Light in the Midst of Darkness: Lived Experiences of Cancer Warriors
A Thesis Presented to the Faculty
Of Graduate School
Golden Gate Colleges
Batangas City
In Partial Fulfillment
Of the Requirements for the Degree
Master of Arts in Nursing
By:
Mignodel M. Morales, RN
October 2012
Golden Gate Colleges Graduate School Batangas City
APPROVAL SHEET
This entitled:
Light in the Midst of Darkness: Lived Experiences of Cancer Warriors
Prepared and submitted by MIGNODEL M. MORALES, RN, approved and accepted as partial fulfillment of the requirements for the degree
MASTER OF ARTS IN NURSING
Crestita B. Tan, RN, Ph.D
Adviser
PANEL OF EXAMINERS
Approved by the committee on Oral Examination with a grade of CUMLAUDE on October 2012
MARILYN D. YAP, RN, Ph.D
Chairman
ELSA V. CASTRO, RN, Ed.D EDEN E. CACANINDIN, RN, Ed.D
Member Member
CRESTITA B. TAN, RN, Ph.D
Dean
Golden Gate Colleges Graduate School Batangas City
Certification of Originality
I hereby declare that the submission of this thesis entitled: “Light in the Midst of Darkness: Lived Experiences of Cancer Warriors” is my own work and that, to best of my knowledge and belief, it contains no material previously published or written by another person to which a substantial extent has been accepted for the award of any degree or diploma of a university or other institute of higher learning, except where due acknowledgement is made in text.
I also declare that the intellectual context of this thesis is the product of my own work, even though I may have received assistance from others in style, presentation and language expression.
Signed: Mignodel M. Morales, RN Signed: Crestita B. Tan, RN, Ph.D
Date: March 2013 Date: March 2013
Table of Contents
Title Page i
Acknowledgement ii
Dedication iii
Abstract iv
Table of Contents v
Chapter I . The Research Problem
Background and Rationale 1
Purpose and Significance 3
Research Impediments / Constraints 4
Chapter II. The Research Question
Review of Related Literature and Studies 5
Theoretical Framework 18
Research Questions 19
Chapter III. Research Methodology
Meaning of the Research Method 20
Subjects of the Study and Sampling Procedure 21
Settings of the Study 25
Instrumentation and Validation 25
Data Gathering Procedure 28
Ethical Considerations 31 Data Analysis 31
Chapter IV. Results and Discussion 35
Conceptual Model 49
Chapter V. Summary, Conclusion and Recommendation 55
Bibliography 61
Appendixes
Appendix A Letter to the Authorities
Appendix B Informed Consent
Appendix C Interview Guide
Appendix D – 1 Cluster of Significant statements
Appendix D -2 Cluster of themes and Associated meaning
Appendix D – 3 Interviews of the Informants
Curriculum Vitae
Acknowledgement
The researcher would like to extend his deepest gratitude to the following for making this study possible:
To Almighty God for giving me the wisdom to conduct the study and the courage to face my informants on a sensitive topic for pediatric patients.
To my beloved family, Mr. Rodel M. Morales and Mrs. Mignonette M. Morales, who had been with my journey in my professional endeavors, my brothers, Kuya Rod and Jr., that had been there for moral support and my Tita Imelda Martin, for the financial support needed for my graduate study.
To Dean Crestita Tan, Ph.D., Dra. Marilyn Yap, Dra. Elsa Castro and Dra Cacanindin for their guidance and sharing their expertise as nurse leader and manager of nursing populace; being there as my adviser and panel and for patiently listening to my queries about qualitative research.
To Dr. Irene Roco, for giving me the enlightenment regarding qualitative research and its analysis and together with the Lyceum of the Philippines University – Batangas, College of Nursing.
To Dr. Yolanda Africa, who gave me some inputs of this study and the Canossa Educative Community which molded me to become a Christian Person, Sharer of God’s Love.
To Professor Jose Macatangay of DLSL, my editor, who meticulously editing my study that made it more substantial.
To the family and the informants of this research , for wholeheartedly accepting the task: to be a living testimony for education and skills enhancement of health care providers. They shared an important bit of their lives to the readers of this study.
M.M.M.
Dedication
The researcher wholeheartedly
dedicated this
study,
to God,
My late Lolo Paping and Nanay Adeling
Lolo Mitchong and Nanay Onie.
Morales and Marasigan Clan
Red Cross and Rotaract Family
And
Friends
“Migs”
Title: Light in the Midst of Darkness : Lived Experiences of Cancer Warriors
Total No. of Pages 61
Type of Document Thesis
Author: Mignodel M. Morales, RN
Name of Institution Golden Gate Colleges
Address: Batangas City
Abstract
Employing a qualitative approach about the lived experiences of cancer warriors, this paper delved into the perceptions of pediatric cancer patients towards cancer, their coping mechanisms, changes that they experienced and their motivations and aspirations that served as their strengths for continuing their treatment. Eight informants were interviewed using the interview guide that was validated and pilot tested. Participants of the study were interviewed in different settings, such as Batangas Regional Hospital and the Clinic for the Sick Child, that cater to hematologic and oncologic pediatric cases. The results were associated with 19 themes: the darkness that lurks within, death whisperer, scourging soul, gloomy in the dusk, fierce flame,game of luck, tone of command, freezing within, cape of deception, inevitable mask, sinking ship,shattered reflection, blinded dreams, prisoners of dusk,stealing the light, going with the flow, holding onto the light, looking beyond the gloom and fuel of hope. The 19 themes correspond with 11 associated meanings: fear of death, a sense of depression and pain,sense of dynamic dependency and tolerance, sense of unchanged status in the community, sense of physical changes, a sense of physical disfigurement that lead to low self esteem and social deprivation, sense of educational importance to the youth, sense of protective isolation, cancer hindrance of dreams, deceiving acceptance and a sparkling light in the midst of darkness. The cancer warriors had been within the darkest hour of their lives because of their medical condition. Cancer had been associated to suffering and death thus, the informants are in the denial stage to provide them the opportunity to live a normal life. They hope to be cure that they cling to faith, to themselves and to their family .
Key Words: Phenomenology, Cancer , Motivation , Health , Adaptation CHAPTER I
RESEARCH PROBLEM
Background and Rationale
“The secret of the care of the patient is caring for the patient, ” thus said Dr. Francis Weld Peabody of the Harvard Medical School. The life of cancer patients is like a journey to the unknown. They struggle and defend their lives even to the point of seeing their body as it slowly deteriorates to cancer. But with the significant others around them, cancer patients find meaning in their everyday existence.
Cancer is not merely a lesion on a diagnostic image or an abnormal proliferation of mutant cells. For many patients, families, and health professionals, it is one of life's most immediate encounters with vulnerability, suffering, and mortality. It has life-altering implications for career, family life, and life expectancy, and it also raises profound questions about the meaning of life and death. It is the whole person, not just the patient's body, whom health professionals need to look after, and one of the best ways of doing so is to gain a deeper understanding of what it means to live with cancer.
Cancer is the third leading cause of morbidity and mortality in the Philippines. Leading cancer sites/types are lung, breast, cervix, liver, colon and rectum, prostate, stomach, oral cavity, ovary and leukemia. There is at present a low cancer prevention consciousness and most cancer patients seek consultation only at advanced stages. Cancer survival rates are relatively low. The Philippine Cancer Control Program, begun in 1988, is an integrated approach utilizing primary, secondary and tertiary prevention in different regions of the country at both hospital and community levels.
According to the Philippine Cancer Control Program, cancer is relatively rare in children. Most cancers (98%) develop in adults, especially in people past middle age. About one out of every six adults will develop cancer during his or her lifetime, while one in 300 boys and one in 333 girls will develop cancer before the age of 20. It is supported by other research that children do suffer from cancers but cancers are uncommon during childhood. In the developed countries where statistical data are more complete, cancers affect 120-160 per 1,000,000 children under the age of 15 years every year. Approximately one in every 300-500 people will develop cancers before their 20th birthday.(http://www.parkwaycancercentre.com/fighting-childhood-)
This study explores the adaptations, effects of disease to cancer warriors in their mere early age that will deepen society’s attachment to people who are optimistic in dealing with their lives. As cited by American Cancer Society, the fuel of the cancer warriors to continue to battle is their motivation. Motivation makes quality of life for people with cancer better. It is a psychological drug that can fight various diseases, including cancer which is considered as one of the leading diseases of the world.
Contrary to what the society believes that if the patient has cancer, he / she will eventually die, the researcher chose to conduct this study because as exemplified by Lance Edward Armstrong, a prestigious cycling athlete who was diagnosed by testicular cancer, his motivating force helped him to continue to direct his thoughts on how to excel rather than drown in lament for the fate suffered in his condition. After winning the Tour de France, Armstrong remained productive coaching for young athletes to excel. He is also wiling to become trainers for others who are battling cancer. He became a pertinent speaker at various meetings that provide motivation and fighting spirit of life for cancer patient.
The study aims to answer the following questions:
1. What are the perceptions of cancer warriors?
2. How do the cancer warriors adapt to life changing situation.
3. What is the driving force of the cancer warriors to pursue their lives?
Purpose and Significance
This qualitative study about cancer warriors will be vital for the community and the healthcare providers for the improvement of clinical and psychological management.
The specific significance of the study in each sector is enumerated as follows:
For the Pediatric Nurses, they can ensure a holistic approach in dealing with patient with special needs. Likewise, they can explore the life of a cancer patients and their adaptation that may link to the current treatment and further enhance the care given to them.
For the Nursing Educators, they can appreciate an illness and course of treatment beyond a theoretical and conceptual perspective. This study may open a new approach in dealing with cancer patients that can lead to a development of new theories.
For the Health Care Institutions, that will become involved in the management of such disease that is costly and deleterious in nature. Similarly, they can improve their facilities to be conducive for the special needs of cancer patients.
The society will be aware that cancer patient can live a normal life and have the capacity to fit in the changing community. The researcher hopes this study will eventually solidify the equality and respect due to the cancer warriors.
The family of cancer patient can accept the truths of life and can deal with stressful events and cope up with seemingly endless fight for the life of their child.
The cancer patients, can inspire children in similar situation. They can share their enlightenment on how they are able to live every moment of their lives with hopes and optimism.
Research Impediments and Constraints
This qualitative study delved into special cases of cancer patients and their family as a support system. Thus, the researcher decided to limit the informants using the following criteria:
a. The pediatric patients have ages ranging from 9 years old – 17 years old.
b. The patients were diagnosed by an Oncologist regarding their conditions.
c. The participants had undergone chemotherapy or any alternative treatment for their cancer.
The researcher limited the sample to only eight respondents for him to extract the essential themes more comprehensively.
CHAPTER II
RESEARCH QUESTION
REVIEW OF RELATED LITERATURE AND STUDIES
The major insights of cancer patients revolve in grief, depression, denial.
Grief is the subjective feeling precipitated by the death of a loved one. It also can occur as a result of variety of losses, in addition to the loss of loved one. They include the loss of status, the loss of a national figure and a loss of a pet. The expression of grief encompasses a wide range of emotions, depending on the cultural norms and expectations and on the circumstances of the loss. (Kaplan, 2001)
Initial grief is often manifested in the state of shock that may be expressed as a feeling of numbness and a sense of bewilderment. That apparent inability to comprehend what has happened may be short lived. It is followed by such expression of suffering and distress such as sighing and crying. Feelings of weakness, decreased appetite, weight loss and difficulty concentrating , breathing and talking also appear. (Kaplan, 2001)
One of the most used and comprehensive views regarding impending death is the theory of Kubler-Ross the stages of dying.
Shock and denial eventually may be experienced by the terminally ill patients. The patients may appear dazed at first and then may refuse to believe the diagnosis or deny that is anything is wrong. The degree to which denial is adaptive or maladaptive appears to depend on whether the patient continues to obtain treatment, even while denying the prognosis. (Kaplan, 2001)
The patient may also feel anger; he becomes frustrated, irritable that they are ill. They become angry to God, their fate, a friend or family members. The health provider should recognize that anger may represent the patient’s desires for control in the situation in which they feel completely out of control. . (Kozier, 2008) Bargaining it is a stage wherein the patient may attempt to negotiate with physicians, friends and even God: in return for a cure, they will fulfill one or many promises, such as giving to charity and attending to church regularly. (Kaplan, 2001)
Depression is one of the common feelings left by the terminally ill patients and also their relatives. The depression may be a reaction of to the effects of illness on their lives such as helplessness, hopelessness isolation from friends and family or it may be an anticipation of the loss of life that eventually occurs. (Kaplan, 2001)
Acceptance is the last stage of grieving process wherein the patient realizes that death is inevitable and they accept the universality of the experience. Their feelings may range from mood that is neutral to one that is euphoric. The patients are able to talk about death in the face of the unknown.
According to the research from America this resulted to the insights regarding persons with cancer due to knowledge scarcity of the disease the people in the study the Tongans viewed cancer as a disease was linked to death. Some of the participants noted that it is a disease where germs, viruses, and cells grow out of control. Likewise, they compared cancer to HIV/AIDS, it is a disease for which there is no cure. That there is no cure for cancer was a perception held by 35 of the 48 participants. The cancer was very much viewed as a death sentence.
Evidence from pediatric cancer shows that giving children appropriate information about the disease reduces anxiety. Children's understanding of cancer and death has an incremental, developmental component that needs to be taken into account when talking to children or preparing literature for them.
Judging children's reactions can be difficult. Children may be very distressed yet may deal with the situation by becoming detached, leading parents to believe that they are unaffected by the news. Although children cannot be protected from adverse events, the quality of the relationships and communication between family members are important for preventing adverse longer term consequences. Thus, in developing appropriate interventions to support children and parents, the children's perspective must be understood and taken into account.
According to the research of Eaton, Hockenberyy . A descriptive, correlational design was used to investigate the relationship of the longevity of the cancer experience and the presence of a relapse to the child's self-perception, cancer stressors, anxiety, and use of coping strategies.. The longevity of the cancer treatment and the presence of a relapse were negatively associated with the child's self-perception. Trait anxiety was positively associated with duration of the cancer experience and with the presence of a relapse. Longevity of the cancer experience and the presence of a relapse may be factors that signal the need for interventions designed to enhance the child's self- perception throughout treatment. Because children in this study who reported lower self- perception and higher trait anxiety levels also reported experiencing more cancer stressors, nursing efforts to develop innovative strategies designed to enhance patients' feelings of self-worth and decrease their anxiety may prove to be important contributions to the care of children receiving treatment for cancer.
Difference of Adult Cancer to Childhood Cancer
The types of cancers that develop in children are very different from the types that develop in adults. Childhood cancers are often the result of DNA changes in cells that take place very early in life, sometimes even before birth. Unlike many cancers in adults, childhood cancers are not strongly linked to lifestyle or environmental risk factors.
There are some exceptions, but childhood cancers tend to respond better to treatments such as chemotherapy. Children's bodies also tend to handle chemotherapy better than adults' bodies do. But cancer treatments such as chemo and radiation therapy can cause long-term side effects, so children who survive cancer need careful attention for the rest of their lives.
Coping Mechanism of Child Warrior
Normal growth and development necessitate movement of an individual from dependency to interdependency and hopefully, to independency. Some individuals may return to dependency or interdependency prior to death. Life involves change, and that change often involves loss and suffering.
Coping and development seem inherently inter-connected. No account of coping is complete without acknowledging the central role that age-graded factors play in shaping an individual’s adaptation to stress… Likewise, no account of development is complete without a consideration of how individuals respond to stress (Skinner and Edge, 2002).
The adaptation of the cancer warriors will be depending on their coping mechanism on their developmental stages. Emotion regulation also depends in early childhood and cultural differences in the expression of emotion emerge at an early stage. For toddlers they are able to solicit social support under stress with strategies other than crying. A parent is often used as security object, with the child running toward, touching, clinging or simply making eye contact with the parent when frustrated, angry or frightened – at least for securely attached toddlers.
Coping mechanism of preschoolers, as viewed by Murphy and Moriary (1976) observed that under duress, nearly all preschoolers would regress in the service of the ego, that is they would loose recently acquired skills such as bladder control. Alternatively, they might take up earlier abandoned behaviors such as thumb sucking or reattaching to transitional objects. Acting in a more infantile manner often gets the parents to focus more attention to them, a reassurance that preschoolers desperately need.
Coping in the Middle Childhood, they become much more adept in calming themselves, although they still tend to become overwhelmed when they cannot manage their feelings. With the development of language and symbolic reasoning in earlier to middle childhood comes more cognitively oriented attempts at emotion an problem – focused coping, including such strategies as cognitive reframing, self talk to calm emotions and the like (Compas, et al, 2001).
