, it is the frequent communication

and moral support given by the family member to the ill member. According to

Ranchor (2008), it has been established that dealing with highly stressful and

traumatic events, such as cancer, rape and bereavement, can lead to positive life

changes, including enhanced personal relationships, personal changes within the

self and changes in life philosophy.

Difficulties Encountered by the Family Members. Healthlink British

Columbia (2009) pointed out that caregivers worry about how they will be able to

take care of the patient and how to take care of themselves at the same time. The

caregiver sometimes has to give up social activities and miss work. This can all be

very hard and very tiring in a physical and emotional way for both the caregiver

and the patient. In this study, it is the different struggles that the family members

encountered while facing this complex phenomenon.

Family. Family is a group of persons united by the ties of marriage, blood

or adoption; consisting of a single household, interacting and inter-communicating

with each other in their respective social roles of husband and wife, mother and

father, son and daughter, brother and sister creating a common culture (Shah,

2016). In this study, the family of the cancer patient was the focus as the

respondents of the study.

Medical condition reassurance. Mandal (2000) listed several methods of

diagnosing cancer. With advances in technologies that understand cancers better,

 35

there is a rise in number of diagnostic tools that can help detect cancers. Once

suspected, diagnosis is usually made by pathologists and oncopathologists and

imaging radiologist. Most cancers need a second opinion regarding diagnosis

before being sure of the diagnosis or stage and type. In this study, it refers to the

different laboratory tests and treatments that are given to the cancer patient.

Reciprocal Altruism. People with altruistic personalities tend to show

empathy and sympathy for others and feel that it is appropriate and right to follow

the norm of social responsibility. These people help more people in a wider variety

of areas, including providing help to co-workers, donating organs, and

volunteering, and also have been found to help more quickly than those people

who score lower on these measures (Penner, 2002). Reciprocal altruism in this

study refers to the learned value of extending help of the family members.

Support to patient. Most patients have families that are providing some

levels of care and support. In the case of older adults and people with chronic

disabilities of all ages, this “informal care” can be substantial in scope, intensity,

and duration (Given, n.d.). The support to patient in this study refers to the ones

that the family members did and experienced while taking care of the ill family

member.
 36

CHAPTER III

RESEARCH METHOD AND PROCEDURE

This chapter provides a brief description of the method of research, the

respondents of the study, data gathering instruments, and interpretative

phenomenological analysis.

Research Design

This study utilized a qualitative research design to gain insight and explore

the depth and complexities inherent in the phenomenon. A qualitative research is

probably the most flexible of the various experimental techniques, encompassing a

variety of accepted methods and structures.

To further understand the experience of family members with cancer

patients, an interpretative phenomenological analysis (IPA) was employed. Smith,

Larkin and Flowers (2009) argue that interpretative phenomenological analysis

(IPA) is “committed to the examination of how people make sense of their own

life experiences.” This approach accepts researchers’ views and interactions with

participants that influenced the data and the subsequent interpretation of the

account. The systematic process towards analysis was well covered and utilized a

form of annotating issues and then labeling themes. The analysis then becomes

structured around clusters and themes representing participant’s meanings. This

theoretical approach allowed the researchers to deeply understand the world of

 37

family members with cancer patient, revealing patterns of meaning in their

thoughts, feelings, and behaviors that shape their experience in coping. In a sense,

integral to this approach is a holistic and unified understanding of a person

showing how family members make sense of their experience with the coping and

how they deal with the everyday practical concerns having this psychological

maladjustment.

IPA has assumptions, namely phenomenology, and hermeneutics.

Phenomenological research is the study of lived experience. It is the study of

the life world - the world as people immediately experience it rather than as

people conceptualize, categorize, or theorize about it. Phenomenology seeks to

come to deeper understanding of the nature or meaning of everyday experiences

(van Manen, 1990). In this study, it was used to describe in details experiences of

the family members of patients diagnosed with cancer and the battle they

encounter as they go through the illness.

IPA is highly associated with hermeneutics or the process of meaning

making (Smith, 2007). It acknowledges the role of the researcher’s interpretation

in understanding a participant’s experiences. However, it moves beyond a one-

sided interpretation of the researcher into a reflexive stance vis-a-vis a

participant’s own process of meaning-making. Smith and Osborn (2009) explained

that “IPA combines an emphatic hermeneutics and a questioning hermeneutics”

(p.53). This means that IPA follows a two-step interpretative activity. On one
 38

hand, the researcher’s task is concerned with trying to understand the point of

view of the participant, i.e. to empathize with the participant’s experience of

illness. On the other hand, the researcher was also critical of what the participant

was saying or not saying (may be less aware of), i.e. to make sense of the

participant’s experience of illness.

Respondents of the Study

The participants of the stud y were five (5) selected family members with

cancer patient undergoing treatment by using non - probability sampling method

in Batangas area. This kind of sampling method used the purposive sampling to

identify families with cancer patient. Alternatively, this sampling method may

prove to be effective as only limited number of people can serve as primary data

sources due to the nature of research design and objectives.

This study’s participants will be from a purposive sample. A purposive

sampling selects respondents based on characteristics of a population and the

objective of the study. Purposive sampling is also known as judgmental, selective,

or subjective sampling. This type of sampling can be very useful in situations

when you need to reach a targeted sample quickly, and where sampling for

proportionality is not the main concern (Cole, 2017).

Participant’s age, sex, and religion were not limited in this study. Any

family member of the cancer patient was considered. Informed consents were
 39

being sought from the participants and their family/caregiver. Full disclosure of

information, background and demographics were likewise withheld. The

researchers had taken reasonable steps whenever they foresee any kind of harm to

research participants. Their utmost sincerity in answering the question on the

conducted in an in-depth interview helped a lot in analyzing the participants’ life

experiences. They were assured that all information gathered will be kept

confidential and will be used for research purposes only.

