“We’re completely back to normal, but I’d say it’s a new normal”: A qualitative exploration of adapted functioning in rural families following a parental cancer diagnosis

Abstract

The Resiliency Model of Family Adjustment and Adaptation (RMFAA) proposes that the diagnosis of cancer constitutes a life crisis for not only the patient, but the family unit as a whole. For rural families, a cancer diagnosis may be particularly debilitating due to the pile up of financial, practical and emotional stressors, all of which stem from difficulties in accessing vital medical and psychosocial care. A body of literature has investigated these issues using an individualistic framework, however, a holistic, family-oriented approach has not been applied to rural families affected by cancer. Therefore, in the current study, the RMFAA was utilised to guide a qualitative exploration into rural families’ functioning throughout the course of a cancer diagnosis. Ten families, wherein a parent of dependent children had received a cancer diagnosis, participated in focus groups. Data were analysed using thematic analysis, and four core themes were identified. “Key challenges to coping in a rural cancer context” encompassed three sub-themes: “frequent travel”, “increased work/financial demands”, and “familial separation”. Similarly, “protective internal factors” comprised three sub-themes: “children’s restricted comprehension of a cancer diagnosis and the need to adapt communication accordingly”, “strong and stable family relationships are highly valued by rural families”, and “the value of problem solving in promoting normality”. “Protective external factors” comprised two sub-themes: “offers of community support can be perceived as both helpful and unhelpful” and “support services are frequently accessed and typically appreciated”. “Not all consequences of a cancer diagnosis are negative” was the final theme to emerge from the data. The findings suggested that rural families’ ability to access external resources was moderated by the strength of their internal protective factors; resulting in significant practical implications pertaining to the development of interventions that accommodate the specific cancer support needs of rural families.