Coping in Adolescence. Adolescents are more capable of reasoned arguments, although the seasoning often appears rather self-serving perhaps reflecting the return of egocentricity in adolescence (Elkind, 1985). Parents still have a large influence on coping strategies. Wolfradt, Hempel and Miles 2003, found parental warmth was most associated with active coping in adolescents. In addition to this, Adolescents are viewed by Piaget, 1972 as young people begins to display formla logical thought process that enable them to reflect upon their own deaths.
A German study found that secure attachment was associated with more active coping and an integrated social network, while those with insecure attachments styles vacillated between help seeking and avoiding others (Seiffge-Krenke, 2004).
The Effects of illness to the cancer Warriors and their significant others.
Most children who have cancer adjust well. Cancer treatment is stressful on the child and the family. However, studies have shown that most children treated for cancer, and children who are long-term survivors of cancer, have few serious psychological problems.
The early days of treatment, when the child is often in the hospital, are usually the most stressful for the child and the family. The child may be anxious about being away from home and receiving new treatment. This anxiety usually decreases over time. Studies have reported that, in general, children treated for cancer have no differences from other children in self-esteem, hopefulness, depression, anxiety, or loneliness.
Children who have a lot of support from their family are less likely to have problems adjusting.
Some studies have shown that physical and emotional distress related to cancer and its treatment can cause mental health problems in certain childhood cancer survivors. These problems include depression that needs treatment and can lead to suicide. Signs of depression include the following, feeling empty, worthless, unloved, or that life isn't worth living, feeling nervous, restless, or irritable, Changes in appetite, Low energy, Sleep problems, decreased interest in activities, increased crying. The situations of the family will brought a different emotions that could be observed while they are in the course of illness and adaptation.
Anxiety s one of the most common emotion s experienced by both patients and family at he end of life. The anxiety relates directly to uncertainties about the manner and time of death.
Depression is common among terminally ill patients and family members, it may be difficult to distinguish from normal grief that accompanies loss and bereavement. The only difference between grief and depression is the intensity and length of the expression of sadness. Care giving doesn’t cause depression and not every caregiver develops depression. But the efforts to meet all the patient’s need can lead a caregiver to sacrifice her own emotional needs to such an extent that ever most capable person would be stressed.
Caregivers tend to experience sleep deprivation, poor eating habits, failure to exercise, and failure to engage in self – care during illness and postponement or elimination of their own medical appointments. Many worry that they won’t outlive the person for whom they provide care.
Fears about an illness recurrence and the late effects of treatment were most prominent among parents of CNS tumor patients. For 7 out of 11 kinds of fear, parents of CNS tumor patients expressed a stronger fear than the reference group. More than a quarter of the parents of children treated for CNS tumors feared a complete decline of the child. Parents of CNS tumor patients experience relatively heightened cancer related fears in several domains. The fear of devastating consequences felt by one fourth of parents signals the need of individualized psychological support and information at diagnosis and follow-up to facilitate parental coping with the posttreatment situation (Hoven and Boman, 2009).
Regarding patients spirituality and their significant others, for them maintaining hope by not revealing terminal diagnoses is the notion that factors outside medical technology, such as divine intervention and personal coping mechanism may play a more significant role in survival than medical intervention. Patient Reactions
Being told that you have cancer can provoke a number of different reactions. One common initial response is stunned incomprehension. Patients may initially find it impossible to go beyond the statement, “You have cancer.” Physicians communicating with patients under these circumstances need to allow them and their families the time they need to process what they are hearing and be prepared to repeat key points of information or even schedule a follow-up meeting to review what has been said.
It is important to recall that many patients diagnosed with cancer do not feel particularly ill. If the cancer has been discovered on a screening examination or as an incidental finding on an imaging examination performed for unrelated reasons, the patient may look and feel perfectly healthy. Forty percent of locoregional breast cancer recurrences are actually diagnosed in the absence of symptoms. Hence, some patients may react to the diagnosis with frank disbelief. After all, why should people who feel perfectly well accept surgery and drugs that they believe will make them look and feel sick? In the face of such an attitude, health professionals need to be calm but firm educators.
Many patients are overcome with an acute sense of fear .“What will happen to me, my job, my family, and my aspirations, now that cancer is threatening to cut my life short?” While prognosis varies widely based on cancer type and stage, it is worth reminding patients that cancer has become a less lethal disease. Although cancer accounts for approximately 25% of deaths in the U.S., it is far from a death sentence. Overall, 5-year cancer survival rates have been rising and now stand at approximately 66%, up from 50% in 1975 .
Physical Changes
Another common patient response to the diagnosis of cancer concerns fears about suffering, disfigurement, and disability. The suffering associated with cancer can take many forms . The most obvious is pain, which for many patients can be distressing and debilitating. Nausea and vomiting, once a source of suffering for 75% of cancer patients, can now be ameliorated in many cases with improved antiemetic agents . Psychological pain, including demoralization and even depression, is another form of suffering. Psychotropic drugs may have a role to play in such cases, but the attitudes of family, friends, and the health care team—including radiologists and their staffs—can also make a significant difference.
Cancer patients may experience a degree of disfigurement. In some cases, the disease itself is disfiguring, while in others the therapy is the cause. Although no one should pretend that such changes are not occurring, health professionals need to avoid overt expressions of surprise at the changes taking place. We can soften the blow by informing our patients and their families in advance what side effects of their cancer and its treatment they might later experience.
“Disability” has a variety of meanings. The most obvious disabilities are those that result directly from cancer or its surgical treatment. Patients with breast cancer may encounter numbness and lymphedema, but head and neck cancer patients may struggle with swallowing, localized pain, and dry mouth. Other forms of disability, such as varying sexual dysfunction experienced by many men treated for prostate cancer, may be more subtle but no less significant for patients and their families. Understanding the risks and benefits of different treatment options can enable each caregiver to respond more effectively to patients' questions concerning their care. Caring responses might include something as simple as offering to hold a patient's hand during a difficult conversation.
Emotional Changes
Patients fear not only their own suffering but also the suffering of family and friends: “Who will support my family? Who will raise my children? Who will keep my business running?” It is not unusual for some patients to experience a deep sense of guilt over their diagnosis. Cancer diagnoses that occur at particularly inconvenient times, such as graduations, weddings, and births, can further exacerbate the cancer patient's sense that the cancer is causing burdens for others.
This sense of guilt may extend further. As we learn more about the causes of cancer, parents may worry that they have passed on to their children an increased risk . Patients whose habits may have contributed to their disease, e.g., smokers, may worry that they have exposed other family members to an increased risk of cancer through secondhand smoke. The point of being sensitive to such concerns is not to pretend that such risks do not exist but to help patients focus less on the past and more on the future.
By recognizing that a cancer diagnosis places patients at one of the most vulnerable points in their lives, the health care team can help patients focus on effective diagnosis and therapy and foster a greater sense of hope. In some types of cancer, cure is unlikely, but even in such cases, major advances in treatment have occurred. For example, 40 years ago pancreatic cancer patients faced a 25% operative mortality rate, but that rate has now dropped to below 3% at centers performing a high volume of such procedures. Patients should be able to trust that, no matter what happens, the members of their health care team will not stop caring.
Men and woman may respond differently to the diagnosis of cancer. For example, some studies suggest that women tend to be more comfortable than men in talking about their disease, sharing their experiences, and seeking support from others. There is evidence to suggest that such sharing may actually improve survival. In contrast, men are more likely to think that they do not need help, that disclosing their illness will stigmatize them, and that dwelling on it will make coping more difficult. Furthermore, a man diagnosed with cancer often harbors a greater degree of concern that he may lose his job and be seen as a burden to others.
According to the American Cancer Society's Global Cancer Facts and Figures, more than 12 million people receive a diagnosis of cancer each year. Fear, anxiety and depression are common responses to the disease, which has the potential to attack any part of the body. Cancer not only places physical demands on the body but also affects the mind and emotions. Cancer patients tend to feel alone or isolated, making it important to receive encouragement, support and motivation---an important part of accepting diagnosis, completing treatment and leading a normal life.
Motivation is the most potent drugs against cancer, just that the motivation is rarely applied in the medical world, most doctors only give medicines that contain chemicals and underestimate the strength of motivation.
Motivation makes quality of life for people with cancer better. Motivation is a psychological drug that can fight various diseases, including cancer which is defined as the deadly disease. Thanks to strong motivation, people with cancer can survive longer.
According to lived experience of Lance Edward Armstrong a world prestigious cycling Athlete and had been diagnosed by testicular cancer. His motivating force helped him to continue to direct his thoughts on how to excel rather than drown in lament for the fate suffered in his condition. After winning the Tour de France, Armstrong remains productive coaching for young athletes to excel. He is also wiling to become trainers for others who are battling cancer. He became a pertinent speaker at various meetings that provide motivation and fighting spirit of life for cancer patient.
According to Dr Francis Weld Peabody of the Harvard Medical School made a famous statement about clinical medicine in 1925: “The secret of the care of the patient is in caring for the patient.”1 This statement contains truth and wisdom and has been used to enlighten generations of medical students. But my question is, what is real and meaningful “caring” for cancer patients by oncology clinicians? Is this kind of caring possible?
As he narrated the lived experience of a promising young female dancer fell accidentally during her performance on stage. She experienced paraplegia. A very renowned physician was invited to treat her. After his examination, his first sentence spoken to her was “Don’t worry. I think the chance that you can sit in a wheelchair and self-manage your daily life is great.” The young dancer immediately refused to have the famous physician treat her and insisted on changing to another doctor for further treatment. Two years later in an interview on a TV show, the same young woman sitting in her wheelchair recalled her experience at that time: “You know, I had a bright future in front of me. I had a very high expectation of being able to dance again on stage. How could I just accept the outcome of ‘self-management of my daily life and sitting in a wheelchair’? That sounded like I was already labeled as a piece of passing-season goods that was now on sale; no more value for a good price. That did not at all match with my life goal.”
These two stories caused me to ponder in a new way the relationship between patients and oncology caregivers and to rethink the meaning of “best caring.” But, one truth that we as oncology specialists may miss is that every patient comes to us from a normal life before a cancer diagnosis. They have their good life, dreams for a better life, and plans to achieve a desired future much the same as we without the diagnosis have. It is not easy and probably not fair for anyone to be forced to give up a good life, dreams, or future plans no matter the reason. Quite naturally, the early hope for patients is for 100% of their normal life to be restored. It may be unrealistic and irrational, but it is their true feelings and thoughts, which makes it hard for an oncology clinician to satisfy patients if we do not first recognize their self-identity. Excellent cancer care demands an understanding of science but also a sensibility about the soul of a human-being.2 We need to conduct more research to figure out “where they are” and “where we are,” to know more about how our patients think and how we think and to explore the gap between the two ways of thinking about the same cancer-affected situation. Such research findings will help us to create a connection. Only when a common understanding is established can a shared goal be established between cancer patients and cancer specialists.
According to Sunberg and Clauia, 2012, Long-term survivors of childhood cancer seem to have resources to cope with stressful situations in life to the same degree as people in general. Survivors with fewer resources to cope and those having received a more intense treatment were more likely to be in need of support. On the contrary according to Australian researchers report patients with a positive attitude fared no better than their less-upbeat peers, leading them to suggest that doctors who encourage cancer patients to remain hopeful following a diagnosis may be doing more harm than good.
"This is a very important study because there is an expectation on cancer patients that they need to be positive or their tumor will grow faster -- and that's just nuts," says psychiatrist Jimmie Holland, MD, of Memorial Sloan-Kettering Cancer Center and author of The Human Side of Cancer, a book dispelling what she calls "the tyranny of positive thinking."
"The idea that if you're not an optimist, you're not going to do as well with this disease is just wrong, and it's a terrible thing to lay on people," Holland tells WebMD. "What this confirms is that if you're not optimistic by nature, it won't affect your cancer."
Herman Eyre, MD, chief medical officer for the American Cancer Society, also praised the study. Although optimism has been promoted by some as a path to longer survival for cancer patients, in reality the scientific evidence of its true role has been mixed.
"There are studies that find that a good attitude is a positive," he tells WebMD. "But sometimes, it gets to the point where patients are overpromised the role of a positive attitude, and wind up with an unrealistic expectation about their outcome."
A positive attitude can motivate cancer patients to take better care of themselves following a diagnosis. "Those who are optimistic are probably more likely to eat well, exercise regularly, stop smoking, and practice other behaviors that are helpful," Eyre says.
"But very clearly, attitude cannot overcome the importance of the basic underlying disease. And in this study, these people had a cancer where the median survival is 16-18 months. Attitude will not change that." Positive Attitude: 'An Additional Burden'
For their study, researchers at six Australian cancer centers tracked 179 patients with a type of lung cancer that typically kills 85% of patients within five years. The patients were surveyed about their attitude and levels of optimism before treatment began, then six weeks after completing treatment. During the five-year study, all but eight patients had died.
The only trend noticed was a small but measurable drop in optimism as patients experienced the toxic effects of their treatment.
"Encouraging patients to be positive may represent just an additional burden," write the researchers. "We should question whether it is valuable to encourage optimism if it results in the patient concealing his or her distress in the misguided belief that this will afford survival benefits."
Theoretical Framework
The researcher used Roy’s Adaptation model with a presumption of those human adaptive systems as complex, multifaceted and responding to myriad environmental stimuli to achieve adaptation. Humans have the capacity to create changes in the environment. Humanism asserts that the person and human experiences are essential to knowing and valuing and that they share creative power.
The theory is beneficial to support the study involving real experience of cancer warriors and their adaptation from the never ending changes in their life situation. As defined by Roy (1999) , adaptation refers to the process and outcome whereby thinking and feeling persons as individuals or in groups, use conscious awareness and choice to create human and environmental integration.
The study dealt with people with different principles and attitudes in life. As Roy, (1999) defined persons as holistic, adaptive systems, they are also described as a whole with parts that function as unity for some purpose. The study dealt not only with cancer warriors but also with their support system. Human systems have thinking and feeling capacities, rooted in consciousness and meaning by which they adjust effectively in the environment and in turn, affect the environment (Roy and Andrews, 1999).
The cancer warriors are affected by their self concept and principles in life in dealing with their situation. This is supported by Roy (1999) , she stated that self- concept is composite of beliefs or feelings that an individual holds about him or her self at any given time.
The other subsystems of the human adaptive process are the interdependence adaptive mode describes the interactions of people in society. The task is to give and receive love, respect, and value. In this study, there will be support system and significant others that can be of utmost help in attaining the research outcome.
Research Questions
The study sought to know the views and perceptions of the cancer patient and their significant others on the course of treatment of cancer. Specifically, the study aimed to answer the following:
1. What are the perceptions of the informants regarding their condition? 2. How do the informants cope with the life changing condition? 3. What are the motives and the driving force of the informants to continue life?
Interview Guide
1. Building Rapport 2. The perceptions of the informants regarding Cancer a. The feeling that accompanied by the diagnosis 3. The adaptation and coping mechanism of the informants. a. The changes within the family b. Changes in the community c. Changes in oneself 4. Aspiration and motivation of the informants
CHAPTER III
RESEARCH METHODOLOGY
RESEARCH DESIGN
The qualitative method of research was utilized in this study. It is defined as the investigation of phenomena, typically in an in-depth and holistic fashion, through the collection of rich narrative materials using a flexible design (Polit and Beck, 2008). The researcher has decided to focus on the qualitative point of views in studying the lived experiences of the pediatric patients and their adaptation to their illness. The life processes focused in the study, such as one’s faith and adapting to illness provided the researchers with critical insights into the informants’ experiences. (Gillis and Jackson, 2002).
Various statements from the interviews with the informants were compiled in order to arrive at a holistic view of their experiences (Polit and Beck 2004). Through the interaction with the informants, the researchers were then able to determine and understand the phenomenon in several ways and form the realities of these participants. In-depth interviews were conducted to come up with a view of reality that informants recognized to be essential and significant. The interviews were then transcribed while focusing on the experiences that were common among them. The researcher was able to identify the different realities, by careful analysis of the responses of the informants. These relativities were then reported through extensive quotation and identification of themes that reflect the point of views of the informants (Gillis and Jackson, 2002).
Descriptive phenomenology perspective of qualitative research is adopted by the researchers to describe thoroughly the experiences of the informants and develop a comprehensive understanding of their realities.
Phenomenology is based on description of experience as they present themselves to consciousness, without recourse to theory, deduction, or assumptions from other disciplines. In the field of research, phenomenology allows nursing to described, analyze and explain a phenomenon for the benefit of its practice, education and further research. When researcher chooses to use this approach, he should base it on the appropriateness and the necessity of shedding light on a selected phenomenon. (Speziale and Carpenter, 2003).
The research design enabled the researcher to conscientiously describe, interpret and conduct an inquiry on the phenomenon under study. There were done in the belief that critical truths about reality are rooted in people’s lived experiences. The method also gave the researcher a chance to indentify preconceived beliefs and insights as well as permit him to keep an open mind to the meanings attributed to the phenomenon by the informants. The research process involved extracting significant statements, categorizing, and giving sense to the essential meanings of the phenomenon (Polit and Beck, 2004).