Data Gathering Instruments

The researchers used an in-depth interview and observation in gathering

information. This study conducted interview with families in the partially

structured manner, described as “the area is chosen and the questions are

formulated but order is up to the interviewer. Interviewer may add questions or

modify them as deemed appropriate. Questions are open ended and responses are

recorded nearly verbatim, possibly taped.

Krathwohl (1998) stated that no interview succeeds unless interviewer

builds a relationship with the respondent in which both are comfortable talking

with one another.

In this study, interviews were taped and fully transcribed as the purpose of

taping and transcription was to have the discussions available to the researcher for

considerations of key words, phrases and ultimately, essences. The

 40

phenomenological interviewer, if truly wanting to go beyond asking questions to

record answers, is required to attempt to enter the life-world of the interviewee

(Lake, 2006).

The interview was guided by questions in understanding the situation, lived

experiences and coping strategies of the participants. The researchers likewise

thoroughly observed and analyzed the research participants’ experience and

situation. These were essential in interpreting their responses. All the responses,

answers, and information gathered were held and treated with utmost

confidentiality by the researchers.

Data Gathering Procedures

The researchers made a preliminary draft of the guide questions and

presented them to the thesis adviser for suggestions and corrections. The questions

focused on the lived experiences of the family in coping with the situation of the

member diagnosed with cancer.

It is deemed important to establish trust and rapport with the family

members participating in the interviews. The researchers presented the informed

consent to the family members, explained to them the purpose of the study and

asked for the permission for the researchers to conduct an in-depth interview. The

researchers assured that the information gathered were confidential and they

would not be forced to answer the questions they are uncomfortable with.
 41

The researchers asked if they could schedule the interview. The interview

process was conducted on the participant’s house. The family member alone was

present with the researchers. The researchers allotted enough time to interact and

get to know the participants in order to establish rapport with each other. The

conversations were recorded as per the permission of the participant. After the

interview, the researchers retrieved the data gathered and transcribed them in

details. The researchers then interpreted and analyzed the data gathered.

Data Analysis

The data gathered were analyzed through the use of Interpretative

Phenomenological Analysis which has the following steps:

The first step of the analysis is looking for themes in the first case. This

involves a detailed reading and rereading of the transcripts and a free textual

analysis to allow salient themes to emerge. The second stage involves connecting

the themes. This layer of analysis aims to produce initial lists of themes, a

clustering of themes into higher-order or superordinate themes, and a table of

superordinate themes and sub-themes. The analysis at this stage is checked with

the data. The third stage is analysis of other cases. Convergences and divergences

across cases are then identified towards developing the final set of superordinate

themes. The fourth and the last stage is the writing up of the narrative account

where themes are explained and illustrated. Throughout the analysis, the
 42

researcher engaged in an interactive process of going back and forth from analysis

to text to ensure the validity of the analysis (Canoy & Olfreneo, n.d.).
 43

CHAPTER IV

PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA

This chapter contains presentation, analysis, and interpretation of the

yielded research findings and results. It also includes the participants’ personal

background.

Personal Background

Participant 1 is 23-year old female, single, and residing at Sta. Maria, Sto.

Tomas, Batangas. She is a Roman Catholic and currently works as a clerk at

Tanauan City Hall. Her mother, 62 years old, was diagnosed with stage 1 breast

cancer last June 2017. She is the only child of her parents and the one taking care

of her mother after her father died in 2016.

Participant 2 is a 44-year old male, a Roman Catholic residing at Poblacion

7, Talisay, Batangas. He is married with four children and works as a welder. His

wife, 45 years old, was diagnosed with stage 2B breast cancer last November 2016

and still undergoing treatment and chemotherapy.

Participant 3 is a 24-year old female, single, and residing at Luta Sur,

Malvar, Batangas. Her family is a Roman Catholic. Her mother was diagnosed

with lymphoma last April 2017 and still undergoing treatment and chemotherapy.

She is the youngest child of her mother so she decided to resign from her previous

job as an administrative staff to take care her mother.

 44

Participant 4 is a 27-year old male, single, and residing at Malaking Pulo,

Tanauan City, Batangas. He is a Roman Catholic. His mother, 50 years old, was

diagnosed with stage 2B breast cancer last June 2017 and still undergoing

treatment and chemotherapy. His mother is a teacher. He is the eldest among six

children so he decided to resign from his previous job as restaurant supervisor in

Silang, Cavite to take care his mother.

Participant 5 is a 27-year old female, residing at Trapiche 4, Tanauan City,

Batangas. Her family members are Latter-Day Saints (Mormons) believers. She is

married and has 4 children. She graduated last June 2017 with a degree of BS

Secondary Education as a Cum Laude. She is an online entrepreneur. After of

series of tests and several opinions from different hospitals her second daughter, 8

years old, was diagnosed with Wilms tumor (cancer of the kidney) last September

2017 and still undergoing treatment and chemotherapy.

Personal information are limited because the ethics review board advised

the researchers not to dig too much of their personal lives for their privacy.

To answer the research question, “What are the lived experiences of the

family in coping with the situation of the member diagnosed with cancer?”

Interpretative Phenomenological Analysis was employed. Among the five

 45

participants interviewed, the account of Liz (not her real name) is presented as the

idiographic case illustration. Data analysis established six higher-order themes that

captured family’s lived experiences with cancer patient. Synthesis table is

presented to visualize the emerging superordinate and sub-themes across cases

(see Table 2). These themes are then illustrated using Liz’s ideographic account.

Table 2. MAJOR THEMES AND SUB-THEMES

Major Themes Sub – themes

1. Medical condition reassurance - Underwent series of tests to

confirm diagnosis

- Supported patient for

chemotherapy treatment and
removal of tumor.

