Concept Analysis of Fighting Spirit in Korean Patients with Cancer

Kyung Ok Kim; Jung A Kim

doi:10.7475/kjan.2019.31.1.50

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Kim and Kim: Concept Analysis of Fighting Spirit in Korean Patients with Cancer

Original Article

Korean J Adult Nurs 2019;31(1):50-60.

Published online: 21 February 2019

DOI: https://doi.org/10.7475/kjan.2019.31.1.50

Concept Analysis of Fighting Spirit in Korean Patients with Cancer

Kyung Ok Kim¹, Jung A Kim^2,

¹PhD Candidate, Graduate School of Nursing, Hanyang University, Seoul, Korea

²Professor, Division of Nursing, Hanyang University, Seoul, Korea

Corresponding author: Kim, Jung A https://orcid.org/0000-0002-6575-452X Division of Nursing, Hanyang University, 222 wangsimni-ro, Sungdong-gu, Seoul 04763, Korea. Tel: +82-2-2220-0799, Fax: +82-2-2295-2074, E-mail: joyhippo@hanyang.ac.kr

Received 3 December 201811 January 2019 Accepted 24 January 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to better understand the concept of fighting spirit in Korean patients with cancer by identifying its dimensions and attributes and clarifying its definition through concept analysis.

Methods

The hybrid model was used to perform the concept analysis of fighting spirit in patients with cancer. Through a review of 11 studies in the theoretical phase and interviews of 12 patients with cancer in the field phase, the derived results were brought together in the integration phase. The interviews were conducted from April 2017 to March 2018.

Results

The concept of fighting spirit in Korean patients with cancer was found to have four dimensions with eight attributes: personal factors (acceptance, self-control, goals of life, change in belief, and positive attitude), sociocultural factors (supportive relationships), environmental factors (therapeutic environment), and spiritual factors (reliance on faith).

Conclusion

In this study, fighting spirit in Korean patients with cancer was characterized as the belief in overcoming cancer by accepting it as a part of life, having a goal in life, maintaining self-control with a positive attitude, and continuing to maintain health with social and spiritual support in a therapeutic environment. Based on the results, future studies should develop a tool for measuring the fighting spirit of patients with cancer and effective programs for improving patients’ fighting spirit.

Keywords: Neoplasms, Patients, Adaptation, Analysis

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Table 1.

Dimensions, Attributes of Fighting Spirit in Patients with Cancer in Literature Review

Authors, Publication year, [Reference number]	Dimensions (attributes)
Greer et al., 1979 [17]	Personal (fully accepts the diagnosis of cancer, optimistic attitude, search for information about cancer, determined to fight the disease)
Greer & Watson, 1987 [3]	Personal (sees the illness as a challenge, positive attitude towards outcome. seeking information about the disease, taking an active role in recovery, live as normal a life, control over the stress, prognosis is seen as optimistic)
Moorey & Greer, 1989 [24]	Personal (sees the diagnosis as a challenge, optimistic view of the future, control over the illness, confrontative coping responses)
Nelson et al., 1989 [25]	Personal (belief in the ability to fight back, conquer, recover from cancer)
Watson et al., 1994 [5]	Personal (determined to beat disease, very optimistic, illness as a challenge, fight the illness)
Oh et al., 1997 [16]	Personal (positive emotions, change of mind), Spiritual (spirituality)
Akechi et al., 1998 [22]	Personal (physical status), Sociocultural (social support)
Kim et al., 2005 [8]	Personal (hope), Spiritual (believing)
Oh, 2008 [11]	Personal (hope, positive belief),
	Sociocultural (social support, therapeutic interpersonal relationship), Spiritual (spirituality),
	Environmental (aesthetic environment, humor)
Johansson et al., 2012 [26]	Personal (actively conquering the cancer, actively seeking information about their disease, actively taking in their treatment)
Patricia et al., 2015 [27]	Personal (positive thinking, fight, never lose hope)

Table 2.

Dimensions, Attributes, and Themes of Fighting Spirit in Korean Patients with Cancer in Field Work

Dimensions	Attributes	Themes
Personal	Acceptance	Try to learn about cancer and treatment
		Accept cancer as a part of life
		Focus on the present without worrying
	Self-control	Strengthen and control my mind
		My will to fight against disease is important
		Behavioral control
		Try hard to overcome cancer
		Continuous health management
	Goals of life	Have a goal in life
		Have things to do in the future
	Change in belief	Recognize the importance of life and health and do best
		Have a generous and relaxed attitude
		Look back upon my life and try to change
	Positive thinking	Be considerate to other and help them
		Positive thinking helps my health
		Live happily doing what I like
		Hope that the disease will improve
Sociocultural	Supportive relationship	Trust the medical team and follow the instructions
		Have family or friends to support and take care of me
		Appreciate and give love to family and friends
		Gain strength from my responsibility and love for my family
Environmental	Therapeutic environment	Live in an environment I like
		Live in an environment that helps my treatment
		Do what I like as a diversion
Spiritual	Reliance on faith	Gain peace of mind through religious life
		Gain strength through religious life
		My faith is deepening

Table 3.

Dimensions, Attributes of Fighting Spirit in Korean Patients with Cancer in Final Stage

Antecedents	Dimensions	Theoretical phase	Field work phase	Integration phase	Consequences
Self-efficacy	Personal	Search for information Accept a diagnosis	Acceptance	Acceptance	Psychosocial adjustment
		Control over the illness	Self-control	Self-control
		Challenge
		Conquer
			Goals of life	Goals of life
		Change of mind	Change in belief	Change in belief
		Hope	Positive thinking	Positive attitude
		Optimistic
		Positive thinking
	Sociocultural	Social support	Supportive relationship	Supportive relationship
	Environmental	Aesthetic environment	Therapeutic environment	Therapeutic environment
	Spiritual	Spirituality	Reliance on faith	Reliance on faith

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