Subjects of the study
The study focused on eight pediatric patients who were diagnosed with malignancies. The informants’ age range from 9 to 17 years old . They are undergoing chemotherapy and any alternative treatment. They have at present their support system that accompanies them through their struggle. The informants were selected due to their age and case of malignancies. To maintain confidentiality, the researcher utilized the initials of his name to represent each informant. Some of the details were obtained from their mothers and significant others.
Informant M is 14 years old , female, with diagnosis of Langerhan’s Cell Histiocytosis, from Occidental Mindoro. She was diagnosed last September 2009 with the chief complaint of axillary mass and sudden weight loss. There were three cases of the bleeding tendencies of her axillaries mass. The first incident she did not tell her mother but due to severe bleeding her mother was alarmed and went to the nearest hospital .She was a typical student of Colegio de San Sebastian and a consistent honor student during her grade school years. As a daughter, she was living with her auntie within the town proper to easily gain access in school. She is a silent type of person who mingles only with person familiar to her.
Informant I , is an 11 year old girl, with diagnosis of Acute Lympocytic Leukemia. She is an incoming grade five student of San Poquinto elementary school, in Malvar , Batangas. She was diagnosed last June 15, 2012. She experienced paleness and weakness. With the presence of rashes they taught it to be dengue but after bone marrow and blood smear analysis, it was confirmed she had cancer. Because of frequent check ups and follow ups for her condition and the start of her chemotherapy, the family decided that she should stop her studies. There are changes observed by her mother such as her being short tempered and always being aloof from people. This made Informant I , isolated and silent all the time. At present, her mother and sister reside in a dormitory near the clinic where she has her chemotherapy.
Informant G is a 17 year old female from San Salvador, Lipa City, Batangas. She is an incoming 1st year college of De La Salle Lipa, to take up BS Management Technology. She is jolly student assistant during her high school years in the said institution. She is very active in the school activities and also in their community. She has a broken family and she resides with her mother and siblings. Her father gives financial assistance for her chemotherapy. Her chief complaint was severe and unusual menstrual bleeding. Then, she had been confined in Lipa Medix due to sore throat. They had tried to seek the help of a faith healer who advised to take herbal medicines that she should drink for one week. The result was remarkable. She felt normal again so she resumed her duty as student assistant but after few days her condition had relapsed. She was diagnosed with Acute Lymphocytic Leukemia last March 2012. After her bone marrow, she started her treatment that caused her hair loss. One of the most depressive situations of her life is to see her hair fall on to her own eyes. At present, she is in a relationship and they are in constant communication with each other. When she was hospitalized her boyfriend was always at her side. She is continuously holding to her mother for her strength to pursue her treatment.
Informant N is 14 years old, from Dayapan , Lemery, Batangas. She has a diagnosis of Acute Lymhpocytic Leukemia. She is an incoming second year student of Governor Feliciano Leviste National High School. She is an achiever in school. She belongs to the top seven of her class. She is a simple girl who wants to dance together with her friends. This year turned out to be gloomy for her because she was diagnosed with ALL and also her father died last June 18, 2012. They need to budget their resources for the treatment and the needs of the family. Her chief complaint was inflamed lower extremities and she cannot walk so she was admitted in Taal Polymedic for her confinement.
Informant O is female, ten years old and from Calaca, Batangas. Though she wears a mask, she remains energetic. She was admitted in Taal Polymedic due to painful thigh and failure to walk. After confinement in the hospital, she was transferred to Infant Jesus Hospital in Manila for further test and evaluation. There, she had been diagnosed Acute Lymphoyctic Leukemia and at present, she is undergoing chemotherapy. Due to her condition, she needs to limit her playing hours to prevent fatigue and exhaustion. She wants to pursue medicine someday because she wants to cure the sick.
Informant D is male, 17 years old and an incoming second year college of BSU taking up BS IT. He is from Mabini, Batangas. He is a typical college male student who smokes due to the exposure to new social environment. He wears a bandana on his head. He is not an active member of any organization. He is fond playing basketball with his friends and his favorite hobby is playing computer games. His illness started from a one month cough. He decided not to consult a physician because he thought he needed to finish his summer class. He had also inflamed lymp nodes on his neck and the fever episodes started. As the family sought medical advice and opinion for the fifth time, the doctors diagnosed him with Lymphoma. Now he feels he is a prisoner because of many limitations and rules he needs to follow. But he is lucky enough to have his family , friends and special someone that support him all the way.
Informant E, is nine years old from Lipa City, Batangas with diagnosis of Osteosarcoma status post above knee left amputation. A boy who dreams to be an Engineer but due to his condition, he decided to take up education major in science. He is weak in appearance, with face mask and pale skin. He is the eldest of the three siblings. His chief complaint was his enlarged left foot. So he was brought to faith healer because of his father but nothing happened. He is at present continuing his chemotherapy to retard the relapse and metastasis of his osteosarcoma.
Informant L, is 10 years old, from Lemery, Batangas and an incoming grade five. He is an energetic boy and always wears a smile on his face. He experienced severe abdominal pain thus, he was confined. After two days, they noticed the abdominal enlargment. For further evaluation and examination, they went to Philippine Childrens Medical Center, where he had his bone marrow examination . He was diagnosed with Acute Lymphocytic Leukemia last October 2011. At present, he is currently continuing his medications and from time to time he is admitted because of cough or stomatitis.
Table 1. Demographic Profile of the Informants
Informants Age Gender Diagnosis Address
M 14 years old Female Acute Mindoro Lymphocytic Leukemnia
I 11 years old Female Acute Malvar, Lymphocytic Batangas Leukemia
G 17 years old Female Acute Lipa City, Lymphocytic Batangas leukemia
N 14 years old Female Acute Lemery, Lymphocytic Batangas Leukemia
O 10 years old Female Acute Calaca, Lymphocytic Leukemia Batangas
D 17 years old Male Lymphoma Mabini, Batangas
E 9 years old Male Osteosarcoma Lipa, Batangas
L 10 years old Male Acute Lemery, Lymphocytic Batangas leukemia
Sampling Procedure
Two sampling methods were used in this study. Purposive sampling was used to elicit data that should be substantial to the research study and to answer the research questions comprehensively. The researcher had a criteria to elicit responses to a specialized group of people, for the purpose of the research. Convenient sampling enabled the researcher to collect data that had been easily available in the field and within the vicinity of the researcher locality. The researcher was able to reevaluate and re validate data that were vague in nature because of the accessibility of the informants.
Settings of the Study
This research was conducted in unusual ways because data depended on the informants, the cases of malignancies in the hospital that they were confined or in some private institutions that cater to their special needs. The researcher conducted interviews from Pediatric Ward of Batangas Regional Hospital and from the Clinic for the Sick Child located in Batangas City proper. The Cancer Warrior Inc. is an organization that helps the family and the patients to cope with the disease and aid for issuance of free chemotherapy. The environment in both settings was conducive for the interview although there were some tolerable noises generated by other patients and the relatives within the vicinity of the clinic and within the hema onco ward. The room was well lighted and ventilated for the informants to be comfortable.
Research Instrument and Validation
Kozier (2008) defined, qualitative research “as a naturalistic inquiry, which explores the subjective and complex experiences of human beings”. It investigates “the human experience as it is lived through careful collection and analysis of narrative, subjective materials” (Polit and Hungler, 1999). Considering the nature of this type of research, the researcher chose to conduct semi structured interview as a method of data collection. The researcher prepared a written interview guide which aimed to ask questions that provide an opportunity for the informants to impart rich and detailed information about the phenomenon under study. This was reviewed and validated by the researcher’s adviser. This technique ensured that researcher will obtain all the information required and gave the informants the free will to respond in their own words and offer illustrations and explanations.
The research instrument was based on the research questions that were conceptualized and meticulously formulated to form the interview guide. This was revised and pilot studied from various pediatric patients with chronic diseases. Some cases of pilot studied were severe asthma. The questions had elicited the necessary answers that were essential to the study.
Participant observation was simultaneously done by the researcher as the interview progressed. This served as guide for understanding the environment of the informants that may affect their experiences as well as their reactions and expressions during the interview.
The researcher used the standards of qualitative studies to prove the authenticity and the credibility of the transcribed interviews that will be used to extract themes and essences.
Credibility refers to the confidence of truth of data and interpretation. This can be observed in the process of this research. The researcher had a prolonged engagement to the informants so that he was being submerged in their culture, insights and feelings. The researcher had been with them for at least 10 minutes to one hour in the conduct of each interview. The researcher was with them every Friday at the clinic and always in close contact with them if they were admitted in the Batangas Regional Hospital. Moreover, the researcher was a persistent observer while conducting the interview to collect salient points of nonverbal communication.
Triangulation was utilized in this study to build its credibility. Polit, (2008) defined triangulation as “the use of multiple referents to draw conclusions about what constitutes the truth and has been compared with convergent validation. The type of triangulation used is the time triangulation that involves collecting data within same phenomenon but in different points in time (Denzin, 1989).
Dependability is the second criterion to gain the trust for research. It is referred to as the stability of the data over time and over conditions. The researcher came up to an inquiry audit wherein he conducted interviews twice. The rigors of qualitative research such as dependability had not been observed due to the location of the patients for re evaluation and validation of data but the researcher ensured that he had comprehensively interview the informants and elicit to them the necessary data to be gathered. It is to scrutinize data and can be supported by documents of the external reviewer.(Polit, 2004)
Confirmability as a criterion of establishing the study is expressed when the researcher did the audit trail that involved an independent auditor who dealt with the collected data such as the transcribed data, theoretical notes, the drafts and the researcher’s intention and disposition (Polit, 2004). Mrs. Irene Roco, PhD, a clinical instructor of Lyceum of the Philippines University Batangas served as the auditor. She reviewed the narrations and statements of the informants, and the theories that were used in the study. Transferability as a criterion of the foundation and trust of research can be depicted when the researchers used the proposed interview guide to other special cases of pediatric patients such as pneumonia or renal diseases. This is to discover the generalizability of the data where findings can be transferred to other settings or groups (Gubas, 1985).
Method of Data Collection: Semi-structured interview
Preparing for the interview
Despite the fact that qualitative interviews are mostly conversational this does not mean that they are treated casually. The conversations are purposeful ones that need advance thought and preparation. Steps were taken to make the interview less stressful and more comprehensive to the informants.
The researcher must undergo a process of self-awareness or bracketing, knowing one’s self because if the researcher has a preconceived data on his own , he has his own principles and a stand for this study thus, eventually the result will be biased. The researcher at the start of the interview presumed to be knowing nothing about the phenomenon for him to extract and saturate data that are pure and not subjective in nature.
The interview guide was carefully constructed by the researcher in order to ensure that the informants understood them and that it can elicit the informant’s lived experience of the phenomenon. The following patterns had been applied in the preparation of the interview.
1. Submitted a letter of approval to the Dean and Adviser 2. Submitted a letter to the Medical Director thru the Chief Nurse of the Hospital, regarding the pursuance of research within Batangas Regional Hospital – Pediatric Ward. Same letter submitted to Dra. Mayie Salvador , of Clinic for the Sick Children, which caters hematologic and oncologic pediatric patients. 3. Purposive and Convenient Sampling 4. Preparation of the interviewer 5. Preparation of the materials to be used during the interview (recorder, pens and papers). 6. Set the venue for the interview
The researcher and informants conversed using Filipino as the medium.
The interview guide was used by the researcher during the interview. Upon the researcher’s discretion, the informants were requested to elaborate their descriptions of experiences. All questions were open – ended except those which were used to verify unclear words and statements. The interviewer explored the aspect that was important to the informant and encouraged spontaneous response that is more self – imparting and personal as well. The interviews were conducted in the following dates: July 25, August 2, 7, 8, 10, 29, 2012 agreed upon by the researcher and the informants and their availability.
During the interaction, the researcher asked questions directly to the informants while taking into account their verbal responses as well as non verbal cues. These non verbal responses included the mood, facial expressions body and hand gestures, intonation, pitch of voice, etc.
Another aspect of the preparation includes the setting of the interviews. Most of the interviews were conducted at the Batangas Regional Hospital where the researcher was affiliated and where there are cases of pediatric malignancies admitted and treated. Other informants were interviewed in Clinic for the Sick Children as special clinic for hematologic and oncologic pedia cases. The researcher exerted efforts to provide a relaxing and conducive atmosphere for the interview.
The researcher anticipated and prepared the necessary equipment and materials prior to the interview. Such materials included the recorder which was tested before the interview, notepads, pens and papers.
Conducting the Interview
Qualitative interviews are typically long sometimes up to several hours because researchers found out that the informant's construction of experience only begins to emerge after a lengthy, in depth dialogues. Considering this, the researchers prepared the informants for the interview by putting them at ease through the sharing of pertinent information about the study and creating a comfortable environment by using the first few minutes of the interview for light conversation. This helped the interviewers gain access to richer information and more personal intimate details of their experiences (Polit and Beck, 2008). The most critical interviewing skill was being a good listener. There were data and expressions that can be deceiving and should be re evaluated and revalidated especially the non verbal communication. Interruption of the informants can be avoided if the researcher will stick to his interview guide. The interviewer strove for a positive closure to the interview through asking the informants any information that he/she had missed out. The interview will end in such a way that it is only a conversation for both the interviewer and the informant.
Prior to the interviews of the informants, the researcher conducted an interview to their parents and relatives for background information and to know how to approach the informants. The purpose of the study was explained to the guardian of the participants. They were likewise told to sign the informed consent form. They were assured of the confidentiality of the information they will disclose and told that the results will be communicated to them.
The planned interview should be solely by the researcher and the informants but to diminish anxiety of the informants, the researcher decided to conduct interviews with their mother at their side. The interviews lasted from 10 minutes to one hour with the interview guide as the researcher’s reference. The interviews ran smoothly with mild distraction such as noise from other patients within the hospital and other patients waiting for their check – up.
Post interview
Recorded interviews were listened to and rechecked for audibility and completeness soon after the interview was over. Manual transcription of the recorded interview was done on paper and then encoded by the researcher. To ensure that the transcriptions had been accurately transcribed, the researcher played and reviewed them at least three times. There were follow up interviews for the researcher to validate and evaluate the answers to the previous questions within the interview guide.
After collating and transcribing the data, the next step was to do the bracketing. As defined, it is “the process of identifying and holding in abeyance preconceived beliefs and opinions about the phenomenon under study”, (Polit, 2004)
Ethical Considerations
In conducting this study the researcher had been sensitive to the life of the informants. Respect for life and autonomy was of paramount consideration in observing the ethical principles. The researcher must accept the decision of the patients and not to coerce them to answer questions that were intrusive in nature. The researcher sought consent to the significant others of the informants before conducting an interview. The principle of veracity was observed in such instance such as telling the truth regarding the purpose of the study and its benefit not only for the researcher but most importantly for the patient. Lastly, the principle of confidentiality was always implemented. Every account and interview was within the utilization solely by the researchers and the informants.
Data Analysis
Data had been gathered and analyzed using Colaizzi’s methodology
Gathered and collated informants’ descriptions of the phenomenon Data Collection : Semi – structured Interview
Transcribed informants’ verbalizations from recorder interview
Rechecked transcribed data
Read and analyzed all data gathered regarding informants’ descriptions of the phenomenon
Extracted significant statements from transcribed data
Identified the perceived meaning in each statement
Generated meaning from each statement
Organized the generated meanings and clustered into themes
Referred back to original statements to check for validity
Formulated exhaustive descriptions of the phenomenon
Validation and confirmation of identified themes with the informants
Figure 1. Diagram of Organization of Data according to Colaizzi’s methodology
In order for the researcher to arrive at the exhaustive description of the essences of the lived experience of the patient with cancer, the researcher first underwent analysis and interpretation of qualitative data gathered which includes the accidental bracketing. Phenomenological Reduction
The aspect was crucial for the preservation of the objectivity in the phenomenological approach. Everything known about the phenomenon was collated and bracketed in an effort to keep what is already known apart from the experiences as described by the informants. No conclusions were made on impulse during the interpretation of data.
Gathering and Collating informants’ descriptions of the phenomenon
Data regarding the experiences of the patient with cancer was collected. Feelings of trust and cordiality was established as a basis to achieve openness between the researcher and the informants. Confidentiality was assured by the researcher to the informants. The informants were assured that their experiences will be treated with utmost confidentiality and data be collected will be shared for the improvement of nursing practice on specific cases of the patient.
A semi structured interview that provides opportunities for specific latitude in the answers that were given by the informants was used. The interview guide which contained open – ended questions were utilized to ensure all pertinent data that will be collected.
Reading and analyzing data collected about the informant’s descriptions of the phenomenon
All data gathered were transcribed manually. It was believed that people can express uninterruptedly in such a manner and that analyses of their descriptions reveal the core or essential structure of the human experience being investigated in the study (Wood and Harper, 1990). The transcribed data were analyzed along with the observed non-verbal responses.
