“Taking Advantage of the Grace I Have Been Afforded”: A Thematic Analysis of Cancer Survivors’ Experiences of Priority Shift After a Cancer Diagnosis

Research Objectives: To investigate the priorities that cancer survivors hold and how cancer survivors understand their shift in priorities since being diagnosed with cancer.

Design: The qualitative data analysis was part of a broader survey study design.

Setting: Participants completed the survey on the online platform, Qualtrics.

Participants: Potential participants were recruited through convenience sampling from the crowdsourcing platform, Prolific. Of the original 406 individuals screened, 17 did not meet full inclusion criteria or finish the screener. Of those 380 people, 250 were invited to take the complete survey, 104 of whom did not open or returned the survey, resulting in 146 people who completed the survey. Of the 146 who completed the survey, 128 people answered at least one of the three open-ended questions used for qualitative analysis.

Interventions: N/A.

Main Outcome Measures: The survey included three open-ended questions:
(1) What are your priorities in life at this moment? In what ways have they been impacted by your cancer diagnosis? (n=127)
(2) Who or what have been important in informing these priorities (e.g., family, sense of purpose, financial responsibilities, etc.)? (n=110)
(3) Is there anything else you think is important for us to know as we continue exploring the influence of cancer on your decisions about work and life priorities? (n=59)

Results: The average age was 54.1 years (SD=13.97); 61.7% female; 91.4% White; 57.0% married; 31.3% breast cancer and 48.4% other single cancer (all n < 10); 69.5% early stage (0-2); and the average years since initial diagnosis was 10.8 (SD=9.8). Using thematic analysis, ten themes emerged from the data. One theme was a list of priorities that cancer survivors hold, with many identifying family, friends, and pets. The remaining nine themes encompass the process of how each construct (priority shift, informing priorities, context, coping and reactions, time, treatment, resources, work, and reconciliation) is critical to understand the values and priority shift cancer survivors experience. There were three primary processes for the shift in priorities: cancer shifted priorities (n = 23); cancer no longer affects current priorities (n = 16); and cancer reinforced existing values and priorities (n = 8).

Conclusions: The findings suggest the importance of close relationships as both the focus of and the process of informing one’s priorities. Consistent with the Disability Centrality Model (Bishop, 2005), shifts in values and priorities may serve to increasing or restoring quality of life (QOL). Understanding how this priority shift occurs could support the psychosocial adaptation and QOL of cancer survivors.

Author(s) Disclosures: This presentation is supported, in part, by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $1,000,000 with 100 percent funding by ACL/HHS (Grant Number 90AREM0005). The contents are those of the presenter(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.