SOCIAL WORK AND MANAGEMENT ›› 2024, Vol. 24 ›› Issue (2): 43-51,86.

• SHEHUI GONGZUO • Previous Articles     Next Articles

Life Disruption or Life Reconstruction: A Study on the Decision-Making Process of Marital and Childbearing Choices Among Gynecologic Cancer Survivors

YAO Hong1, ZHANG Yixin1, CHEN Liyun2   

  1. 1. School of Ethnology and Sociology, Minzu University of China, Beijing, 100081, China;
    2. Faculty of Social Sciences, The University of Hong Kong, Hong Kong, 999077, China
  • Received:2023-11-14 Online:2024-03-15 Published:2024-03-15

Abstract: With the increasing incidence of gynecologic cancer, a growing number of survivors are confronting the challenges of post-treatment life as cancer survivors. This study delves into the shifts in the life trajectories of gynecologic cancer survivors, especially in terms of marital and reproductive decisions. Employing qualitative research methods, the study spanned from November 2022 to June 2023, recruiting respondents through online purposive and snowball sampling. Data were gathered via online semi-structured in-depth interviews. Findings reveal that gynecologic cancer, as a major life event, places dual pressures on survivors’ marriage and parenting decisions: health challenges and social role expectations. Notably, unmarried or childless young survivors faced crucial decisions during critical life stages, intensifying the nexus between illness and choices regarding marriage and parenting, profoundly altering their life trajectories. Nevertheless, gynecological cancer survivors exhibited remarkable autonomy in navigating marital and reproductive decisions. They redefine these choices, prioritizing individual physical and psychological needs over societal conventions. In this context, gynecologic cancer survivors’ active coping not only reflects their autonomy in marriage and parenthood decision-making, but is also key to reshaping their biography. The study emphasizes the necessity for comprehensive, long-term support services in health social work. These services are crucial in alleviating the tension between illness and marital choices, aiding survivors in negotiating the complexities of medical and marital decision-making.

Key words: gynecologic cancer survivors, life disruption, constructive orientation, marital choice, marital autonomy

CLC Number: 