Extracting significant statements and generating the meaning of each significant statement After the initial data analysis, the researcher reviewed the original transcribe data to discern significant statements that were missed out but were essential in the research outcome.
Organized the generated meanings into clusters of themes/essences
All the important data were subsequently categorized according to the emerging themes or essences. Non – verbal data were also taken to consideration.
Composing an exhaustive description of the phenomenon
The researcher then described fully the data collected in connection with the phenomenon under study, which was the experience of the cancer warriors in the course of their treatment.
Returning to informants for validation of the description
The researchers eventually stopped the data gathering since data saturation was achieved. Debriefing was done to the informants to re-evaluate and re-validate the data gathered and if there were changes on their answers on the later part of the study.
CHAPTER IV
RESULTS AND DISCUSSION
Phenomenological Reduction (Bracketing of Accidental Qualities)
Essential in progressing from data collection to data analysis is Phenomenological reduction. This is done by bracketing accidental qualities or perceived data, perceived and co-perceived data prior to analysis of data. These data may be the characteristics or behaviors that are directly perceived by the senses, either by the researchers or the participants. They may also be preconceived by the senses, either by the prejudice held by the researcher or knowledge received by the mother caring for cancer patient coming from external sources.
Perceived Data Sets
Perceived data are those data that can be directly observed or gathered using the senses which also included the environment setting upon interaction. Both purposive, and convenient sampling were used in providing the sample until data saturation occurred. The sampling method came up with eight eligible participants. They were aged 9 to 17 years old. Five of the participants have Acute Lymphocytic Leukemia, one with Langerhans Cell Histiocytosis, one with Lymphoma, and one with Osteosarcoma. They were all diagnosed by an oncologist in private or government hospital. All of the informants had undergone chemotherapy as a means of treatment for their condition. Seven of the informants came from Batangas Province and one is from Mindoro. The researcher and the informants mutually agreed on the dates, time and the place for the interview to take place. Three of the informants were interviewed inside the hospital premises where they were admitted. Four of them were interviewed within the Clinic of the Sick Children wherein they are undergoing chemotherapy or having their follow up check-up. One of the informants was interviewed by the researcher in their house.
Co-perceived data Sets
Co-perceived data are those that were not directly observed through the senses at the time of the interview and just extensions of the perceived data including the informant’s family and educational attainment. All of the informants live with their family, except for two informants who temporarily left their home because of their continuous chemotherapy. Two of the informants are in a college level and the remaining six are in an elementary level. All of the informants needed to stop their studies due to their condition. During the interview, the informants shared stories about their experiences and other aspect of adaptation which were considered extraneous since these were not part of the phenomenon under study.
Results Using Colaizzi’s methodology, significant themes or essences were extracted from the narrative statements of the eight participants. A rich description of the phenomenon, the lived experience of cancer warriors was gleaned and the phenomenological residuum consisted of meanings and experiences they intended. The analysis had been in the form of metaphorical themes where the significant statements were clustered and reviewed to come up with themes that can be symbolically presented.
Perceptions of the Informants towards Cancer : Fear of Death
Darkness that lurks within
Fear is a distressing emotion aroused by impending danger, evil, pain. Fear is much like a dark side of being human that weakens the personality of the person. The cancer patient has always been experiencing fear. Fear of death, disfigurement, isolation and dependence. As the disease progresses it lurks not only in their temporal body but in their innate self. Darkness of fear slowly divulged their personality. It was depicted and proved by the statements of the informants with the sense of hesitancy and fear of tone of voice. Natatakot po ako sa sakit
Kabado lang po kasi po, akala ko po nun eh isang oras lang po eh mag chechemo na
Supported by the statements of other informants , with a vague description of the illness and its results
Parang nakakatakot po eh yung iba po dun ay naaanu po nawawala na po eh
Death Whisperer
Cancer is one of the leading causes of death in the country, thus some of the people had already perceived cancer as a stepping stone to death or it leads to death. Death is inevitable but due to the increasing number of people who had cancer and the mortality cases of a specific cancer of different aged groups, the researcher came up with a death whisperer as a theme because , cancer patient had an idea that he or she may eventually lead to a sad story: death. As supported by the research from America this resulted to the insights regarding persons with cancer due to knowledge scarcity of the disease they viewed cancer as linked to death. Cancer was very much viewed as a death sentence as manifested by the informants’ narrations
hinihintay mo na hanggang saan ka na lang Kasi di ga siyempre nag papagamot kami pag nag papagamot ka parang ang iniintay mo ay gumaling o hinihintay mo na hanggang saan ka na lang
Scourging soul
Pain is an unpleasant feeling that is conveyed to the brain by sensory neurons. The discomfort signals actual or potential injury to the body. However, pain is more than a sensation, or the physical awareness of pain; it also includes perception, the subjective interpretation of the discomfort. Perception gives information on the pain's location, intensity, and something about its nature. The researcher decided to utilize scourging soul as the analysis of the statements regarding pain because the pain that the informants experiencing is beyond the physical discomfort, but also their hardships of adaptation and changes of their life as manifested by the statements:
Malala po Masakit po Baka po masakit sa pakiramdam Nakakalbo
As oncologic patients know their diagnosis, they feel the fear within them. Cancer not only places physical demands on the body but also affects the mind and emotions. Cancer patients tend to feel alone or isolated, making it important to receive encouragement, support and motivation---an important part of accepting the diagnosis, completing treatment and leading a normal life. The early days of treatment, when the child is often in the hospital, are usually the most stressful for the child and the family. The child may be anxious about being away from home and receiving new treatment. This anxiety usually decreases over time. Studies have reported that, in general, children treated for cancer have no differences from other children in self-esteem, hopefulness, depression, anxiety, or loneliness.
Children who have a lot of support from their family are less likely to have problems adjusting. As manifested with the statements of the informants
umiyak, syempre di ga si Francis Magalona kaya namatay dahil sa Leukemia
Nakapag emote na
Feelings of Informants towards Cancer : Sense of Depression and Pain
Gloomy in the dusk
Depression is one of the common feelings felt by the terminally ill patients and also their relatives. The depression may be a reaction of to the effects of illness on their lives such as helplessness, hopelessness isolation from friends and family or it may be an anticipation of the loss of life that eventually occurs. (Kaplan, 2001). As interpreted by the researcher, sadness will always be accompanied to any disease thus the informants felt the gloomiest days of their lives within the context of a terminal disease: Malungkot Nakapag emote na Masakit sa pakiramdam
Fierce Flame
The patient may also feel anger; he becomes frustrated, irritable that they are ill. They become angry to God, to their fate, to a friend or even to family members. The health provider should recognize that anger may represent patient’s desires for control in the situation in which they feel completely out of control (Kozier, 2008). The researcher used fierce flame because a patient with this kind of disease tends to be more sensitive than others. The patients became stubborn and with bad temper because of their condition. Because of failure to comply with their wants, they tend to burst to hostility. This was manifested by the informants’ statements:
Naiinis syempre di pwedeng gumala Nagagalit
Changes experienced by the informants within the family : Sense of Dynamic Dependency and Tolerance
Game of Luck
Families who care for a child with cancer incur considerable costs during the diagnostic, treatment, and follow-up care phases of the disease. Out-of-pocket treatment expenses are one of the burdens of the family with a cancer patient. As the researcher analyzed the statement, it could be associated with a game, a game called life. A cancer patient is full of uncertainties, but these uncertainties have a tag price. They considered themselves if the results are negative and they pray not to have a relapse. It is shown in the following statements of the informants:
Mahirap po pala , kasi podahil po anu po mag hanap na po kayo ng pera pang chemo Malaking gastos Kasi di ga siyempre nag papagamot, kami pag nag papagamot ka parang ang iniintay mo ay gumaling o hinihintay mo na hanggang saan ka na lang
Tone of Command
The study deals with people with different principles and attitudes in life. Thus, as Roy, (1999) defined persons as holistic, adaptive systems, they are described as a whole with parts that function as unity for some purpose. The study dealt not only with the cancer warriors but also with their support system. Human systems have thinking and feeling capacities, rooted in consciousness and meaning by which they adjust effectively in the environment and in turn, affect the environment (Roy and Andrews, 1999). The researcher decided to use the metaphorical theme Tone of Command because the family or the support system will always obey what the patients had told them because it may somehow lessen the burden the patient was experiencing which will enable him to feel that they have a support from his or her significant others in their journey. As depicted by the following statements:
Naging maasikaso po sila Maalaga po Sinusunod po nila ang gusto ko Ako po binibili lagi ng gusto ko ako lang nakain
Freezing Within
The illness of one family member disrupts the whole family. When a family member becomes ill, other family members must alter their lifestyle and take on some of the role functions of the ill person, which in turn affects their own normal role functioning. Freezing as a word means stunted or hindered thus a patient with cancer was hindered in doing what he or she is obliged to do and to let go of his or her responsibilities and delegate them instead to much more capable members of the family. This depicts in the narrations of the informnats:
Di na po ako masyadong nakikipaglaro sa mga iyon minsan po pag ako’y minsan lang po nakakapag laro, di gaya ng dati na lagi ako nag lalaro
Changes experienced by the informants within the community : Sense of unchanged status in the community
Changing the unchanged
Shock and denial eventually may be experienced by the terminally ill patients. The patients may appear dazed at first and then may refuse to believe the diagnosis or deny that something is wrong. The degree to which denial is adaptive or maladaptive appears to depend on whether the patient continues to obtain treatment, even while denying the prognosis. (Kaplan, 2001). As the researcher had associated unchanged status to the medical condition of the patient, that in the reality cannot be detach to the patient, changing the unchanged means the changes that had been experience by the patient such as living a normal life, and changing their perceptions of their life. This was supported by the narratives of the informants:
mas lalu pa dumami yung mga kaibigan ko sila na nagimik sa akin di ako tinuturing na may sakit, talaga normal na tao Hindi ako pinagbabawalang lumabas Nagtititnda, nag aalaga ng aking pamangkin
Being with a lot of changes within the family and the community, there are aspects that have not changed but rather they develop and increase the capacity to have a lot of acquaintances and friends. As narrated by the informants:
Parehas pa rin ang trato Anu po di namn po ako yung laging kulong sa bahay , nagala din po ako kasama ang barkada Dati eh ung kapatid kung 16 years old sinabi nya eh pansin niya ang lahat sa akin ang attention , pero ang toto ay di namn , pantay pantay kami, lamang pa nga sila sa amin Di ako tinuturing na may sakit, talaga normal na tao
The changes for the better will be supported and proven by the statements of the informants
Lance Edward Armstrong, a world prestigious cycling athlete and was diagnosed by testicular cancer, directed his thoughts on how to excel rather than drown in lamentation. After winning the Tour de France, Armstrong remains to be productive coaching young athletes to excel. He is also willing to become trainers for others who are battling with cancer. He became a pertinent speaker at various meetings that provide motivation and fighting spirit of life for cancer patient.
mas lalu pa dumami yung mga kaibigan ko
naging maasikaso pa sila
Di na nga kami naghihiwalay
As depicted by the experiences of the informants they had denied the fact that they can push through a normal life, but it shows that they can be adaptive as possible, and can cope for what they have right now.
Inevitable Mask
Many people with the disease do not want others to know they are sick. This is especially true to those people who had close interaction, because they tend to increase the sense of illness to the person. He or she is sick and he or she has not in control of her or his life. Thus, it worsens not the physiological aspect but the emotional components of a person. Inevitable mask is the best description because every single moment of a cancer patient, he or she needs to wear mask to hide his/her fear and wear mask to hide their happiness. As manifested by the informants statements:
Dati ang mga kaklase ko dumadalaw sila punong puno ang ospital parang mag check ng attendance dun , di ko lahat sila kinausap gawa ng anu ayaw ko talaga , ayaw ko ng ganun
Kasi dati nasanay ako ng ako ang dumadalaw, ayw ako ung ako’y dadalawin o puntahan
Naiisip ko na may sakit ako Yun na pabayaan pagchicks
Life Changes of the Cancer Warrior
Sinking Ship : Sense of physiological changes experienced by the informants In the process of the disease, the informants experienced some physical changes that succumb their temporal body. The darkness that lies within the disease itself disfigured their mere entity. The following descriptions depict the physical changes experienced by the informants: may bukol sa kili kili
Nilalagnat po
Nagdurugo ang ilong, as in buo ang nalabas sa ilong, sa ganun then tonsils yun lahat sumakit
Parang may beke daw, malaki nga siya, ganun di ako makalakad ng isang Linggo UTI namn .
Tapos nuneg gabi po , din a po talaga yung mata ko daw po may pasa pasa, yung dila kop o brown daw po.
inuubo ako tapos nag karoon ako ditto ng kulani, akala ko dati sipun lang
Yung paa kop o, bukol pos a paa ko
sumakit po tiyan ko
Sobrang sakit po pinacheck up po ako Tapos makalipas ang 2 araw lumaki ang tyan ko
Cancer patients may experience a degree of disfigurement. In some cases, the disease itself is disfiguring, while in others the therapy is the cause. Although no one should pretend that such changes are not occurring, health professionals need to avoid overt expressions of surprise at the changes taking place. We can soften the blow by informing our patients and their families in advance the side effects of their cancer and its treatment they might later experience. There are physiological changes that affect their daily life such as depicted by the words from the informants: Hindi po nakakalakad
masakit yung mga hita ko ganun
Di ako makalakad Shattered Reflection: Sense of physical disfigurement that leads to low self esteem and social deprivation.
Cancer patients are experiencing bodily changes that may affect their perception towards themselves and their social environment. They isolate themselves and they experienced social withdrawal due to their physical attributes that are unusual to a normal person. The statements of the informants clearly depicts social stigma:
Di po ako makatingin sa salamin Nakakalbo po Yung sa rob kasi , yung lady guard , parang bago palang yun , di ga di naman lagi may lady guard dun ,eh nakabonet ako nuon , pinapatanggal , na pa ha ganun, ako eh sabi nung lalaki hindi po hindi po parang hiyang hiya yung lalaki , nakakinis
Blinded Dreams: Sense of educational importance to the youth
As a student and in an early age, education is one of the important tasks that should be accomplished thus, blinded dreams could mean the attainment of their dreams hindered by their medical condition and the future will be vague for them. The following statements show their conditions:
Nakakaabsent ako
isang Linggo po ako lumiban
ipinasa na po ako
Prisoners of dusk: Sense of protective isolation
There are adjustments made by informants to the point that they had been prisoners of their own illnesses. There are many restrictions and rules that they need to follow to maintain their health status.
Adolescents are more capable of reasoned arguments, although the seasoning often appears rather self-serving perhaps reflecting the return of egocentricity in adolescence (Elkind, 1985). Parents still have a large influence on coping strategies. Wolfradt, Hempel and Miles (2003), found parental warmth was most associated with active coping in adolescents. In addition to this, adolescents are viewed by Piaget, (1972) as young people who begins to display formal logical thought process that enable them to reflect upon their own deaths.
A German study found that secure attachment was associated with more active coping and an integrated social network, while those with insecure attachments styles vacillated between help seeking and avoiding others (Seiffge-Krenke, 2004). The following statements show the restrictions experienced by the cancer warriors:
Nakakairita lalu pag di pwedeng akong umalis Kung pwede nga lang nag papagamot eh pumapasok unti unting pumapasok kahit hindi gusto ang course Ako nga eh naiinis syempre pag alis eh di pwedeng mag gala ng mag gala Parang nakakulong , parang nasa kampo ng military lahat may limit
They are also prisoners of their dreams and what they opted to do
hindi na po ako sumama nun sa pag sasayaw dahil sobrang sakit ng paa ko di ko po maigalaw Tapos sapul na ako po’y nag kasakit din a po ako nagsasayaw minsan po pag ako’y minsan lang po nakakapag laro, di gaya ng dati na lagi ako nag lalaro
Stealing the light: Hindrance of Dreams
Present condition steals the dream of the cancer patients:
hadlang sa pamumuhay gaya ng dati
Nakakhadlang sa kabarkada , nag overnyt saya saya ngaun eh hindi na
nakakaladlang pos a pagtututloy ng pag aaral, makatulong sa pamilya at magandang trabaho
Yun na pabayaan pagchicks
As cancer progresses, changes will inevitable. The informants viewed their illness as thief of their dreams. Being left stunted in their present condition though they have the eagerness for their dreams but eventually hold back by their medical condition
Coping of Informants towards Cancer: Deceiving Acceptance Going with the flow Cancer patients tend to cope in their own way. Such as in one of the informant’s experiences, he used classical conditioning in coping and adapting to his present situation. He was scheduled for amputation but because of his readiness and emotional preparation , he fully accepts it. As cited in his narrations:
“anu po para pong pag isip ko o nuon parang puputulan yata isip kopo puputulan ako yan ganun nga nagyari kaya po mula po wala na po , kinabahan lang po”
Coping of Informants towards Cancer: A Sparkling Light in the Midst of Darkness
Holding onto the Light
Despite their conditions, the informants dream to achieve their goals in life. The flickering light of hope is fueled from strength they derive from their significant others. The informants shared their dreams:
gumaling ako , makapag tapos ng pag aaral , mag karoon ng magandang trabaho
mag patayo ako ng hotel or restaurant
Dati kasi dapat sami kami sa world series ng soft ball , gusto ko sana sumama dun
Wala nmn parang kung sa kanila dalwang taon gusto ko mas maiksi
maging sundalo po sa Airforce
maging doctor
Makapagtapos ng pag aaral
ana maging Engineer, kaya lang po nag kaganito kaya teacher n alang pos a science
Maging normal ang buhay Kasi po ngaun po ay lagi akong nasa ospital kasi po nung nakakapaggala po ako amin
maging seaman
According to Pilitteri (2007), as adolescents show increased interest in learning, they select a job field and come to see education as relevant to their future. Their conditions did not prevent them from dreaming for themselves and for their families.
