"Setting boundaries" - mental adjustment to cancer in laryngeal cancer patients: an interview study

To increase the understanding of mental adjustment responses in laryngeal cancer patients, as well as the outcome of these responses. Further, to evaluate the content validity of the Swedish version of the Mini-MAC (Mental Adjustment to Cancer) Scale with regard to findings from the patient interviews.

Data was collected with semi-structured interviews and analyzed using a constant comparison technique consistent with Grounded Theory. Eighteen participants were selected according to the idea of theoretical sampling.

The core category arising was "Setting boundaries". This seemed to be a prerequisite for mental adjustment to diagnosis and treatment without major negative impact on mental health or health-related quality of life (HRQL). Five descriptive categories also emerged: Fighting Spirit; Avoidance; Comparisons; Anxious Preoccupation; and Social Interactions. When comparing these results with the domains of the Mini-MAC Scale, the Fighting Spirit, Cognitive Avoidance and Anxious Preoccupation domains were clearly represented. Concerning the Fatalism and the Hopeless-Helpless domains the support was somewhat weaker.

Central theme of mental adjustment responses in laryngeal cancer patients was "Setting Boundaries", concerning above all patients' attitude to information and thoughts about the cancer. This response seems to be the dividing line between good and poor adjustment. The results emphasize the importance of adapting the information given and rehabilitation options to each individual patient. The findings largely support the Swedish version of the Mini-MAC, but some deviations were found which should be considered when interpreting results from the Mini-MAC in laryngeal cancer patients.