2. Difficulties Encountered by the - Lessened socialization and

Family Members recreational activities
- Neglected other family
members
- Unattended other duties and
responsibilities
- Found alternative source of
income
- Sought financial support from
the government’s medical
assistance programs (DOH,
DSWD, and PCSO)
- Asked help from relatives

3. Support to patient - Gave up work to attend to the

patient’s needs
- Experienced compassion fatigue
- Provided all the patient’s needs
 46

and requests
- Imposed discipline in the
lifestyle of the patient

4. Closer Family Relationship - Frequent communication

- Moral Support

5. Coping Techniques - Emotional disguise and

regulation
- Stress eating resulting to weight
gain
- Optimism and
intellectualization
- Belief in Spiritual Healing
- Resiliency

6. Reciprocal Altruism - Learned the value of extending

help to others

The synthesis table explains the lived experiences of family members with

cancer patients. The experiences of family members are clustered on six major

themes: (1) Medical condition reassurance (2) Difficulties Encountered by the

Family Members (3) Support to patient (4) Closer Family Relationship (5) Coping

Strategies (6) Altruism. The first major theme stated how the family members

confirmed the cancer diagnosis and how they supported the patient through

chemotherapy treatment and removal of tumor. The second major theme is about

the difficulties encountered by the family members which include lessened

socialization with other people; neglected other members of the family; unattended

duties and responsibilities because they were focused on taking care of the patient;

found alternative source of income to support the financial needs of the patient
 47

during their medication; sought help from the government for the chemotherapy,

surgical operations and medicines of the patient; and asked help from their

relatives. The third major theme is about supporting the patient. The family

members gave up their work to have more flexible time in taking care of the

patient. They experienced compassion fatigue; provided the patient’s needs and

requests; and imposed discipline on the lifestyle of the patients. The fourth major

theme covers the situation that brought the family to become closer. The fifth

major theme is about how the family members coped with the situation. Lastly, the

sixth major theme discussed how they learned the value of sharing despite of their

situation.

Medical Condition Reassurance

Underwent series of tests to confirm diagnosis. Before the official

diagnosis, Liz’s family required her daughter to undergo several tests such as CT-

Scan and biopsy to ensure accurate diagnosis. The result showed that her daughter

was diagnosed with Stage 3 cancer and after the second opinion and retesting of

procedures at the Philippine General Hospital the result showed that the cancer has

spread on the lungs, pelvis, and the backbone and finally was diagnosed with

Stage-4 Wilms tumour or the cancer of the kidney.

“Yun nga eh, actually maraming tests na nagpapakita ng sign

na may ganyan syang sakit pero yung official diagnosis, last
Thursday (October 26, 2017) lang din nung nagpunta kami dun,
yun, dun lang din ang official diagnosis. Kasi sa PGH namin sya
 48

dinala pag dinala nyo doon ire-review ulit nila, hindi sila umaayon
sa test na nagawa ng ibang doctor, kailangang makasigurado sila
inuulit nila lahat, inulit ang CT-scan yung biopsy pinakuha samin
ung sample dun sa ospital yung nakuha sa kanya na specimen ni-
review ulit nila and then dun sila nagbigay ng diagnosis and
pagdating namin dun ang diagnosis na sa kanya ay stage three na
and then mabilis syang nai-akyat sa stage four kasi nung lumabas
na yung resulta nung pinaulit nila na test nakita nila na meron na sa
baga, meron sa pelvis sa backbone, yun na nga kalat na kaya stage
four.”

What Liz’s family underwent can be seen from what Mandal (2000)

mentioned about diagnosing cancer. There are different diagnostic tools that can

help detect cancer and as soon as it is suspected, diagnosis will be made by

pathologists, oncopathologists and imaging radiologists. There are types of cancer

though that are hard to classify like lymphomas. Classification becomes difficult

even if they are made by experts. Most cancers need a second opinion regarding

diagnosis before being sure of the diagnosis or stage and type.

Supported patient for chemotherapy treatment and removal of tumour.

Despite the danger and effects of chemotherapy and surgical operations, Liz’s

daughter started a series of chemotherapy sessions. Although there is no assurance

whether her child would be cancer – free or not, they still let her daughter undergo

chemotherapy to reduce the tumor size and to prevent from cancer cells from
 49

spreading to other parts of the body. Eventually, her daughter will be subjected for

operation to completely remove the tumor.

“Ano yang chemotherapy nagstart sya last Thursday

(October 26, 2017) tapos ang isang cycle isang confinement kasi
nun isang cycle ang tawag, tatlong chemo na gamot ang binigay sa
kanya then pahinga after three weeks then balik ulit dun continuous
lang. (How many sessinos will the patient undergo?) di pa masabi
kasi yan kasi ang di masabi pag cancer e kung hanggat nandon pa
ano yung cancer cells e di tuloy kung kailangang operahin may
bukol kagaya ng kanya may bukol pag napaliit na nung chemo o-
operahan tatanggalin tapos io-observe uli.”

What the family did to support the cancer patient is supported by what

Kazemi et al. (2013) revealed that different methods of treatment such as surgery,

radiation and chemotherapy should be considered. It can also be seen from the

interview that daily life as well as the quality of life of the family and the patient

are affected. Different methods of treatment and providing care for patients with

cancer can distress the daily life of patients and affect their quality of life. Even

when the treatment is successful, patients live with the fear of relapse and

complications of the treatment.

Difficulties Encountered by the Family Members

Lessened socialization and recreational activities. After Liz’s daughter

was diagnosed with Stage-4 cancer, their life really changed a lot. They are not
 50

able to do the things that they used to do such as family bonding activities. Their

socialization and recreational activities were very much affected.