Sana po eh lagi po kami malalakas kahit wala nap o ang aking ama eh patuloy kami nalaban lagging matatag Para guminhawa ang buhay
Cancer is a chronic disease that exhausts the patients hopes and dreams. Being a cancer patient, they have on their hands the light of healing and recovery. In unison the eight informants had answered makatulong sa pamilya,
Sana po eh lagi po kami malalakas kahit wala nap o ang aking ama eh patuloy kami nalaban lagging matatag
Looking beyond the gloom
Being healed and regained their strengths they want to show their gratitude to those people who have been in the gloomiest days of their life. As uttered by the informants :
Magpapasalamat po sa mga tumulong sa akin
Some informants have undying faith, sharing gratitude to God, as manifested on the statements:
lagi pong mag papasalamat sa Panginoon
magpapasalamat kay Jesus
The cancer warriors believe that divine intervention still plays a more significant role in the survival than medical intervention.
Some of them want to continue their normal life as a student , a friend, a family member and a member of the community
Babalik po ako sa pag aaral mag – eenrol na agad ako
At yung gusto gusto kong pagsasayaw Makiki hang out
Fuel of Hope
Motivation remains to be the most potent drugs against cancer. Even though motivation is rarely applied in the medical world, most doctors only give medicines that contain chemicals and underestimate the strength of motivation.
Motivation makes the quality of life of people with cancer better. Motivation is a psychological drug that can fight various diseases, including cancer which is considered as a deadly disease. Thanks to strong motivation, people with cancer can survive longer. The researcher used darkness to represent cancer and light as the informants hope which they attributed to their significant others. Most of them get their hope from their loved ones but amazingly, one informant told that he derived his hope from him self alone. The following statements show the fuel of their hope:
sa pamilya ko at sa mga friends at yung aking pinakamamahal bale ako na lang po eh Sa mami sa daddy at sa aking mga kapatid. sa mga magulang ko po
Conceptual Model
Perceptions of
the informants
regarding Changes in the Cancer family • Financial Darkness that Game of lurks witin luck • Family task Death Tone of Whisperer command
Freezing within A Coping Changes in Sparkling Mechanism oneself • Physical Light in Denial Sinking ship the Midst Changing the Shattered Unchanged reflection of Anger • Emotional Fiere flame Tears of Darkness Bargaining heaven
Depression • Social
Gloomy in the Prisoners of dusk dusk • Educational Acceptance Blinded
Motivation and Dreams Adaptation Changes in the Holding onto community the light Cape of L ooking Deception beyond the Inevitable Mask gloom
Fuel of hope
Figure 2. Conceptual Model Light in the Midst of Darkness: Coping and Adaptation of Cancer Children
The figure shows the relationship of the perception of the informants regarding their condition, their coping mechanism and eventually their adaptation and motivation to continue their medical treatment. These concepts had changed their family, community and themselves. Thus, showing the end result that had been metaphorically presented by the researcher: A Sparkling Light in the Midst of Darkness. Perceptions of the informants ranging from 9 -17 years old had been affected by the extent of their information and knowledge about the disease. It had been affected by media (di ba leukemia kinamatay ni Francis Magalona? ) and the people that surround them, such as the person who also is suffering from cancer, the perception of the community, and their own interpretation of the disease (nakakalbo po). The perceptions that were saturated in this study showed that the informants feared death as manifested by the statements : ang iniintay mo ay gumaling o hinihintay mo na hanggang saan ka na lang , Parang nakakatakot po eh yung iba po dun ay naaanu po nawawala na po eh.
The perceptions of the informants affect their coping mechanisms as cited by Compass (2001) in the Middle Childhood, they become much more adept in calming themselves, although they still tend to become overwhelmed when they cannot manage their feelings. With the development of language and symbolic reasoning in earlier to middle childhood comes more cognitively oriented attempts at emotion an problem – focused coping, including such strategies as cognitive reframing, self talk to calm emotions and coping of adolescents , they are more capable of reasoned arguments, although the seasoning often appears rather self-serving perhaps reflecting the return of egocentricity in adolescence (Elkind, 1985). The informants said “anu po para pong pag isip ko po nuon parang puputulan yata isip ko po puputulan ako yan ganun nga nangyari kaya po mula po wala na po , kinabahan lang po” . This shows that they do classical conditioning. They conditioned their mind before amputation or chemotherapy has to occur to decrease the pain and anxiety. Other analysis of coping mechanism and behaviour had been observed through the informants can be shown in the Stages of Grieving by Kubler Ross. The researcher observed the stages of grieving as the interview with the informants progresses. Denial had been a major concern to them. As defined, denial is a conscious or unconscious refusal to accept facts, information, reality, etc., relating to the situation concerned. It's a defense mechanism and perfectly natural. Some people can become locked in this stage when dealing with a traumatic change that can be ignored. Death of course is not particularly easy to avoid or evade indefinitely. As depicted on their statement : “Nanunuod ako ng TV para malimutan ko ganun eh” . In the analysis of the statements arose the theme changing the unchanged means that unchanged status is their medical condition , but changing their perception of their life is a means of denial as manifested in these statements: “mas lalu pa dumami yung mga kaibigan ko”, “ Sila na nagimik sa akin” , “Di ako tinuturing na may sakit, talaga normal na tao” , “Hindi ako pinagbabawalang lumabas” “nagtititnda, nag aalaga ng aking pamangkin”
Anger had been also a part of the process of coping of an informant with cancer. Anger can manifest in different ways. People who are emotionally upset can be angry with themselves, and/or with others, especially those close to them. Knowing this helps keep them detached and non-judgemental when experiencing the anger of someone who is very upset. The anger that had been manifested by the informants can be associated to the meaning of prisoners in the dusk and fierce flames : “Nagagalit kasi tinatago ung avr sa computer “”Naiinis syempre di pwedeng gumala”. Depriving their freedom and their usual activities of daily living.
Depression, had been an inevitable part of the patient’s disease process. Depression even started from their own perception of cancer. But eventually due to their physical, emotional and shifting of task, the family aggravated the situation. Depression is a sort of acceptance with emotional attachment. It is natural to feel sadness and regret, fear, uncertainty, etc. It shows that the person has at least begun to accept reality.
Adaptation and Motivation had been discussed with the utilization and guidance of Sister Callista Roy’s adaptation model, with a presumption of those human adaptive systems as complex, multifaceted and responding to myriad environmental stimuli to achieve adaptation. Humans have the capacity to create changes in the environment. Humanism asserts that the person and human experiences are essential to knowing and valuing and that they share creative power.
The theory is beneficial to support the study involving lived experience of cancer warriors their adaptation from never ending changes in their life situation. As defined by Roy (1999), adaptation refers to the process and outcome whereby thinking and feeling persons as individuals or in groups, use conscious awareness and choice to create human and environmental integration.
The cancer warriors are affected by their self concept and principles in life in dealing with their situation. This is supported by Roy (1999), when she stated that self- concept is composite of beliefs or feelings that an individual holds about him or her self at any given time.
The other subsystems of the human adaptive process are the interdependence adaptive mode describes the interactions of people in society as depicted by the statements of one of the informants : “sa pamilya ko at sa mga friends at yung aking pinakamamahal”. The task is to give and receive love, respect, and value. Such in this study their support system and significant others can be and outmost help.
Motivation had been subjected by the way of adaptation of the patient, because as the associated theme emerge : Holding on to the light or a sense of hope, because they hold on to their dreams and pursue of giving better future for their family had been a fuel for them to continue their life journey . some informants believe for themselves some had been clinging for their family , for support and guidance until their last breath.
Changes had been inevitable, intractable to people with chronic illness, for this study is cancer. The three changes of family, self and community had been experienced by the informants in dealing with their cancer.
With the family,the researcher used the associated meaning : Senses of dynamic dependency and tolerance. It is also the associated meaning of the clustered of themes. It is because there were many changes of the family. First is the financial concerns because of the cost of treatment but limited budget to the point of allocating it properly to sustain their family needs. As supported by the narrations of the informants Mahirap po pala , kasi po dahil po anu po mag hanap na po kayo ng pera pang chemo , Malaking gastos. Second is the shifting of family task , because of their younger age, they tend to be a more school oriented person and as a youth , they should play , but because of their condition, everything changes as shown in this statement “nakakapag laro, di gaya ng dati na lagi ako nag lalaro.”
For the changes in the community, the researcher defined it as sense of unchanged status in the community , having a mask of deception towards their condition. Seeing themselves as normal individual and having a social special environment to meet their adaptation as cited by the informants “mas lalu pa dumami yung mga kaibigan ko”. “Sila na nagimik sa akin.” “Di ako tinuturing na may sakit, talaga normal na tao”. . For their life changes , used the analogy prisoners in the dusk because prisoners are deprived of their freedom: “Parang nakakulong , parang nasa kampo ng military lahat may limit” and in education” Sa halip na ang naiipon ay test paper eh ang result ng CBC, sari sari eh buti’t ang chemo din a dedelay ang pasok, di na napasok” “Kahit ako’y yayain eh ayaw ko (crying) ayaw na ayaw ko na umalis nan dito na are , saan ka pa pupunta.”
The physical and physiological changes they have to endure is like there are being stolen of their dreams and hopes : “Sobrang sakit po pinacheck up po ako tapos makalipas ang 2 araw lumaki ang tyan ko” , succumbing their temporal body to the point of weakening , losing their function not only to their family and community but also their responsibility for themselves: “tapos sapul na ako po’y nag kasakit din a po ako nagsasayaw.” “Bawal na ko mag laro”.
A Sparkling Light in the Midst of Darkness
The researcher was struck with these statements: Interviewer: “ Anu ang pinakamasakit na naramdaman mo ? ” Interviewee: “ malaman ko po ang sakit ko yun yung pinakamasakit ” Interviewer: “bakit ito ang pinakamasakit nung nalaman mo ang sakit mo? ” Interviewee: “di na po ako makapagtapos”.
The significant statement depicts the darkness of cancer, which affects the totality of a person, blinded their dreams , being a prisoner of themselves, hindering the pursuit of what they want to achieve. Darkness envelops the social environment , thus their significant others their family and the community also adapt to their condition. They have to be treated as normal individuals and the family members have to be careful with the way they interact with them. The researcher had viewed the motivation of the informants in their struggle with their disease. Sparkling light from the lamp symbolizes the hopes and dreams of the informants that ignite their strengths and motivate them to continue their treatment and their journey to the unknown . The flame of the lamp can symbolize their hope and the guidance from their support system. The fuel of hope is rooted in their self concept and their positive social environment. “Sana po eh lagi po kami malalakas kahit wala na po ang aking ama eh patuloy kami nalaban laging matatag” they felt they are not alone , they had a companion until to what ends lies.
CHAPTER V
SUMMARY, CONCLUSION AND RECOMMENDATION
SUMMARY
As William James Stated “the best use of life is to spend it for something that outlasts life”. For a cancer patient, this statement is relevant , because battling with death is not easy yet they still go on because they believe what they go through is a challenge from God. This study showed the views, the life of juvenile cancer warriors.
Cancer patients have been struggling all their lives and keeping their eyes to their journey to the unknown. The child with cancer defends his/her life to illness that succumbs their temporal body but they are blessed with their significant others who sustain their hopes and equip them to continue living. It is supported by the statements of Dr Francis Weld Peabody of the Harvard Medical School that “the secret of the care of the patient is in caring for the patient.”
Cancer is not merely a lesion on a diagnostic image or an abnormal proliferation of mutant cells. For many patients, families, and health professionals, it is one of life's most immediate encounters with vulnerability, suffering, and mortality and continuous life changing. It has a life-altering implications for career, family life, and life expectancy, and their own self and it also raises profound questions about the meaning of life and death. Cancer warriors give meaning in every detail of their lives, adapting to a world that had been only confined to them. For them, it is living for a life somewhat resurrected and imprisoned by their own protection.
Qualitative approach was used in the study in order to have a deeper understanding of the life experiences of cancer patients , and their adaptation and motivation in facing the unknown. The descriptive phenomenological approach of Qualitative research was used in order to describe the different metaphorical themes or essences of the lived experiences of the informants.
Bracketing also known as Phenomenological Reduction was essential in the study which all everything known about the phenomenon which are the concepts regarding cancer was collated and bracketed or set aside in an effort to keep what is already known separate from the lived experience as described by the informants.
The study used both purposive and convenient sampling. The sample was composed of 8 informants, majority from Batangas Province, ranging from 9 to 17 years old. All participants met the prescribed eligibility criteria and were all asked to sign process consent forms together with their legal guardian.
The data collection process was done through a semi- structured interview, to gather narrative data needed for qualitative analysis. All interviews were tape recorded and manually transcribed by the researcher. The researcher took notes regarding the observed behavior of the informants that may coincide or oppose the informants narrations. Open – ended questions were used to elicit elaboration of ideas of the informants.
After transcribing the collected data, the researcher, clustered significant statements with the same ideas or essences and came up with a metaphorical themes that were utilized for data analysis. The associated meanings derived were: fear of death, a sense of depression and pain,sense of dynamic dependency and tolerance, sense of unchanged status in the community, sense of physical changes, a sense of physical disfigurement that lead to low self esteem and social deprivation, sense of educational importance to the young, sense of protective isolation,cancer as hindrance of dreams, deceiving acceptance and a sparkling light in the midst of darkness. These were the meanings extracted and resulted from the interviews and which also came from the authentic primary source. These meanings went beyond the empirical thought and inquiry. These essences give value to the experiences and are grasped only through phenomenological inquiry. This paper did not claim generalizability. The essential meanings of the lived experiences of the eight cancer warriors represent only their group. However, phenomenology assumes that some of these meanings may also be present in the life – world of other cancer patients across the country as well as in the world.
CONCLUSION
Perceptions of the cancer warriors about their conditions were centered to darkness associated with the sense of fear and fear of death. Self concept, their social environment and media affect their perceptions towards cancer. In the 19 themes arrived from the analysis of the significant statements it was depicted that, cancer patients perceived their condition as leading to the end. They had a strong fear of death such that they adapt negatively to the situation that leads to depression and anger as in the stages of grieving by Kubler Ross had discussed.
Coping mechanisms used by the cancer patients was affected by their changes of self, family and environment. As the associated meaning of it, came out as changing the unchanged, the patient adapts simultaneously to their medical condition which led to the informants’ denial in part of the social environment. Coping mechanism of the informants were influenced by media, friends and other people.
The motivation and the adaptation of the informants , revolved on the people around them. Those people gave them their shield and sword and the perpetual strength and encouragement to continue their fight until the end. As the researcher observed, the eagerness of the informants to be cured and their hopes and dreams are their weapons to survive. The informants narration “nung nalaman ko na may sakit ako yun yung pinaka masakit kasi di na ako makakapag tapos”. Vividly showed that having cancer can could mean a broken dream.
In closing , one cannot disregard the statements of the cancer warriors because they are the ones who experienced the process of disease and the changes that they go through is as authentic as their statements. The ideas and feelings captured by this study is genuine and pure within the context of cancer pediatric patients.
RECOMMENDATIONS
Cancer is inevitable. This disease not only affect the physical attributes of a patient but also other aspects such as, emotional, social and spiritual. Thus, these recommendations had been proposed by the researcher in different fields of nursing:
Nursing Practice
Nurses will and always be the primary caregiver of patients. Cancer patients had special needs to attend to, thus the nurse somehow needs to adapt to the patient desires. In line with the result of the study, the researcher recommends the following:
1. Nursing staff specially pediatric oncology should be subjected to intense training regarding the interactions towards the special case of the patient. 2. Nursing staff should be sensitive enough to the grievances of the patients to be able to feel the genuine care that patient longs to receive. 3. The nursing staff should be always within the optimistic environment to aid in developing a positive mind set within the hospital. Nursing interventions however, bounded by each policy of different hospitals and the institution should be dynamic enough to cope with a different medical condition specifically terminally and chronic illness such as cancer, to be able to achieve the goal of each hospital which is giving quality health care for each diverge patient.
