Biographical compromise when living with a chronic condition and caring for someone with cancer: A grounded theory analysis

Abstract

The number of carers caring for a patient with cancer and at the same time, having a chronic condition is on the rise. These carers are at a higher risk of experiencing health problems and hence, being unable to provide high quality care to the patient. Furthermore, there is a paucity of information on how carers live with their conditions, whilst caring for someone with cancer.

Twenty-seven participants were recruited in this study. In-depth interviewing following an interview guide was the predominant mode of data collection. Constructivist grounded theory methodology was used to guide data collection and analysis. The qualitative data analysis programme NVIVO Version 12 was used to manage the organisation of the data.

The theory of biographical compromise emerged from the data. The core category of this theory is ‘Making Concessions’, which describes how carers try to reach a compromise between living with their chronic conditions and the caregiving situation. They do so by doing the bare minimum, which allows carers to maintain a sense of control over their conditions and at the same time, do not allow their conditions to interfere with the patient’s care. The extent of this compromise depends on three sets of contextual factors: (i) the characteristic features of the caregiving role; (ii) the social context; and (iii) the personal context. This core category relates to three major categories: ‘Feeling Obliged’, ‘Changing Biography’, and ‘Minimising Interference’.

The study findings contribute to knowledge by merging the two processes of living with a chronic condition and caring for a patient with cancer into one process, that of biographical compromise. The empirical literature tends to explain these processes separately and does not explain how these experiences are intertwined. Furthermore, the theory of biographical compromise highlights which contextual factors impact this process. Hence, it provides important information which can be utilised to develop carer assessment tools to identify those carers who are struggling more and provide the necessary support as early as possible. The study findings also illustrate how all the carers in this study would prefer health care professionals to assist them directly in the management of their conditions and hence, this emphasises the importance of integrating the care of the carer as part of the overall care plan of the patient with cancer.

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Identifiers

ORCID for Lynn Calman: orcid.org/0000-0002-9964-6017

ORCID for Claire Foster: orcid.org/0000-0002-4703-8378

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