“Totally ano, hindi mo magagawa lalo’t hindi kaya ng

pasyente namin, kasi kami mahilig kami pumasyal kaya nga may
tricycle kami, mahilig kaming gumala, punta dito, dalaw sa kamag-
anak, tapos sa park dyan sa may simbahan kasi kapag hindi namin
kayang isama ang anak naming pasyente, hindi kami naalis,
syempre ayoko, gusto nga nya mag swimming e kaya lang hindi
naman nya kaya hindi namin magawa, yun hindi kami
nakakapasyal, sa bahay lang”

It shows that even if family members wanted to continue the usual way of

life, hindrances arise. It was supported by Healthlink British Columbia (2009)

which mentioned that caregivers worry about how they will be able to take care of

the cancer patient and to take care of themselves. The caregiver sometimes has to

give up social activities and miss work. This can all be very hard and very tiring in

a physical and emotional way for both the caregiver and the patient. These

demands can be especially hard on older caregivers.

Neglect of other family members. Because Liz’s ill daughter needs most of

her time and attention, her eldest daughter somehow feels neglected. She is unable

to do the things that she used to do to their family especially to her other children.

She misses their old life very much.

“Yung panganay ko nga di ko alam kung papaano pa

nakakapasok mag-isa ‘yun gigising nalang kami magpapaalam na
 51

yun papasok na pero kagaya nyan active din ‘yun sa school kagaya
nitong may sakit kong anak, so may sayaw sila, hindi ako nakaka
attend yung kapatid ko yung na-attend sila ang nag-aayos ng
gagamitin so ano nagtatampo yun tapos nagtatampo na yung
panganay ko kasi hindi namin sya napapanuod pero, napapaintindi
naman namin sa kanya so yun pag maguusap kaming mag-asawa
parang nakakamiss yung dati naming buhay na papasok ang mga
anak ko aawas magagalit kasi kalat ang pinaghuraban, sana pala
ganun nalang sana hindi na ganito.”

It was emphasized by Health Talk Organization (2005) that people who

became caregivers for a sick parent, child or other relative found that caregiving

was likely to take its toll on the relationship with their own partner or other loved

ones. Focusing time and attention on the sick person meant that carers were less

available for the needs of others and less patient than they might have been

otherwise.

Unattended other duties and responsibilities. Liz graduated from college

last June 2017 but was unable to take the board examination for teachers as

planned. She was not able also to attend her online shop and her responsibility as

PTA officer and over-all DepEd secretary either. Her focus is on her ill daughter

all the time.

“Kaga-graduate ko lang kasi ng college kahit may anak ako

pumasok ako, nag-aaral ako, last June lang ako grumaduate 2017.
Nag-aaral tapos may online shop ako, malakas din yun kaya ang
time ko dun na nauubos and then sa mga bata pero mas takaw oras
 52

talaga nung nag-aaral ako tapos yung business ko tapos PTA din
ako dito sa school ng anak ko tsaka overall ng buong DepEd,
secretary ako, kaya parang yun parang hindi ko sila masyadong
natutukan, gusto ko kaya lang andaming umaagaw sa time ko.”

Found alternative source of income. Since the family needs more financial

resources due to increasing expenses for medicines and treatment, Liz and her

family need to find other sources of income. The family use all the resources that

are available to provide their financial needs. They are thinking of tricycle driving

as alternative to her husband’s previous job and online shop for Liz. These jobs

would give them earnings and at the same time they can look after their sick child.

“So yun ang plano namin since may tricycle kami nagkataon
yung binili naming tricycle may linya, and then ako plano kong
bumalik muna sa online shop ko since three weeks pa naman bago
sya uli maconfine sa second cycle ng chemo.”

Sought Financial Support from the government’s medical assistance

program (DOH, DSWD, and PCSO). Government health programs are a big help

for them to support the medication and treatment of their ill child, thus, their

financial difficulties are aided. Through the mandate of President Rodrigo Roa

Duterte to the Department of Health, all indigent families with children who are

diagnosed with cancer are treated for free at Philippine General Hospital and other

public hospitals.

“Okay ito kasi sa chemotherapy fortunately talaga dahil nung

naupong presidente daw si, di ba sa PGH kami Manila, magastos
 53

daw talaga yan umaabot ng 500K ang bill pag nagke-chemo ka pero
fortunately nang naging presidente si Digong, sa mga bata cancer
ng mga bata, sinagot nya ang pagpapagamot, so naglagay ng DOH
sa PGH, may DOH dun Department of Health, i-interviewhin ka
pag ikaw ay magulang ng cancer patient or kamag anak i-
interviewhin ka then i-issuehan ka ng white card katunayan na
indigent ka na hindi mo kaya, sabagay kahit naman may trabaho ka
di mo talaga kakayanin kasi mapapatigil ka sa trabaho, sunod ang
mahal ng chemo hindi mo rin kakayanin kaya nung nabalitaan
namin yun, edi dinala namin dun ininterview kami nakapasa naman
kami nabigyan kami ng white card and then kasi iyan maraming
yang series of confinement habang nagcchemo ibig sabihin series of
bayarin din kung hindi naging presidente si Digong pero dahil may
bigay sya pag may white card ka maddischarge ka sa unang cycle
kunyare naconfine ka punta ka lang sa DOH dadalhin mo dun
bibigyan ka nila ng biling makikita mo sa amin ay umabot sya ng
35K imagine nyo yun kung walang Digong kung walang white card
edi DOH tas yun wala ka talagang babayaran as in zero ang
babayaran mo lang dun pagkain pero kami babago palang yung
pagpapagamot hindi mo na masyadong problema yung gastos
nalang sa araw araw.”
Montales (2011) reported that the Department of Health recently launched

the Breast Cancer Medicine Access Program that offers financially challenged

patients diagnosed with breast cancer stages 1 to 3A free chemotherapy from

beginning to end. The patient should be Philhealth-subscribed or endorsed by the

Department of Social Welfare and Development. Final screening for patients to be

qualified is done by the patient navigators of Philippine Cancer Society.