Nursing Education
Nursing education is the foundation of knowledge, skills and values of young nurses. Since the research is qualitative in nature, the researcher wants to impart the results to widen the realms of nursing education in terms of oncology nursing . The researcher recommends the following to nursing educators:
1. The findings of this study be incorporated into the discussions of oncology nursing in the classrooms of various nursing schools. 2. Future nurse researchers can utilize the conceptual model forwarded in the study. (Light in the Midst of Darkness: Adaptation and Motivation of Cancer Children) 3. Young nurses can pursue qualitative research to provide them an in depth analysis of things that are relevant to nursing. Seeing things in other lenses and sides of nurses’ life and patient’s perceptions can be a challenging contribution. 4. The study can be replicated with different informants such as other terminal illnesses, End Stage Renal Disease, Severe Pneumonia and in other age range , adult , young adult or geriatrics. 5. A qualitative research pertaining to the significant others or support system and their coping mechanism and motivation towards their cancer patient.
Nursing Profession
Cancer is one of the causes of mortality in the Philippines and in the world. As the nursing profession diversified itself , giving way to different fields of specialization, such as an anesthetist , forensic and oncology, nurses had a bulk of responsibility to address the problem of public health towards cancer. As found in the study, there are cases of depression, denial and anger that were experienced by the patients thus, the researcher recommends: 1. Intensify the oncology nursing specialization , dealing not only with physical signs but also on their emotional state. 2. Be adaptable to the continuous change of health care especially for cancer patients. 3. Have some tie-ups with government and non – government organizations in addressing the problems of cancer patients.
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Appendix A -1
Golden Gate Colleges Graduate School Batangas City
Mr. Renato M. Dimayuga, MD Chief of Hospital III Batangas Regional Hospital
Thru: Mrs. Amor B. Calayan, RM, RN, MAN, PhD. Chief Nurse Dear Sir:
Warm Greetings!
I am Mr. Mignodel M. Morales, a Graduate Student of Golden Gate College is currently conducting a research study entitled “A Sparkling Light in the Midst of Darkness: Life of A Cancer Patient”, in partial fulfillment with the requirements for the Degree of Master of Arts in Nursing.
In line with this, may I request from your good office to please permit me to conduct interviews with the patients with cancer in Station V (Pediatric Ward). Rest assured that the information gathered will be used for educational purposes only and wil be treated with outmost confidentiality.
Hoping for your favorable response.
Thank you very much
Respectfully yours,
Mignodel M. Morales, RN
Master in Nursing candidate
Appendix A -2
Golden Gate Colleges Graduate School Batangas City
Dra. Mayie Salvador Clinic of the sick children
Dear Madam:
Warm Greetings!
I am Mr. Mignodel M. Morales, a Graduate Student of Golden Gate College is currently conducting a research study entitled “A Sparkling Light in the Midst of Darkness: Life of A Cancer Patient”, in partial fulfillment with the requirements for the Degree of Master of Arts in Nursing.
In line with this, may I request from your good office to please permit me to conduct interviews with the patients. Rest assured that the information gathered will be used for educational purposes only and will be treated with outmost confidentiality.
Hoping for your favorable response.
Thank you very much
Respectfully yours,
Mignodel M. Morales, RN
Master in Nursing candidate
Appendix B
Golden Gate Colleges Graduate School Batangas City
Informed Consent
Warm Greetings!
I am Graduate student of Golden Gate College is currently conducting a research study entitled: “Light in the Midst of Darkness: Lived Experiences of Cancer Warriors”, in partial fulfillment with the requirements for the Degree of Master of Arts in Nursing.
In line with this, may I request to please allow me to conduct interviews with your son/daughter. Rest assured that the information will be used for educational purposes only and will be treated with utmost confidentiality.
Hoping for your favorable response.
Thank you very much.
Respectfully yours,
Mignodel M. Morales, RN Master in Nursing candidate
______Informant’s Signature / Date Parent’s/ Guardian’s Signature / Date
Appendix C
Interview Guide
1. Building Rapport Magandang umaga po, kumusta na po kayo? Anu pong pangalan ninyo? Saan po kayo nakatira ? ilang taon ka na ? Nag aaral ka pa ba? Kumusta ang mga kaibigan mo ? kapatid?
2. Insights and Perception of informants Anung iyong mga naging reaksyon nang malaman mo na may ganito kang kalagayan ? sa iyong opinion anu ibig sabihin ng sakit ? at anu iyong naramdaman nang malaman mo na may ganito kang sakit?
3. Adaptations and Coping mechanisms of informants Anung mga pag babago ang iyong naranasan nang malaman mo na may sakit ka? Panu mo ito kinabagayan? May nag bago bas a pamilya ? sa kaibigan ? o sa eskwela ? anung gngwa mo pag naging ganun ang sitwasyon? Anung pagbabago naranasan mo sa iyong pamilya nung nagkasakit ka ? anung mga pagbabago sa komunidad? Anung pagbabago naranasan mo sa iyong saili?
4. Motivation and Aspiration of informants Anu ang mga pangarap mo sa buhay ? . bakit kailangan mo pang lumaban ? anu ang mga hinahangad mo sa iyong sarili ?
APPENDIX D-1
CLUSTER OF SIGNIFICANT STATEMENTS
1. What are the perceptions of the informants regarding Cancer A. Pagsinabi bang Cancer anu ung naiisip mo ? M – wala • Malala
I – natatakot po Masakit po • Natatakot po ako sa sakit
G – kung hanggang kalian ka na lang • Kasi dig a siyempre nag papagamot, kami pag nag papagamot ka parang ang iniintay mo ay gumaling o hinihintay mo na hanggang saan ka na lang • Ang buhay mo ay mag pagamot na lang , na pwede kang gumaling
N – hindi po malala nuon, akala ko po • Mahirap po pala , kasi po dahil po anu po mag hanap na po kayo ng pera pang chemo tapos paparito pa po kayo ginagabi ka uuwi, anu po mahirap po
O – ewan ko • May sakit sa dugo cancer • Baka masakit pagtuturukan
D – nakakalbo • Di ko alam • Alam ko po pag may cancer nakakalbo ang buhok yun pala ay dahil sa chemo
E – kabado lang po kasi po, akala ko po nung eh isang oras lang po eh mag chechemo na • Parang nakakatakot po eh yung iba po dun ay naaanu po nawawala na po eh • Natatakot ako sa sakit ko • Akala ko po naming dati mga nuno at lamig lang po ganun
L – masakit po • Di na po makapasok • - di na po ako nakikipag laro
1. B. Nung nalaman mo iyong sakit anu naramdaman mo ?
M – malungkot I – tumatahimik lang po • Malungkot po G – umiyak, syempre di ga si Francis Magalona kaya namatay dahil sa Leukemia N – ayus lang po , akala ko’y din a po chechemo , akala ko po basta sakit O – wala naman D – Nakapag emote na • May pagkakataon nagagalit E – medyo natakot po ako L – masakit po • Masakit pos a pakiramdam • Nag iisip isip po ng sakit ko
1. C. Sa tingin mo ba ay nagiging hadlang sa pangarap mo ung iyong sakit ?
M – nakakahadlang po sa pagtututloy ng pag aaral, makatulong sa pamilya at magandang trabaho D – hadlang sa pamumuhay gaya ng dati Nakakhadlang sa kabarkada , nag overnyt saya saya ngaun eh hindi na
2. A. Anung mga pag babago bas a iyong katawan ? M – may bukol sa kili kili • Nakirot • Lumiliit na bukol ko, tumataba na ako I – ah yun po nahihilo • Bukol po, hindi po masakit • Nilalagnat po • Namutla G –namutla • Nabaha ang menstruation malakas talaga as in • Nagdurugo ang ilong, as in buo ang nalabas sa ilong, sa ganun then tonsils yun lahat sumakit • Parang may beke daw, malaki nga siya, ganun di ako makalakad ng isang Linggo UTI namn . • Sunod na dun ay pag taas ng aking sugar N – nung sa paa kop o , namaga po , • Hindi po nakakalakad • Pag po ako’y tamlayin alam na po nila na may nararamdaman na ako • Lagi pong nakahiga alam na po nila na may nararamdamn ako • Nang hihina po • Tapos nung gabi po , di na po talaga yung mata ko daw po may pasa pasa, yung dila ko po brown daw po. Kaya po dinala ako sa Taal Polymedic • Nag papasa ako dito O – masakit yung mga hita ko ganun • Di ako makalakad D – inuubo ako tapos nag karoon ako dito ng kulani, akala ko dati sipon lang • Noong makailang buwan sabi nila mag pacheck – up na ako • Baka malala na are eh para may matapos ako • Nilagnat na ako, at mag kakakulani nga at nag karoon ulit sa kabila lumalaki. E – para po siyang umo K naman po ako kaya lang po pagkalabas ko sa ospital nanghihina po ako after 1 week umo ok na po pakiramdam ko • Yung paa ko po, bukol po sa paa ko • Di po ako makalakad L – sumakit po tiyan ko • Sobrang sakit po pinacheck up po ako • Tapos makalipas ang 2 araw lumaki ang tyan ko
2. B. Anu napapansin mong pag babago sa iyong pamilya nung nag kasakit ka ? M – wala naman • Parehas pa rin ang trato • Di na ako nalabas ng bahay I – naging maasikaso po sila • Sabay sabay na kumain • Maalaga po G – simula nung nadiagnose ayaw ko nang umalis dito, lahat ng atensyon nasa akin , kahit ako’y yayayain ayaw ko • Ayaw na ayaw ko umalis , san ka pa ba pupunta? • Di na nga kami naghihiwalay • Wala nang pupuntahan pupunta ng clinic kami mag kakasama, mag papacbc kami padin, san ka pa N – sinusunod po nila ang mga gusto ko • Anu po di namn po ako yung laging kulong sa bahay , nagala din po ako kasama ang barkada O – wala namn D – wala naman • Dati eh ung kapatid kung 16 years old sinabi nya eh pansin niya ang lahat sa akin ang attention , pero ang toto ay di namn , pantay pantay kami lamang pa nga sila sa amin • Hiniling mo pa na mag ka gay-an mag pa bone marrow ka na laang E – wala naman po • Di na po ako masyadong nakikipaglaro sa mga iyon • Minsan ay nag – aaway kaming dalwa • - pag laruan po ung pinag aawaan L – wala naman
2.C Anung napansin mong pagbabago sa kabarkada mo kaklase at sa community? M – wala namn • Ganun pa din I - ok lng namn N – mas lalu pa dumami yung mga kaibigan ko • Di ako tinuturing na may sakit, talaga normal na tao G – ayos namn nung nasa ospital padalaw dalaw kahit ayaw kong ako’y di nadalaw dalaw pinupuntahan • Dati ang mga kaklase ko dumadalaw sila punong puno ang ospital parang mag check ng attendance dun , di ko lahat sila kinausap gawa ng anu ayaw ko talaga , ayaw ko ng ganun • Kasi dati nasanay ako ng ako ang dumadalaw, ayw ako ung ako’y dadalawin o puntahan • Naiisip ko na may sakit ako E – nalabas po dati • Konti nadalaw • Lahat po sila pumunta pos a bahay namin • Nagulat po sila L – di na nag lalaro • Dati po lagi nasa labas
2.D. anung pagbabago napansin mo sa iyong pag aaral? M – di na nag aaral • Nakakaabsent ako • Top 16 sa buong batch nung 1st year , naging top 18 nung 2nd year I – isang Linggo po ako lumiban G – stop na po • Wala naiyak ako baka di ako makagraduate • Sa sports best in soft ball • Sa halip na ang naiipon ay test paper eh ang result ng CBC, sari sari eh • Buti’t ang chemo di na dedelay ang pasok N- di na napasok • Gusto ko po mag aral ulit • Umiyak po ako gustong gusto ko pumasok O – di muna ako napasok D – tumigil na din ako sa pagpasok. E – ipinasa na po ako L – tumigil po ako sa pag aaral
2.E Anung mga pagbabago naranasan mo sa iyong sarili ? M – wala akong masyadong pinagkakaabalahan • Hindi ako pinagbabawalang lumabas • Nagtititnda, nag aalaga ng aking pamangkin I – tumatahimik lang po • Dati po nag pupuyat • Sabay sabay na po kumain G – hilig kong mag luto • Active ako sobra sa community • Nakakairita lalu pang di pwedeng ako’y umalis • Kung pwede nga lang nag papagamot eh pumapasok unti unting pumapasok kahit hindi gusto ang course • Ako nga eh naiinis syempre pag alis eh di pwedeng mag gala ng mag gala • Dati gusto ko lagi lumayas, pag alis nila nandun lang ako sa labas, sabihin ko pasama , pag alis sabay na ang gala daan dito ikot sa mall • di nga ako natingin sa salamin • madaling mag init ang ulo ko • Kahit ako’y yayain eh ayaw ko (crying) ayaw na ayaw ko na umalis nandito na are , saan ka pa pupunta
N – hindi na po ako sumama nun sa pag sasayaw dahil sobrang sakit ng paa ko di ko po maigalaw • Tapos sapul na ako po’y nag kasakit di na po ako nagsasayaw • Ayaw kong pagamit ang mga gamit ko O – wala nmn bad na nangyari • Bawala ko mag laro • Nanunuod ako ng TV para malimutan ko ganun • Lagi mag mask, mag ingat , huwag lang yan ang isipin nila, yung masasaya nilang ginagawa dati D - nakakalabas ako ngunit takas sa computer shop ako napunta • Di na ako nag mamask bawas pogi points • Sila na nagimik sa akin • Yun na pabayaan pagchick s • Parang nakakulong , parang nasa kampo ng military lahat may limit E – minsan po pag ako’y minsan lang po nakakapag laro, di gaya ng dati na lagi ako nag lalaro • Katulad pa rin po ng dati • - bawal po chicken , lollipop , maalat at matatamis L – nag bago yung kinanakain ko Dati po chichiria Di na po makakain ng maalat
2.F Panu mo kinabagayan ang iyong sakit ? O - Nanunuod ako ng TV para malimutan ko ganun L – eh anu po para pong pag isip ko po nuon parang puputulan yata isip ko po puputulan ako yan ganun nga nagyari kaya po mula po wala na po , kinabahan lang po
3. A. anung hinihiling mo ? M – sana gumaling na ako I – sana po gumaling na agad ako G – instant galing N – sana tuloy tuloy na pagaling ko O – gumaling ako D – syempre para gumaling na ako E – gumaling na lang po L – sana po gumaling nap o ako
3.B Anung mga pangarap mo sa iyong sarili ? M – gumaling ako , makapag tapos ng pag aaral , makatulong sa pamilya, mag karoon ng magandang trabaho I – sana gumaling na ako G – mag patayo ako ng hotel or restaurant • Dati kasi dapat sami kami sa world series ng foft ball , gusto ko sana sumama dun • Wala naman parang kung sa kanila dalawang taon gusto ko mas maiksi N – maging sundalo po sa Airforce • Lagi kami malakas • Sana po eh lagi po kami malalakas kahit wala na po ang aking ama eh patuloy kami nalaban lagging matatag O – maging doctor • Makapagtapos ng pag aaral D – syempre makatapos ng pag aaral E- sana maging Engineer, kaya lang po nag kaganito kaya teacher n alang pos a science • Maging normal ang buhay • Kasi po ngaun po ay lagi akong nasa ospital kasi po nung nakakapaggala po ako amin L – maging seaman • Para guminhawa ang buhay
