Patient Competence for Coping with Disease - A Qualitative Analysis in Women with Breast and Gynaecological Cancer

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The study explores challenges, competencies, and helpful support in coping with the disease of patients with breast cancer and gynaecological cancer and how patient competence as an interaction of these factors might be promoted. Semi-structured interviews were conducted with 19 patients in acute care, 20 patients undergoing rehabilitation, and 16 participants in a self-help group and evaluated using qualitative content analysis. The challenges are summarised in the main categories - diagnosis processing, treatment/recurrence fears, illness processing and adaptation, worries about relatives, reactions of the social environment, and worries about the workplace. The named personal competencies in dealing with these challenges were assigned to the following main categories: cognition-related coping, action-related coping, self-regulation illness processing, obtaining and accepting support, self-determined communication of the illness, identifying and applying helpful strategies, illness-related experience, favourable life circumstances, openness to offers of help. Helpful emotional, informational or instrumental support is perceived by relatives, friends, animals, colleagues/employers, treatment providers, rehabilitation, fellow patients, self-help, and counselling facilities. The women describe a variety of competencies, which corresponds to a needs-oriented, self-directed coping process. The individuality and complexity of the interaction of the components of patient competence underline the relevance of patient-oriented care. Empowerment and an active patient role are necessary to promote their coping skills according to their needs. Support from practitioners or the private environment can reduce challenges or promote competencies and application.