 54

The free treatment is for anyone in the country who meets the screening

requirements, but the chemotherapy can only be administered in the following

Metro Manila hospitals: East Avenue Medical Center, José Reyes Memorial

Medical Center, Philippine General Hospital and Rizal Medical Center. This is a

pilot program which the DoH hopes to expand. It is on a first-come, first-served

basis.

Under this PCSO program, medical assistance is given to individual patient

through the issuance of guarantee letters to hospitals where the patients are

confined. A guarantee letter is a certification issued to hospitals for a particular

charity patient under the PCSO medical assistance program where the agency

assumes the obligation of settling the cost of hospitalization, including the

medicines, medical, surgical or blood supplies, and diagnostic procedures

(Philippine Cancer Organization, 2008).

The Department of Social Welfare and Development on December 27,

2016 announced that indigents from five regions will be given free medical

assistance courtesy of President Rodrigo Duterte's social fund. Under

Memorandum Circular No. 16, DSWD field offices in Regions III, VI, VII, XI,

and the National Capital Region have been directed to provide medicine assistance

to indigent patients or clients, pending Malacañang’s P1 billion fund transfer

(Roxas, 2017).
 55

Asked help from relatives and friends. They sought help from their

relatives, friends, and church mates. These kind-hearted people responded to them

and gave them grocery and cash.

“Ang ginawa namin nagmessage kami sa mga kamag-anak

namin, sa kakilala, kaibigan, luckily naman simbahan namin
nagrespond agad nagbigay samin ng grocery na marami, pagkain
binigay nila samin yung mga kamag anak namin nagbigay ng pera.”

Support to patient
Gave up work to attend to the patient. When someone in the family is

diagnosed with cancer, the other family members need a lot of time to take care of

the ill family member. Liz`s husband had to give up his regular job to have

flexible time with his family, especially her daughter. He must be available

whenever she needs her during check-up or hospital confinement.

“So yun ang plano namin since may tricycle kami nagkataon
yung binili naming tricycle may linya, mamamasada muna ang
mister ko kasi nagresign sya sa trabaho para hawak nya ang oras,
so yun mamamasada muna sya, and then ako plano kong bumalik
muna sa online shop ko since three weeks pa naman bago sya uli
maconfine sa second cycle ng chemo.”

It was observed according to Edwards (2004) that when someone is

diagnosed with a terminal illness there are likely to be financial implications to

cope with. Carers may give up work to care for their friend or relative, or they may

need to pay for care at home or in a care home. Additional costs of heating bills,
 56

food and laundry, and personal care can all mount up. These extra expenses can

create financial worries and add to the stress that carers and their friends or

relatives are already going through.

Compassion Fatigue. Liz experienced stress while taking care of her ill

daughter but still she has to attend to and provide for the needs of her other

children. Eventhough she is satisfied that she can still perform her role as a mother

to all her children and taking care of her ill daughter, she is still a human that can

feel stress and exhaustion.

“Parang stress sa pag-aalaga nung anak ko, gusto ko yung

ginagawa ko kaya lang syempre nakakastress yun. Tapos pag-uwi
syempre pagod na pagod ka pa pero kailangan atupagin mo rin
yung dalawa mong naiwan na anak tapos maya’t maya balik balik
sa ospital. Yun yung buhay namin ngayon na naka focus muna dun
sa isa na may sakit.”

Givens (2011) emphasized that the impact on psychological health of

family caregivers has been a common area identified as negative as a result of

caregiving. This is an area commonly discussed in research studies, but is not an

area where much formal effort or programs has been directed to support family

caregivers. Issues discussed in the area of psychological health by family

caregivers include anxiety, worry, burden, depression, and anger. Most of the

literature is on anxiety, depression, and burden. Descriptions are beginning to

 57

mention compassion fatigue and post-traumatic stress as psychological health

concerns for family caregivers; especially family caregivers of hospice patients. 

In addition, Hodges et al. (2005) found that family caregiver's responses to

cancer were interdependent and affected each other's emotional well-being. Early

interventions are recommended for family caregivers to prevent later

psychological distress.

Provided the entire needs and requests of the patient. Although Liz

sometimes feels like losing her temper for the attitude of her child, she seems to

understand her by reminding herself of her condition. Despite the situation, stress

and problems it brings, she always provides anything that her daughter requests.

“Kailangan lagi ka nasa tabi nya kasi nire-request din nya

na gusto lagi nasa tabi kami tapos sya in pain kasi sya masakit ang
likod masakit ang, kinuhanan kasi sya ng bone marrow sample nito
lang isang araw lang, kaya siguro ano ang sakit padin, kailangan
nasa tabi ka lagi, kailangan, mahina ang boses nya eh pag
nagsasalita kasi hindi sya makapagsalita ng ayos kasi nanghihina
nga sya, kailangan pakinggan mo agad, gawin mo agad ang gusto
nya kasi mainit ang ulo, kahit naman sinong may nararamdam
mainit ang ulo at hindi naman nya ginusto na uminit ang ulo nya
talaga lang automatic yun pag may nararamdaman ka talaga
automatic iinit ang ulo mo, pag may hindi ka nagagawa sisigawan
ka talaga, minsan kahit iniintindi mo minsan nakakaano na, parang
kasi laging galit sayo, ginagawa mo naman ang lahat, nakakapikon
na, nakakasagad na, pero lagi mong ibabalik sa isip na,
 58

nahihirapan ‘tong anak ko e hindi naman nya ginusto ‘to e, kung

wala syang sakit hindi naman yan ganito lagi ‘tong nasa labas
maglalaro at tsaka pagbigyan na kasi may sakit ‘tong nai-stress ‘to
sa sakit nya e tayo naman wala di ba, bakit tayo mai-stress kung ba
ga kung iyon ang maitutulong natin sa kanya, kung iyon ang
makakagaan ng loob nya e gagawin”

Imposed discipline on the lifestyle of the patient. The chemotherapy kills

both the cancer cells as well as the good cells that could lead immune system of

the patient to become vulnerable. That is reason the patient’s environment should

always be disinfected and free from germs because the patient’s body does not

have enough strength to fight those. The patient is fed by nutritious food like

vegatables and protein-rich foods for her to become healthy.