3.c Anung una mong gagawin pag gumaling ka ? M – Masaya • Mag papasalamat I – lagi pong mag papasalamat sa Panginoon • Babalik po ako sa pag aaral G – mag – eenrol na agad ako N – mag papasalamat po ako sa Diyos • Magpapasalamat po sa mga tumulong sa akin • Opo tuloy ko po pag aaral ko • At yung gusto gusto kong pagsasayaw O – magpapasalamat kay Jesus • Mag aaral ulit ako, babalik na ulit ako sa skul D – di ko alam • Makiki hang out E – mag aaral na po L – mag aaral po • Mag lalaro
3.D Anung nag pupursige sa iyo para pagpatuloy ang iyong laban o gamutan? D – sa pamilya ko at sa mga friends at yung aking pinakamamahal E – bale ako na lang po eh • Sa mami sa daddy at sa aking mg akapatid. L – sa mga magulang ko po
Appendix D - 2
SUMMARIZED TABLES OF THE SIGNIFICANT INFORMANTS, CLUSTER OF THEMES AND ASSOCIATED MEANINGS
Table 1. Perceptions of the informants regarding Cancer
Significant Statements Themes Associated Meanings Natatakot po ako sa sakit kabado lang po kasi po, akala ko po nun eh Darkness that lurks isang oras lang po eh mag chechemo na Natatakot ako sa sakit ko within Parang nakakatakot po eh yung iba po dun ay naaanu po nawawala na po eh hinihintay mo na hanggang saan ka na lang Death Whisperer Kasi di ga siyempre nag papagamot, kami pag nag papagamot ka parang ang iniintay mo ay Fear of Death gumaling o hinihintay mo na hanggang saan ka na lang Parang nakakatakot po eh yung iba po dun ay naaanu po nawawala na po eh
Malala po Scourging soul Masakit po Baka po masakit sa pakiramdam Nakakalbo
Table 2. Feelings of the Informants regarding Cancer
Significant Statements Themes Associated Meanings
Malungkot Gloomy in the dusk Nakapag emote na Masakit sa pakiramdam Sense of depression Umiyak dahil d iba sa Leukemia namatay si and pain Francis Magalona Nagagalit Fierce Flame Naiinis syempre di pwedeng gumala
Table 3. Changes experienced by the informants within the family
Significant Statements Themes Associated Meanings Mahirap po pala , kasi po dahil po anu po mag hanap na po kayo ng pera pang chemo Game of Luck Malaking gastos Naging maasikaso po sila Sense of Dynamic Maalaga po Tone of Command Sinusunod po nila ang gusto ko Dependency and Ako po binibili lagi ng gusto ko ako lang nakain Tolerance Di na po ako masyadong nakikipaglaro sa mga iyon minsan po pag ako’y minsan lang po nakakapag laro, di gaya ng dati na lagi ako nag Freezing within lalaro
Table 4. Changes experienced by the informants within the community
Significant Statements Themes Associated Meanings mas lalu pa dumami yung mga kaibigan ko Sila na nagimik sa akin Cape of Deception di ako tinuturing na may sakit, talaga normal na tao hindi ako pinagbabawalang lumabas nagtititnda, nag aalaga ng aking pamangkin
Sense of unchanged status in the Dati ang mga kaklase ko dumadalaw sila Inevitable Mask punong puno ang ospital parang mag check ng community attendance dun , di ko lahat sila kinausap gawa ng anu ayaw ko talaga , ayaw ko ng ganun
Kasi dati nasanay ako ng ako ang dumadalaw, ayaw ako ung ako’y dadalawin o puntahan Naiisip ko na may sakt ako Yun na pabayaan pagchicks
Table 5. Life changes experienced by the informants
Significant Statements Themes Associated Meanings • may bukol sa kili kili • nakirot Sinking Ship Sense of physiological • lumiliit na bukol ko, tumataba na ako changes experienced • ah yun po nahihilo by the informants • bukol po, hindi po masakit • Nilalagnat po • Namutla • Nabaha ang menstruation malakas talaga as in • Nagdurugo ang ilong, as in buo ang nalabas sa ilong, sa ganun then tonsils yun lahat sumakit • Parang may beke daw, malaki nga siya, ganun di ako makalakad ng isang Linggo UTI namn . • Sunod na dun ay pag taas ng aking sugar • nung sa paa ko po , namaga po , • Tapos nung gabi po , din a po talaga yung mata ko daw po may pasa pasa, yung dila ko po brown daw po. Kaya po dinala ako sa Taal Polymedic • Nag papasa ako ditto • masakit yung mga hita ko ganun • Di ako makalakad • inuubo ako tapos nag karoon ako dito ng kulani, akala ko dati sipun lang • Noong makailang buwan sabi nila mag pacheck – up na ako • Baka malala na are eh para may matapos ako • Nilagnat na ako, at mag kakakulani nga at nag karoon ulit sa kabanila lumalaki. • para po siyang umo K naman po ako kaya lang po pagkalabas ko sa ospital naghihina po ako after 1 week umo ok nap o pakiramdam ko • Yung paa ko po, bukol po sa paa ko • Di po ako makalakad • sumakit po tiyan ko • Sobrang sakit po pinacheck up po ako • Tapos makalipas ang 2 araw lumaki ang tyan ko
• Di po ako makatingin sa salamin Shattered Reflection Sense of physical • Nakakalbo po disfigurement that • Yung sa rob kasi , yung lady guard , leads to low self parang bago palang yun , di ga di naman lagi may lady guard dun ,eh nakabonet ako esteem and social nuon , pinapatanggal , na pa ha ganun, deprivation ako eh sabi nung lalaki hindi po hindi po parang hiyang hiya yung lalaki , nakakinis • Wala pa nun, pero habang ako’y nagsusuklay unti unti nang nanlalagas , nag puyod ako nuon , dalawang araw na di ko siya sinuklay, kasi nga natatanggal na nga , pag ka gising ko nakapatong na lang , ganun ginupit na lang • Laging nakamask • Nang hihina po • Hindi po nakakalakad • Pag po ako’y tamlayin alam na po nila na may narramdaman na ako • Lagi pong nakahiga alam na po nila na may nararamdamn ako • Nang hihina po • Di ako makalakad
• di na nag aaral Blinded Dreams Sense of educational • Nakakaabsent ako importance to the • Top 16 sa buong batch nung 1st year , youth naging top 18 nung 2nd year • isang Linggo po ako lumiban • stop na po • Wala naiyak ako baka di ako makagraduate • Sa sports best in soft ball • Sa halip na ang naiipon ay test paper eh ang result ng CBC, sari sari eh • Buti’t ang chemo din a dedelay ang pasok • Di na napasok • Gusto ko po mag aral ulit • Umiyak po ako gusting gusto ko • di muna ako napasok • tumigil na din ako sa pagpasok. • ipinasa na po ako • tumigil po ako sa pag aaral • Kasama din naman yun di ga siyempre, kaya ka nga mag aral, di para sa sarili mo, pag gumaling ka lalung gaganahan kang pumasok, yung wala ka na sa age ng ganito gagraduate ka na matanda ka na , yung hindi mo na iisipin nag sarili mopag pumasok ka , yung mga tao na lang na nagpalakas ng loob mo nung nalaban ka
• Nakakairita lalu pang di pwedeng ako’y Prisoners of Dusk Sense of protective umalis isolation • hindi na po ako sumama nun sa pag sasayaw dajil sobrang sakit ng paa ko di ko po maigalaw • Tapos sapul na ako po’y nag kasakit din a po ako nagsasayaw • Bawala ko mag laro • nakakalabas ako ngunit takas sa computer shop ako napunta • Parang nakakulong , parang nasa kampo ng military lahat may limit • Kahit ako’y yayain eh ayaw ko (crying) ayaw na ayaw ko na umalis nan dito na are , san ka pa pupunta
• hadlang sa pamumuhay gaya ng dati Stealing the light Cancer as a hindrance of dreams • nakakhadlang sa kabarkada , nag overnyt saya saya ngaun eh hindi na
• nakakaladlang pos a pagtututloy ng pag aaral, makatulong sa pamilya at magandang trabaho
• Yun na pabayaan pagchicks
Table 6. Coping of Informants towards Cancer
Significant Statements Themes Associated Meanings Nanunuod ako ng TV para malimutan ko ganun eh Going with the flow Sense of deceiving acceptance anu po para pong pag isip ko o nuon parang puputulan yata isip kopo puputulan ako yan ganun nga nagyari kaya po mula po wala na po , kinabahan lang po
Table 7. Motivation and Dreams of the Informants
Significant Statements Themes Associated Meanings • sana gumaling na ako • instant galling Holding onto the light A Sparkling Light in • sana tuloy tuloy na pagaling ko the Midst of Darkness • gumaling ako , makapag tapos ng pag aaral , makatulong sa pamilya, mag karoon ng magandang trabaho • mag patayo ako ng hotel or restaurant • Dati kasi dapat sama kami sa world series ng soft ball , gusto ko sana sumama dun • Wala naman parang kung sa kanila dalawang taon gusto ko mas maiksi • maging sundalo po sa Airforce • Lagi kami malakas • Sana po eh lagi po kami malalakas kahit wala na po ang aking ama eh patuloy kami nalaban lagging matatag • maging doctor • Makapagtapos ng pag aaral syempre makatapos ng pag aaral sana maging Engineer, kaya lang po nag kaganito kaya teacher nalang po sa science • Maging normal ang buhay • Kasi po ngaun po ay lagi akong nasa ospital kasi po nung nakakapaggala po ako amin L – maging seaman • Para guminhawa ang buhay
• Mag papasalamat Looking beyond the • lagi pong mag papasalamat sa Panginoon Gloom • Babalik po ako sa pag aaral • mag – eenrol na agad ako • mag papasalamat po ako sa Diyos • Magpapasalamat po sa mga tumulong sa akin • Opo tuloy kop o pag aaral ko • At yung gusto gusto kong pagsasayaw • magpapasalamat kay Jesus • Mag aaral ulit ako, babalik na ulit ako sa skul • Makiki hang out
• sa pamilya ko at sa mga friends at yung aking pinakamamahal Fuel of Hope • Di na nga kami nag hihiwalay , di na kami nag hihiwalay , pupuntang clinic kami mag kasama , mag papacbc kami pa din , oh san ka pa , ang punta lang lagi sa clinic , sa ospital sa laboratory sa halip na naiipon ay test paper eh ay ang result ng CBC (laugh) • bale ako na lang po eh • Sa mami sa daddy at sa aking mga kapatid. • sa mga magulang ko po
Appendix D -3
Interviews of the Informants
Informant M
R: So good morning anu ako si Mignodel Morales, a graduate student of Golden gate anu nag aaral ng masteral nandito ako para mag conduct ng study po anu regarding Lived experience of a cancer warriors so kumusta kana? I: Ok lang R: Ok lang R: Anung pangalan mo I: Informant m R: Anung apelyido mo I: Informant m R: Nag aaral ka pa I: Di na R: Anung year mo n asana I: Third year R: Nung bago ka mag kasakit kumusta naman ung pag aaral I: Ok lng R: Taga san ka I: Batungbuhay sablayan , occidental minodro R: Kumusta ang Mindoro I: Ok lng R: Ok lng R: Anu gngwa mo dun sa Mindoro I: Nag aaral R: Nag aaral? R: Kumusta nmn ang mga kaibigan mo dun I: Ok lang R: Ok lng I: Kapatid? R: May kapatid ka pa ? pang ilan ka sa mag kakapatid ? I: Pangatlo R: Pangatlo oo R: Alam mo yung sakit mo ? alam mo ? anu un I: Langerhan cells histiocytosis R: Anu daw ibig sabihin nung langherhans histiocytosis anu daw un ? I: SILIENECE R: Ok po basta un lang may nag bago ba sa iyo dun nung biglang anu naramdaman mo nung sinabing may ganito ka Langerhans ganun anung naramdaman mo may nagbago baa nu ? Malungkot R: Malungkot . R: Tapos anu nagyari nung nalungkot ka anung ginawa mo I: Nag pray R: Anung pray mo kay Jesus I: Sana gumaling na ako R: Sana gumaling ka R: Tapos ung tungkol namn sa pag aaral mo kumusta naman nung nalaman mo nag papachechk up ka na nun I: (Nodding) R: Tapos may mga possibilities ba na na absent ka nag kakaroon ka ba na anu napunta ka dito sa Batangas I: Nodding R: Panu mo kinabagayan ang sakit , panu ka nakicope up sa sakit mo kunwari eh nung dati ganun pa rin ba ginawa mo I: Nodding R: Ganun pa din R: Ung pagbabago mo sa family sa kapatid may nag bago ba , sa loob ng family may nag bago ba I: Wala R: Wala naman Parehas pa rin ang trato sau dun sa loob I: Nodding R: Ung kaibigan mo ung sa skul anu mga sinasabi nila , kinukumusta ka b aanu (mother) top nga yan sa skul eh R: Wow congrats ung pag aaral mo (mother bumaba nag grades nya kc sa isang buwan nag pupnta para mag paycheck up) Kaw pala eh top sa class Mother R: So anu ang pangarap ni M , mga pangarap sa buhay Makapagtapos ng pag aaral R: Anu pa ? Anu pa inyong pangarap , sige heheh ewan wala pang plano kunwari nasagot agad ni ah Jesus gumaling ka agad anu mararamdaman mo I: Masaya R: Wow Masaya R: Tapos nau gagwin mo Mag papasalamat R: Then babalik ba tayo sa pag aaral I: Nodding Tapos (mother scholora kc sya sa skul nila , pwede nmn siyang bumalik sa pag pasok ok pa nmn kanyang scholoraship) R: May nararamdaman ka pa ba ngaun walang masakit Wala namang masakit or anu So ung sakit mo alam mo alam na alam mo sya , o ung pangalan lang tapos tawag dito anung pag babago nakita mo sa katawan mo sa sarili mo nung mga nag daang araw R: Nung nasa skul ka anu nararamdaman mo nun May nasakit ba sa iyu nag susuka ka ba (mother wala nmn ) Nasan po bukol I: Nasa may kilikili Dapat tapos na kami 6 cycles di pa 2nd cycle kami R: Kumusta nmn ung pag aggamot saiyo do nmn masakit Lumiliit ung bukol Pero ung katawan mo R: Di kaba nag hina I: Di naman R: Dati payat ka I: Laugh R: Nag kalaman na Kumusta nararamdaman mo I: Ok na Na may sa susunod na mga araw na R: Wag ka mahiya Kabarkada mo ako kapamilya kapuso anung nakikita mo sa susunod na mga araw I: Na uuwi nakami R: Uuwi na tayo sa Mindoro ok maraming salamat
July 31, 2012