  • C916
[1] ZHENG R, ZHANG S, ZENG H, et al. Cancer incidence and mortality in China, 2016[J]. Journal of the National Cancer Center, 2022, 2(1): 1-9
[2] SANKARANARAYANAN R, FERLAY J. Worldwide burden of gynecological cancer: the size of the problem[J]. Best practice & research:clinical obstetrics & gynecology, 2006, 20(2): 207-225
[3] 曹毛毛, 陈万青. 中国恶性肿瘤流行情况及防控现状[J]. 中国肿瘤临床, 2019(3): 145-149
[4] ZENG H, CHEN W, ZHENG R, et al. Changing cancer survival in China during 2003–2015: a pooled analysis of 17 population-based cancer registries[J]. The lancet global health, 2018, 6(5): e555-e567
[5] MULLAN F. Seasons of survival: reflections of a physician with cancer[J]. New England journal of medicine, 1985, 313(4): 270-273
[6] MILLER K, MERRY B, MILLER J. Seasons of survivorship revisited[J]. The cancer journal, 2008, 14(6): 369-374
[7] MEIROW D, NUGENT D. The effects of radiotherapy and chemotherapy on female reproduction[J]. Human reproduction update, 2001, 7(6): 535-543
[8] 卢光琇, 席周欢, 刘锐, 等. 肿瘤患者的生育风险评估[J]. 国际生殖健康/计划生育杂志, 2013(6): 419-423,432
[9] STAFFORD L, SINCLAIR M, GERBER K, et al. Isolation experienced by women with gestational cancer: could peer support and tailored information be the answer?[J]. Supportive care in cancer, 2021, 29(12): 7135-7138
[10] 王彬, 江子芳, 吴雪萍. 年轻妇科恶性肿瘤患者生育忧虑的研究现状与展望[J]. 中国现代医生, 2022(24): 99-102
[11] 陈露露, 李敏. 妇科癌症患者常见的心理问题[J]. 中国医药指南, 2012(9): 58-60
[12] EKWALL E, TERNESTEDT B M, SORBE B. Recurrence of ovarian cancer-living in limbo[J]. Cancer nursing, 2007, 30(4): 270-277
[13] POORT H, FENTON A T, THOMPSON E, et al. Lived experiences of women reporting fatigue during PARP inhibitor maintenance treatment for advanced ovarian cancer: a qualitative study[J]. Gynecologic oncology, 2021, 160(1): 227-233
[14] JEFFERIES H, CLIFFORD C. Aloneness: the lived experience of women with cancer of the vulva[J]. European journal of cancer care, 2011, 20(6): 738-746
[15] SORIANO E C, PASIPANODYA E C, LOSAVIO S T, et al. Social constraints and fear of recurrence in couples coping with early stage breast cancer[J]. Health psychology, 2018, 37(9): 874
[16] BURY M. Chronic illness as biographical disruption[J]. Sociology of health & illness, 1982, 4(2): 167-182
[17] 郇建立. 慢性病与人生进程的破坏: 评迈克尔·伯里的一个核心概念[J]. 社会学研究, 2009(5): 229-241
[18] TRUSSON D, PILNICK A, ROY S. A new normal? women’s experiences of biographical disruption and liminality following treatment for early stage breast cancer[J]. Social science & medicine, 2016, 151(2): 121-129
[19] LARSSON A T, GRASSMAN E J. Bodily changes among people living with physical impairments and chronic illnesses: biographical disruption or normal illness?[J]. Sociology of health & illness, 2012, 34(8): 1156-1169
[20] CARRICABURU D, PIERRET J. From biographical disruption to biographical reinforcement: the case of HIV-positive men[J] Sociology of health & illness, 1995, 17(1): 65-88.
[21] FAIRCLOTH C A, BOYLSTEIN C, RITTMAN M, et al. Sudden illness and biographical flow in narratives of stroke recovery[J] Sociology of health & illness, 2004, 26(2): 242-261.
[22] 涂炯, 程瑜. 食管癌患者的疾病解释:理解、合法化与意义追寻[J]. 思想战线, 2016(3): 52-60
[23] 何雪松, 侯慧. “过坎”: 终末期肾病患者的疾痛体验[J]. 社会学研究, 2020(5): 25-50, 242-243
[24] 余成普. 社区参与、家庭责任与慢性病人的道德生活——基于一个侗寨的调查[J]. 西北民族研究, 2020(2): 88-98
[25] REYNOLDS F. Women’s narratives of living with MS in the family context: reconciling complex experiences, integrating complex identities[M]// UNIVERSITY OF HUDDERSFIELD. Narrative, memory & identity: theoretical and methodological issues. Huddersfield: University of Huddersfield, 2004: 139-151.
[26] POUND P, GOMPERTZ P, EBRAHIM S. Illness in the context of older age: the case of stroke[J]. Sociology of health and illness, 1998, 20(4): 489-506
[27] ENGMAN A. Embodiment and the foundation of biographical disruption[J]. Social Science & Medicine, 2019, 225(2): 120-127
[28] MONAGHAN L F, GABE J. Chronic illness as biographical contingency? young people’s experiences of asthma[J]. Sociology of health & illness, 2015, 37(8): 1236-1253
[29] SINDING C, WIERNIKOWSKI J. Disruption foreclosed: older women’s cancer narratives[J]. Health, 2008, 12(3): 389-411
[30] WILLIAMS S. Chronic illness as biographical disruption or biographical disruption as chronic illness? reflections on a core concept[J]. Sociology of health & illness, 2000, 22(1): 40-67
[31] TAYLAN E, OKTAY K. Fertility preservation in gynecologic cancers[J]. Gynecologic oncology, 2019, 155(3): 522-529