“Kailangan malinis ang paligid nya, kailangan laging nadi-

disinfect pati sahig, pati kama kasi nagcchemo bumababa ang
resistensya, so kailangan malinis na malinis, tayo kaya nating i-
tolerate ang bacteria pero pag tayo napalapit sa pasyente or kahit
sa paligid nya may madumi hindi nya kakayanin mao-overwhelmed
ang katawan nya so kailangan madisinfect”
“Ah kailangan lang pakainin sya lagi ng masusustansya ng
gulay tapos di na sya gaanong kumakain ng karne, itlog, ganun lang
protein, tokwa yung tofu.”
Closer Family Relationship
Moral Support. The relationship of Liz and her husband became more

intact for they are the only source of strength of their child’s recovery from cancer.
 59

They can also rely to her mother and siblings to attend her other children and

household chores while they are attending on their daughter’s treatment.

“Sa asawa ko mas naging malapit ako, mas naging malapit

kami sa isa’t isa syempre kami lang naman ang magtutulungan and
then mas minahal namin ang mga anak namin”
Liz’s mother and sister are always there to help her on her other responsibilities.
They see to it that they are available when Liz and her family need them.
“Yung tindahan namin nandun naman lagi yung mommy ko,
kapatid ko, dun nalang nakakahiya nga kasi ano e wala naman
akong binibigay doon pero sa kanila lagi sila lagi yung
namomorblema. Tinutulungan nila ako, sila yung nagbibigay sa
mga costumers ko.”

Despite the situation, the family sees something positive built because of

the illness. Something good comes out of a supposedly bad situation. Ranchor

(2008) pointed out that dealing with highly stressful and traumatic events, such as

cancer, rape and bereavement, can lead to positive life changes, including

enhanced personal relationships, personal changer within the self and changes in

life philosophy.

Coping Techniques

Emotional disguise and regulation. After the result of the first test that

confirmed her daughter being diagnosed having cancer of the kidney, they were

still praying and hoping for a negative result, but the other test showed a clear sign
 60

of cancer diagnosis. Liz found it hard to accept and cried a lot but she has to hide

her emotions to her child.

“Sa akin syempre kahit kanino bilang ina lalo ang bata pa ng
anak mo, talagang dun palang sa mga unang tests nya na
nagiindicate na, nagbibigay ng sign na ganun, talagang dasal kami
ng dasal sana po hindi, sana hindi, iyak ako ng iyak sa asawa ko,
hindi kasi pwedeng ipakita sa anak ko kasi matalino yun magiisip
yun, tapos hindi ako pwedeng umiyak, tapos sumunod na mga test
parang yan na lumilinaw na ganun, parang hindi ko matanggap
tapos nung naconfine sya yung unang confinement nya sa Batangas
maya’t maya ako iyak ng iyak sa asawa ko nung pagtitingin ako,
syempre ang iniisip ko agad yung OA agad magisip, yung nandun
ka na agad sa end na agad, tas yun, yung asawa ko malakas, lagi
nya sinasabi sakin pag pinoroblema natin ang problema walang
mangyayare, kaya ang gawin lang natin ngayon nasa atin pa naman
ang anak natin solusyon, gawin natin ang lahat ng solusyon kesa
isipin natin ang ending solusyon muna ngayon solusyon”.

Stress eating resulting to weight gain. Due to physical and emotional

stress, Liz gained weight because she finds comfort whenever she eats.

“Emotionally down, physically down, stressed ako hindi lang

halata pero kasi pag stressed ako malakas ako kumain kaya nagge-
gain ako ng weight pero ano financially din hindi kami makapag
trabaho kasi kailangan naming mag-focus sa anak namin kasi
unpredictable kung kailan sya iko-confine ulit, kasi ino-observe ‘yan
lagi pag bigla biglang bumababa ang dugo or kailangang mong
ipacheckup kailangan available kami pareho.”
 61

Mayo Clinic (2016) revealed a study emphasizing that sometimes the

strongest food cravings hit when a person is in their weakest point emotionally.

They may turn to food for comfort consciously or unconsciously when facing a

difficult problem, feeling stressed or even feeling bored.

Optimism and intellectualization. Though they are going through a tough

battle, giving up did not ever cross their mind because they see that their child is

fighting; they should be stronger. In the first place, she is their child that needs

their love and protection.

“Minsan parang naiisip mo na, naiisip lang ha, na mahirap pala

ang ganito kasi first time ko, anyway lahat naman yata, bata pa
pero pag iniisip ko, hindi, anak ko ‘to, kung ang anak ko nga
nahihirapan sa kundisyon nya, sya yung may sakit sya yung
nahihirapan pero lumalaban sya, sino pa ako? na wala naman
akong sakit na tutulungan ko lang sya, ibig sabihin mas kailangan
kong tatagan tsaka anak ko yun, bat ako mapapagod anak ko yun
kahit pa, sabi ko nga kahit mag-alaga pa ako ng habang buhay ko
dun sa anak ko gagawin ko. So yun hindi, hindi ako dumating talaga
sa point na yun na gusto ko ng sumuko, hindi as of now.”

