Purpose. This study has focused upon the meaning women with breast cancer attach to their illness. According to the common-sense model of health and illness there are five domains of illness representation: causes, identity, timeline, consequences and controllability. From a developmental perspective based on the social and cognitive-developmental theory, health and disease processes experienced by adults may be represented as different levels of openness, flexibility, inclusiveness and abstraction and can be ordered in a sequence from least to more mature. Within this framework we developed a study with two main objectives: (1) to assess in breast cancer patients the five domains of their illness representation and, (2) to verify if those domains can be ordered developmentally from least to more mature.
Method. Fifty women treated for breast cancer as outpatients by the Breast Surgery Multidisciplinary Team at Hospital S. José, Lisbon, Portugal, were randomly selected and interviewed using a semi-structured method in order to obtain data on the significance they attached to their illness.
Results. The qualitative data show that, for each domain of illness representation, it was possible to identify a typical breast cancer representation profile; it was also possible to classify women’s illness meanings into different developmental levels. A developmental sequence of meanings for breast cancer is presented.
Conclusions. The implications of this approach to clinical intervention suggest that accessing the patients’ meanings about their illness helps understanding the emotional reactions and coping processes they use with the stressful situation. Also it enables the clinician to match clinical methodologies with the patient’s cognitive-developmental level, which would be of greater efficacy and improve outcomes.