[32] KOMATSU H, YAGASAKI K, SHODA R, et al. Repair of the threatened feminine identity: experience of women with cervical cancer under going fertility preservation surgery[J]. Cancer nursing, 2014, 37(1): 7582
[33] BURNS M, COSTELLO J, RYAN-WOOLLEY B, et al. Assessing the impact of late treatment effects in cervical cancer: an exploratory study of women’s sexuality[J]. European journal of cancer care, 2007, 16(4): 364-372
[34] AK P S, GÜNÜSEN N P, TÜRKCÜ S G, et al. Sexuality in Muslim women with gynecological cancer[J]. Cancer nursing, 2020, 43(1): E47-E53
[35] JURASKOVA I, BUTOW P, ROBERTSON R, et al. Post-treatment sexual adjustment following cervical and endometrial cancer: a qualitative insight[J]. Psycho-oncology: journal of the psychological social and behavioral dimensions of cancer, 2003, 12(3): 267-279
[36] LLOYD P A, BRIGGS E V, KANE N, et al. Women’s experiences after a radical vaginal trachelectomy for early stage cervical cancer: a descriptive phenomenological study[J]. European journal of oncology nursing, 2014, 18(4): 362-371
[37] PIVETTA E, MAULE M, PISANI P, et al. Marriage and parenthood among childhood cancer survivors: a report from the Italian AIEOP Off-Therapy Registry[J]. Haematologica, 2011, 96(5): 744-751
[38] GORMAN J R, BAILEY S, PIERCE J P, et al. How do you feel about fertility and parenthood? the voices of young female cancer survivors[J]. Journal of cancer survivorship, 2012, 6(2): 200-209
[39] ADAIR L E. Fertility decision making: to what extent do adaptations, social pressures, and individual differences influence plans to have a child?[D]. Kansas: Kansas State University, 2013:15-38.
[40] SONG Y, LIU H, WANG S. et al. Correlates of posttraumatic growth among spouses of newly diagnosed gynecological cancer survivors: a cross-sectional study[J]. European journal of oncology nursing : the official journal of European oncology nursing society, 2021, 54, DOI: 102039.
[41] YAO H, CHAN C H Y, CHAN C L W. Childbearing importance: a qualitative study of women with infertility in China[J]. Research in nursing & health, 2018, 41(1): 69-77
[42] GILLESPIE R. When no means no: disbelief, disregard and deviance as discourses of voluntary childlessness[J]. Women’s studies international forum, 2000, 23(2): 223-234
[43] SOMERS M D. A comparison of voluntarily childfree adults and parents[J]. Journal of marriage and the family, 1993, 55(3): 643-650
[44] WENZEL L, DOGAN-ATES A, HABBAL R, et al. Defining and measuring reproductive concerns of female cancer survivors[J]. Journal of the national cancer institute, 2005, 90(34): 94-98
[45] CARTER J, LEWIN S, ABU-RUSTUM N, et al. Reproductive issues in the gynecologic cancer patient[J]. Oncology, 2007, 21(5): 598-606
[46] GARDINO S, RODRIGUEZ S, CAMPO-ENGELSTEIN L. Infertility, cancer, and changing gender norms[J]. Journal of cancer survivorship, 2011, 5(2): 152-157
[47] 李强, 邓建伟, 晓筝. 社会变迁与个人发展: 生命历程研究的范式与方法[J]. 社会学研究, 1999(6): 1-18
[48] 陈心想, 王杰. 生命历程中的关键时刻与时间重构: 基于老年癌症患者及社会工作介入的研究[J]. 社会, 2021(2): 192-217
[49] FLEISCHMAN S. I am.., I have.., I suffer from..: a linguist reflects on the language of illness and disease[J]. Journal of medical humanities, 1999, 20(1): 3-32
[50] SCHIPKE T. The chronic sick role: its time has come[J]. OMEGA-journal of death and dying, 2021, 83(3): 470-486
[51] 曾书清. 疾痛意义建构与生命代价承受——脊髓性肌萎缩症患者的叙事[J]. 医学与哲学, 2021(4): 32-36
[52] LOCOCK L, ZIEBLAND S. Mike Bury: biographical disruption and long-term and other health conditions[M]// COLLYER F. The palgrave handbook of social theory in health, illness and medicine. New York: Springer, 2015: 582-598.
[53] JEFFERIES H, CLIFFORD C. All change: the lived experience of younger women with cancer of the vulva[J]. Journal of clinical nursing, 2012, 21(15–16): 2327-2335
[54] SEKSE R J, RAHEIM M, BLAKA G, et al. Living through gynaecological cancer: three typologies[J]. Journal of clinical nursing, 2021, 21(17–18): 2626-2635
[55] MARZORATI C, RIVA S, PRAVETTONI G. Who is a cancer survivor? A systematic review of published definitions[J]. Journal of cancer education, 2017, 32(2): 228-237
[56] CHAN J L, LETOURNEAU J, SALEM W, et al. Regret around fertility choices is decreased with pre-treatment counseling in gynecologic cancer patients[J]. Cancer survive, 2017, 11(1): 58-63
[57] ANDERSON R A, AMANT F, BRAAT D, et al. ESHRE guideline: female fertility preservation[J]. Human reproduction open, 2020, 20(4): 1-17
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