According to Ashley (2017), a positive attitude can also help family

members feel better and contribute to a more nurturing family environment. Most

cancer patients as well as their family members know all too well the stark

realities of cancer. It is difficult to carry on when patients receive bad news.  But a

positive attitude helped them want to do things that they knew would be beneficial
 62

to an outcome and helped them endure the fatigue, neuropathy, thinning hair and

low blood counts which were the side effects of chemotherapy.

Belief in Spiritual Healing. The initial reaction of the family after a

member is diagnosed with cancer was to be overwhelmed and sad. Liz questioned

God but eventually her unending faith to the Almighty God helped her cope with

the difficult situation. They believe that God will not let the situation to happen if

they could not surpass the challenge and that everything is God’s will.

“Actually tinanggap ko na, and then eto kasi ha nung sinabi

samin ng doctor, talagang ano ako talagang nagbreakdown na ako,
talagang iyak ako sa asawa ko, yung asawa ko matatag din yan e
pero nung sinasabi samin umiyak din sya edi lalo na ako, tapos
sinabi samin na kung stage ano, kung ano talaga yung sakit, tas
nung sinabing kumalat, masakit, pero alam mo kung what’s amazing
sa paniniwala ko talaga sa panginoon alam ko na hindi talaga nya
kami papabayaan, lahat ng sabihin ng doctor na mga sumunod
parang hindi na ako tinatalaban parang mamanhid na ako, hindi na
ako naglulupage, tanggap lang ako ng tanggap kasi ang iniisip ko
kung para sa amin, para sa amin, kung hindi, hindi, pero habang
buhay pa yung anak ako hanggang nandyan ang anak ko,
nagdadasal kami ng milagro, nagdadasal kami ng miracle pero
kung hindi nya kami pagbibigyan syempre may kapalit may
pinapangako ako sa Panginoon, na pagalingin nyo lang po ang
anak ko ganito ganyan, habang buhay po kami magsisilbi sa inyo,
pero kung hindi naman po Thy will be done, ako kasi ang motto ko
“Thy Will Be Done” hindi ang kagustuhan ko ang masusunod,
kagustuhan lagi ng Diyos, kung gusto ng Diyos na sa kanya na,
 63

wala naman akong magagawa sa kanya na, may dahilan sya, ang
inaano ko nalang, magkikita kita pa naman kami mabilis lang ang
buhay sa mundo, pero syempre hanggat nandyan buhay aasa ka
talaga ng milagro, magdadasal ka ng milagro tsaka sabi ko lalaban
ako, lalaban ko parin, lalaban kami hanggang sa huli, tingnan natin
kung dinggin kami, kasi totoo naman ang milagro, kung didinggin
kami o hindi ang kagustuhan Nya ang masusunod”

Difficult times make people develop a stronger faith as reported by

National Cancer Institute (2015) particularly, that many patients with cancer rely

on spiritual or religious beliefs and practices to help them cope with their disease.

This is called spiritual coping. Both patients and caregivers rely on spiritual

coping. Each person may have different spiritual needs, depending on cultural and

religious traditions. For some seriously ill patients, spiritual well-being may affect

how much anxiety they feel about death. For others, it may affect what they decide

about end-of-life treatments. Some patients and their family caregivers may want

doctors to talk about spiritual concerns, but may feel unsure about how to bring up

the subject.

Resiliency. Even though they are going through hard times, Liz and her

husband strive hard to become strong again after their daughter was diagnosed

with Stage-4 cancer. They will not let cancer stop their life.

“Sabi nya (husband) hindi naman pwede kasing itigil natin

ang mundo natin, parang kasi ako sabi ko sa kanya (husband) nung
una, unahain muna natin ‘to, magfocus muna tayo sa anak natin,
 64

hindi ako makakafocus sa business ko, sa una ganun talaga kasi as

time goes by maiisip mo ay kailangan pala talaga kasi may mga
anak pa kami, yun sabi ng asawa ko hindi kami pupwedeng itigil
namin ang buhay namin dahil lang nagkasakit ang anak namin,
nandyan yung aasikasuhin namin talaga sya, ibibigay namin ang
lahat pero kailangan namin isabay ang paghahanap buhay namin
kahit pareho kaming tuliro."

It is deemed important for people to regain strength and to remain positive.

It is evident when Reding et al. (2014) stated that cancer treatment has its own

stressors, including treatment challenges, adverse events, and life changes.

Promoting resilience mechanisms during cancer treatment may encourage better

adaptation and other positive psychosocial outcomes during and after treatment.

Studies have suggested that baseline characteristics and resilience mechanisms can

affect patient psychosocial functioning.

Reciprocal Altruism

Learned the value of extending help to others. The family’s difficult

situation brought Liz a lot of lessons in life. She experienced a lot of trials and
hardships after her daughter was diagnosed with Stage-4 cancer she realized that
they could never overcome it without the help of their relatives, friends, and
church mates. The most important realization they have is that they would do the
same if others would need their help. Lending a helping hand is essential.

“Nung kami na kasi ang nangangailangan, naka receive ng

tulong ang sarap sa pakiramdam so yung pananaw ko sa mundo
nag-iba kasi ngayon ang narealize ko kapag merong, sabi ko nga sa
mister ko kapag tayo naka raos dito, kapag merong
 65

nangangailangan ng tulong natin ang sarap sa pakiramdam na

matulungan, tulungan natin, lalo na yung mga kamag anak natin,
yung mga kaibigan lalo na yung mga naoospital, ganun pala yun
yung akala natin nabalitaan natin naospital si ano ah, tas kakilala
naman natin hindi natin dinadalaw, dalawin pala natin kahit hindi
tayo close, kunyare hindi nyo close pero kakilala nyo, dinalaw nyo,
kasi kami kahit hindi namin kaclose hindi namin akalain na
dadalawin naming, ang sarap pala sa pakiramdam, may concern
pala yun, nagbago ang pananaw ko na ganun pala dapat, parang
ang daming naituro na experience na ito sa amin”

“Dahil nga natutunan ko ang value of sharing nung naka

confine pa kami nagbigay pa kami ng 500 dun sa isang bata na
nagpapagamot na walang wala talaga sila, nalaman ko yung value
of sharing, nagbigay din kami, dun din namin binigay sa binigay
samin. Pumupunta ako sa milkbank nagddonate ako ng gatas ko
maya’t maya, nadayo ako ng milk bank kahit malayo ang lalakarin
ko pero para sa mga baby so siguro pag nakikita man ng Panginoon
na bukal naman sa puso mo yun, tumutulong ka din, sana
pinagdadasal namin na dinggin kami, hindi ko naman binabao sa
kanya na ganito kami”

It is clearly seen that people learn a lot from their experiences and what

others make them feel and see are vital in what they realize after being stuck in a

difficult situation. Penner et al. (2002) emphasized that the altruistic personality

involves both the cognitive and the emotional responses that people experience

around others. People with altruistic personalities tend to show empathy and

sympathy for others and feel that it is appropriate and right to follow the norm of
 66

social responsibility. These people help more people in a wider variety of areas,

including providing help to co-workers, donating organs, and volunteering, and

also have been found to help more quickly than do people who score lower on

these measures. In this sense, the value of extending help is always reciprocated.

CHAPTER V

SUMMARY, FINDINGS, CONCLUSION AND RECOMMENDATIONS

This chapter presents the summary, findings, conclusions, and

recommendations of the researchers.

Summary

This study aimed to determine the coping strategies used by the family

members with cancer patients and their lived experiences in coping with the

situation, which is important in determining the effect of the disease to the family.

This study utilized a qualitative research design to gain insight and explore

the depth and complexities inherent in the phenomenon.. The participants of the

study were five (5) family members that were selected by a purposive sampling

method. The data were gathered by using an in-depth interview and was analysed

by using Interpretative Phenomenological Analysis (IPA) to further understand the

experience of family members with cancer patients.

 67

This study aimed to find out the lived experiences of family members with

cancer patients in coping with the situation. It also includes medical condition

reassurance, difficulty encountered, support to patient, financial needs and

concerns, and closer family relationship.

Findings

Based on the data gathered, analyzed and interpreted, the lived experiences

of family members with cancer patientare thefollowing:

1. Medical Condition Reassurance. Before the official diagnosis,the ill

family member underwent several tests such as CT-Scan and biopsy and

supported patients for chemotherapy treatment and removal of tumor.

2. Difficulties Encountered by the Family Members. Because of this

complex phenomenon, the family members experienced limited

socialization and recreational activities. Some of the family members

were being neglected. Somehow they fail to do their responsibilities and

other duties because they need to find alternative source of income and

tend to seek help financial assistance given by the government as well

as from their relatives.

 68

3. Support to the Patient. The family members tend to give up their work

to attend to the patient’s needs and to provide the entire patient’s needs

and requests. They also ensure healthy lifestyle of the cancer patient.

4. Closer Family Relationship. The family members’ relationship with

each other became closer and they support each other morally.

5. The family members cope with the situation through emotional

regulation, stress eating, optimism and intellectualization, belief in

spiritual healing, and resiliency.

6. The family members developed reciprocal altruism.

Conclusion

In the light of the findings of the present study, the researchers have drawn

the following conclusions:

1. Before the official diagnosis, the patient underwent several medical

attention and procedures to ensure accurate findings.

2. There are difficulties encountered by the family members while the

member is struggling with cancer. Their socialization and recreational

activities were lessened, other members of the family are being neglected

and their duties and responsibilities were being unattended because their

attention is mainly focused on the ill member. The family members used

the resources available to provide the needs of the patient, especially the
 69

financial aspects. The health programs of the government are a major help

for those families who are financially incapable.

3. To give full support to the patient, the family members came to the point of

giving up their work. They experienced compassion fatigue while taking

care of their ill family member. They provide the entire patient’s needs and

requests, and ensure patient’s healthy lifestyle.

4. Difficult situation brought the family into a closer relationship. They

morally help and support each other.

5. Coping Techniques. The family members use different coping techniques to

overcome the stresses that they encounter while taking care of their ill

family member such as emotional disguise and regulating; stress eating

resulting to weight gain; optimism and intellectualization; belief in spiritual

healing; and resiliency.

6. The family members developed and learned the value of sharing and

realized the nature of helping others despite being the ones in need. This

was a result of understanding the sense of reciprocal altruism of the

participants.

Recommendations

In light of the findings and conclusion, the following recommendations are

given:
 70

1. The government should provide enough funds to provide medical assistance

to the cancer patients because it is not easy to sustain the treatment of the

patients knowing it costs a lot. It would be a big help for them to be given

some financial assistance, especially in their chemotherapy, surgical

operations, medications, etc. The government should also establish

programs where the financially incapable families of cancer patients would

be given workshop/trainings and capital to support their financial needs.

2. Non-government organizations, foundations, and other advocates should

create campaigns not only for the cancer patients’ awareness but also on

how the family can cope with the situation.

3. Family members must ensure emotional regulation and more intact family

relationship by frequent communication, optimism, resiliency, and belief in

spiritual healing while coping with the situation.

4. The researchers recommend to the close family relatives and friends to

support the family members and the cancer patient, emotionally and

morally.

5. Researchers may propose intervention program for the family of cancer

patients to adapt to the difficulties they encounter.

6. Related studies may be conducted focusing on the other variables or coping

strategies that were not included in this study for better understanding.
 71

7. The researchers recommend to further study about the other side of the

context such as inability to cope with the difficulty brought about by the

situation of having family member with cancer.

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