R: Good morning kumusta ka na I: Ok naman po R: Kumusta ka na nag start ka na chemo I: Nodding R: Ah kumusta nmn ung chemo therapy I: Ok lang R: Ah cge pag narinig mo un gung tulad na ng naririnig mo do ito mga kasamamhan mo dito ung cancer anu un pag sinabi cancer ? I: Wala (laughing) R: Regarding sa kundisyon mo pwede mo bang ikuewnto sya pamula nung nandun ka sa inyo ikwento mo ung nag yari kung ok lng pero kung di ok lnag din I: Silence R: Kwento mo ungnagyari , Nung pamula nung una sige kwento mo nung nagyari nung pa mula nung nasa MInodro hanggang kau eh makarating ditto sige sabihin mo akoy nakikinig lang kaya mo yan I: Silence R: Anu ng anu nasabi s aakin ng mami mo na may pagkakataon na nag karoon ng pag durugo dawanu naramdaman mo dun , bakit may dugo anu naramdaman mo I: Natakot R: Tapos tapos nasabi rin ng mami mo na anu na nahiya ka daw sabihin sa kanila bakit? Bakit parang nahiya ka I: Wala R: Tapos nung nasabi mo n aganun na meron akong bukol anu naramdaman mo nun I: Masaya na R: Yung dinala ka nasa ospital nag papacheck up ka na anu yung nag bago , yung mga kapitid mo ba anu ngyari sa kanila, dati nag lalaro ba kau I: Nanuood lng ng tv R: Ngaun I: Wala R: Ung tungkol sa skul ulit , honor student ka ba dati honor student ka I: Nodding R: Pang ilan ka nung anu grade 1 3rd placer honor R: Punta tayo grade 6 sa buong clase na 4th honor R: Nung nag first year ka Top 16 sa buong batch ito Sa buong batch ngaun 2nd year Top 18 na R: Nung second year R: Anung award mo nakuha I: Most kind R: Anu naramdaman mo nung parang kailangan mo mag pacheck up kailangan mo na ulit umbasent I: Malungkot R: anu sinsabi ng iyong mga kaklase Kumusta na daw R: Pag ba kau eh nauwi Mindoro pumupunta sila, ung napunta sila sa inyo pero kaw eh close sa inyong mga classmates, kinukumusta ka naman sa text o sa facebook , tapos ung tungkol sa mga kapatid mo ilan kau mag kakapatid ? kaw eh pang ? I: Pangtatlo R: Eto ay mala baby baby mala spoiled ung parang padulo nag bago ba ang tartao nila sa iyo mas maganing close ba kayo or anu may napansin ka ba Ung pangay I: Lalaki R: Anu un pag panu un pag nakikita ka nung bunso Ah ate bakit lagi kang wala (mother ah nasabukid sila nauwi sila pag sabado) R: San ka nauwi nagun nung napasok ka Sa mga tita mo , sa bukid R: Ikaw lang nasa bayan ung tatlo nasa bayan di miss mo na kapatid mo lalau na nagun I: Nodding R: So panu ka nakikibagay ngaun tulad ngaun nasa ospital tau anu ngaun ginagawa mo I: Wala Wala ka pang masydong pinag kakaabalahan R: Nagungumusta ka sa clasmante mo sa collegio de san sebatsion , ah di na di ka na ulit nakikipag usap sa kanila bakit I: Wala akong number nila R: Pag magkakaron ka nag chance na mag ka number ka nila txt mo ba sila ? miss mo na ba mga classmate mo na magagaling isn mga kalevel mo din In ka bas a sports Sa music? Baka kaw eh nalaban sa pageant Wow nmn astig namn yan R: Anu pa panagrap ni m anu pa pangarap mo I: Makapag tapos ng pag aaral R: Anu pa Makatulong sa pamilya R: Anu pa I: Mag karoon ng magandang trabaho R: Yun nakikita mo ba yung sakit mo ay nagiging sagabal I: Oo R: Nung sanabi mo na tatlo makapagtapos ng pag aaral , makatulong sa pamilya at mag karoon ng magandang trabaho ang sakit mo parang anu nakakahadlang ba sya Naniniwala ka bang meron tayong kung tayo eh kung mag kakaroon ng pagkataon na wala na ung bukol babalik na tayo ulit I: Nodding R: Yung naikwento ni mami dun sa bdayhan nag kagulo adun natakot ba nagkakagulo natakot ba ung buong I: Nodding R: Anung nararamdaman mo nung mga oras na iyon I: Natakot R: Anu pa I: Nalungkot R: Bakit ka nalungkot anu kadahilan bakit ka nalung kot kc anu Natakot dahil natakot dahil I: Dumudugo R: Madami b a R: Nung bago nun may masakit ? I: Nakirot R: Nakirot tapos ulitin natin nag tanung ko kanina bakit ayaw mong sabihin kay mami , kay ate or kay kua kasi po I: Natatakot ako R: Natatakot ka na anu Bakit ka natatakot Natatakot ka ba sa ospital I: Oo R: Natatakot ka sakarayom I: Dati R: Ngaun I: Di na R: Ilang pag kakataon nga ung pag durugo tatlo ba mag katabi kau ni mami , bday at ung nilinis n itita I: Opo R: Dun sa family mo may nagbago ba natapos na ung pag durugo pag kalabas nyo sa ospital may nag bago ba kaw ba eh mga pinagbawalan tulad nang punta skul, bahay then tulog may nag bago ba dun sa ginawa mo lagi lagi Nag karoon nang naging laging absent sa skul Lagging nadugo R: Dati ung nalabas k ang bahay ngaun ba ay pinagbawalan ka na ba I: Hindi R: Hindi naman R: Ung magagalaw nalaro I: Nag bbike R: Wow san ka nagbibike I: Kila ate R: Binabike mo yun (mother) Malapit lang sa bayan akala ko binibike mo ung bukid malau yun R: Pag ikaw eh nag papahinga lang I: Nanunuod ng tv R: Anu pa lumalabas ka ba nanuod lnag ng tv di ka katulad ng ibang bata gigimik or lalabas Invite mo ako sa inyo Di sila mahilig mag gala R: Anu ginagawa ninyo mag kakapatid na mag kakasama I: Nuod ng tv R: Anu ginagawa mo pag napunta ka kina ate I: Nagtitinda , R: Nagtitinda , nagtitinda biruin mo namn nakag tinda ka pa nag aalaga ka pa kay pamangkin I: Nodding R: Anu un lalaki o babae Ilang taon na I: 1 year old R: Naku anu lalaki pag un eh lumaki ang tigas tigsa na ng ulo tapos ,alapit po talaga sya Malapit lang isang kanto Hinahatid sya ng motor R: Kung papasok ka ulit anu ineeye mo na anu gusto mo makamit pag ikaw eh 3rd yr or 4th year na wag ka na mahiya I: Mapabilang sa top 10 R: Un mahirap hirap din un pero kakayanin tapos maintain mo lang scholarschip nandun naman si tita ayus lang nya yan para sa college maganganda ang credentials nya Tapos regarding Balik tayo sa parang sa topic kasi naexpose ka din sa ibat ibang clase ng cancer pero kahit sabhin mo sau eh di pa masyado pero ung sa ib pag sinabing cancer, kunwari ang tito ko may canser sa baga anu perception mo anung nakikitta mo anung tingin mo sa sakit na un I: Malala R: Anu I: Malala na R: Panu mo masaabing malala na ang isang sakit I: Silence R: Naku cancer malala na un dahil anu anu kaya anu kaya naiicip mo na cancer malala Un ba yung napapnsin mo nakikita mo sa kanila itsura R: Anu ba talaga itsura ng may cancer I: Nakakalbo R: Tulad ng sa atin sa organisasyon anu un nga mahirap lalu na pag babae Ikaw anung mga pag babagong naramdaman mo nung nag chemo ka ngaun nag undergo ka na ng gamutan I: Lumiit na bukol ko , tumaba na ako R: Maganda nga yan kesa nmn mamayat , Hindi naman masakit pag gagamot I: Nakirot po R: Tapos , di ba nakaatend ka na miting ng organisasyon kay Dra. Mayie kumusta naman yun pag kasama mo sila I: Masaya din R: Bakit mo nasabing masaya ka pag kasama mo sila I: Maraming mga bata R: Maraming bata maraming makakausap Masasabi mo bang nakaka relate ka sa kanila ung parang eh parang eh methotrexate pareparehas ba, mga kwento nila I: Nodding R: Alam mo ang gamut mo I: Methotrexate , folinic and methotrexate R: Gusto ko sana kasing ikwento mo sya nung kung paanu kinuwento ni mami ung anu may pag kakataon ba nung nag dugo or something , kaw ba eh nalungkot ka di ba di ka ba kumain nawalan ka ba gana kumain , I: Hindi R: Oo lalu ka kumain , di nmn Ala bakit ganun kaw ba eh nanuod nalng ng tv para malkalimutan mo , dati daw ayaw mo mag pagamot I: Natatakot R: Natatakot san sa turok o sa epeko ng gamut san ka natakot I: Parehas R: Kasi nakikita mo sa iba un ba un , nakita mo sa ating mga kasamahan , I: Nodding nag chemo agad kaya ah un pag kuha ng dugo Ung pagbiopsy , R: Masakit ba ung biopsy , masakit pala ito un lnag naman gusto ko I clear R: basta kay mag pagaling kumain ng maaus kuamain ng masusutansya wag na mag papapuyat wag ka naring makipag sa lamuha sa may mga may sakit pwede naman mag exercise pero huwag masyado baka kasi mag dugo or anu ,tapos ay , ayusin ang pag kain pagtulog at bawal ung mga junk foods ihaw ihaw at ung mga may preservatives. Mahilig ka nmn ata dun I: laughing kumakain ka ng chichiria tigas ng ulo pag sabihn nyo na din nag dadalaw pwede naman pakontokonti R: ngaun anu na nararamdaman mo ito nasa ospital ka, tapos ay nag gagamot ka na parang alam mo lumiliit na sya anu nararmdaman mo ngaun I: Masaya na R: Dahil alam mong Gagaling na ako R: Think positive, lagi ka bang nag darasal I: Hindi Pero mag pag kakataon ba na parang hiniling mo a I: Gumaling na ako R: Kay jesus hiniling mo talaga sya Hayaan mo ibibigay niya sa iyo
Informant I
R: Magandang uamaga po anu , magandang umaga ako si Mignodel Morales nurse nandito ako upang mag interview s ainyo kumusta kana? I: Ok lng po R: Anung pangalan mo I: Informant I R: Informant I R: Ilang taon ka na I: 11 years old R: Saan ka po nakatira I: Sa malvar R: San sa Malvar I: Kapitan maria R: Kaptan maria , ilan kayo mag kakapatid ? I: Apat po R: Pang ilan ka I: Pangatlo po R: Pganatlo , so ilan kayo apat tapos pangatlo ka so yung panganay , anung pangalan nung panganay ? I: Merlyn R: Ilang taon si Merlyn I: 15 yung pangalwa melody R: Ilang taon na po si Melody I: 13 year old R: Yung pangatlo kayo , yung bunso ninyo I: Si Melvin R: Ilang taon na si bunso I: 9 R: Saan ka nag aaral ngayon I: San poquinto R: San poquinto elementary school . grade anu ka na dun I: Grade 5 R: Grade 5 nun , kumusta naman pag –aaral dun sa san poquinto elemtary school I: Mabuti po R: Mabuti naman , kumusta naman yung kabarkada mo oh yung mga kalaro mo I: Ok lang po R: Ok lang sa bahay , kumsuta naman sa bahay , anung ginagawa mo tuwing Sabado o Linggo anu ginagawa mo dun I: Nag lalaro R: Nag lalaro , sinung kalaro mo I: Mga pinsan ko R: Mga pinsan so anu yun malaking lugar I: Opo R: Malaking lugar , so saan kayo nag punta dun anung ginagawa ninyo, nandun lang basa bahay o napunta kayo sa ibang bayan or bahay I: Doon lang po sa bahay R: Pag asa school ka , masipag bang mag aral si I , masipag bang mag aral si I I: Opo R: Honor student si I I: Hindi po R: Pero nakakasabay sa ating mga kaklase I: Nodding R: Kumusta namany yung mga kakalase mo ?may mga kabarkada ka bas a school ? Meron po R: Madami? I: Opo R: Marami , ah kumusta nman yung mga kapatid mo Mabuti naman po R: Ok naman I: Opo R: Hindi ka namn kinulkult I: Hindi po R: Ang mami at dadi ok naman sila I: Opo R: Yan so ah anung I, nung nakaraaang buwan may napansin ka bang sa katawan mong kakaiba? I: Meron po R: Anu yun I: Anu po nahihilo po a R: Nahihilo ka, anung yun nung nasa school ka biglang nahihilo biglang naghihimatay o di nahihimatay, nahihilo lang I: Nodding R: Anu gagawin mo pag kaw ang nahilo I: Na ubob na lang po R: Di mo sasabihin kay teacher, bakit di mo sinasabi kay teacher bakit di mo sinasabi kay teacher , dahil natatakot ka I: Di naman R: Di namn bakit di mo sinsabi kay teacher teacher akoy nahihilo pag umuwi ka sa bahay ok kan a I: Ok naman R: Sinasabi mo kay mami I: Sinasabi ko po R: Anung gagawin ni mami pag sinabi mong nahihilo ka, anung sinasabi I: Wala po R: Wala, di ba yung tulog ka na lang anak or anu hindi? Tapos wala kang napansin na dito sa iyong leeg I: meron po R: anu yun anu yan anu napansin mo I: bukol po R: masakit ba yung bukol nayan I: hindi po R: hindi, hindi masaki t tapos eh may mga pula pula di naman siya Makati di naman siya Makati I: hindi po R: tapos dumaan sa mga buwan na bigla kang bigla kang anu anung mga nangyari , hindi ba I: nahihilo ka tapos biglang yung mga nakaraang buwan anung nangyari nilalagnat po R: nilalaganat na, ilang araw ang lagnat mo mga anu I: isang lingo R: isang lingo , tapos nakakain ka ba naman nun I: opo R: pero napasok pa, napasok ka pa rin , tapos tumagal pa rin ng ilang araw anu nang nagyari I: I: biglang anu kaya yun kaya ay nasugod ka ba sa ospital na mutla R: nung nakita mong maputla ka anung naramdaman mo I: anu po nahilo R: nahihilo ka, ay yung nararamdaman mo sa loob mo, kaw ba eh anu wala wala kang naramdaman di ka natakot I: hindi po R: hindi namn ,talagang matapang ,tapos nung dirediretso na nag karoon ba tayo ng pag akaktaon na lumiban na opo R: ilang lingo ka daw lumiban isapo R: isang lingo anu sabi ng mga kaklase mo I: wala po kinukumusta lang po R: yung teachers o yung adviser mo I: kinukumusta din po ako R: eh anu sinasabi mo pag natanung kumusta ka na anung sinasabi mo I: mabuti ok na po R: ok ka na , pagtuloy pa rin ang pamumutla san kayo nag punta na kayo sa ospital I: opo R: pag katapos naung nag paunta sa ospital anung sinabi daw anu daw sakit ,mo I: Acute Lymphocytic Leukemia R: Sinu nag sabi sa iyo nung acute lymphocytic leukemia I: Ang mama po R: Ang mami mo , noon, yung anu nairirnig mo ang sakit na ganun, o yung mga katulad niyang I: sakit , anung ang nasa ispi mo . anung ba yung sakit na ALL siya ay? Cancer R: Pag sinabi kong cancer , anu yung napasok sa utak mo agad , anu yung napasok sa utak mo ,nung nasa school ka pa “yung ganyang cancer” anung napasok sa isip mo I: Takot po R: Bakit ka natatakot,pag sibnabing uy si ganun kapit bahay natin may cancer bakit may nararamdaman kang ganyan dahil , anu sige dahil dahil anu po , I: Natatakot po R: Dahil yun ba ay sa proseso ng sakit yun ba ay sa paggagagamot , san ka natatakot I: Sa sakit po R: Sa sakit mismo , hmm may nakita ka na bang may cancer wala pa I: Wala pa R: Wala pa nagun , dun sa anu sa ating clinic venue ka na sila ay ganun din I: Opo R: Ahm ikuwento mo or kung gusto mo kung kaya mong ikuwento yung sinasabi ni mami yung ALL naintindihan mo ba yung ALL I: Hindi R: Pag sinasabing ALL anu siya anung uri ng sakit I: Sakit daw sa dugo , caner R: Cancer ok so pwede mo bang ikuwento anung nangyari nung sinasabi nang mami mo yung nangun sinasabi ng mami mo anung ginawa mo , anung ginawa mo nung araw na iyon yung bang nanahimik ka ba di ka kumakain , tumulog ka na lang anung ginagawa mo I: Tumatahimik po R: Bakit ka natahimik anu napasok sa iyong isip “ala akoy tahimik na dahil , dahil yes gud tahimik talaga tahimik , pero iniisip mo yung sinasabi mami mo Opo R: Talagang lagi mo iniisip naapektuhan ba yung pag kainin mo o pagtulog I: Di po R: Di naman panu ka nakibagay dun sa ngayong sitwasyon I: Silence R: Panu ka nakikicope or nakakaadapt tulad nito kunwari tulad ng lagi kaya dito sa Batangas City tapos yung dadi at mga dalawa mong kapatid eh anu, anu nararamdaman mo dun yung nag kalayo kau I: Malungkot po R: Kasi di kayo nag kakasamaa oh, pero sa tingin mo parang may nag bago ba sa loob ng family ninyo I: Meron po R: Anung mga pagbabago po, pagtrato mo sa mami, sa dadi, sa kuya, sa kapatid mo anu mga pag babago sa mami, sa dadi at sa kapatid I: Naging maasikaso po sa akin R: Wow maasikaso , ika nga pang princess and I ., princess and you kaw si di ko alam pangalan , yun si princess and I ako si Daniel padilla (laugh , baka kaw eh umiyak sa sinasabi ko , dun sa kaibigan mo dinadalaw ka ba nila , Dinalaw ka ba ? di na dalaw ka ng teachers? I: Opo R: Ang adviser nung mga kaklasmate ko I: Opo sa amin po R: Anung sa inyo , anung nakita mo, yung papunta na dtto yung mga classmate ? anung naramdaman mo I: Masaya R: Bakit ka masaya bakit naging masaya si I I: Kasi po dinalaw ako R: Wow kais dinalaw ka tapos ahm , yung bang gusto ko ng ganito gusto ko ng ganito gusto ko ganyan binigigay ba sa iyo I: Opo R: Ok anu pa ang pangarap ni I I: Teacher po R: Maging teacher po,pangarap at wish ni I ngaun I: Sana gumaling ako R: So nag dadasal ba si I lagi I: Opo R: Anu lagi mong pray mo kay Jesus I: Sana po ay gumaling agad ako R: Pag ikaw ay gumaling anu una mong gagawin I: Lagi pong magpapasalamat sa Panginoon R: Ok habang tayo ay nagpapasalamat sa Panginoon ., anu pa kunwari yan negative na tayo sa ALL anu mga sunod mong gagawin , tayo ba’y babalik sa pag- aral I: Opo R: Ah may pagkakataon na ba naiisip mo na dapat ako’y nag aaral ngaun naisip mo yun dati I: Opo R: Anung nararmdaman mo nung naiisip mo yun yung mga classmate ko ng aral ako ito naiwan anu nararamdaman mo nun I: Malungkot po R: malungkot may pag kakataon na nag tetetxt na kakausap mo sila I: Opo Nagsusulat, sulat talaga yung papel , wow papel, ganito , Batangas to Malvar (Mother) nag susulatan sila mag pipinsan (teary eyed mother) R: Ah yun so anung pangarap mo din sa yong sarili pala, anung pangarap mo sa sarili mo I: Maging teacher R: Anu pangarap mo sa family mo I: Sana po di mag kasakit sana walang magkasakit R: So napakahirap nga kung may magkasakit may pag kakataon ba na kung anu ito naman ay parang sitwasyon kung di kaw nagnagkasakit at ang nagkasakit ay yung ibang kapatid or pinsan mo or kabarkada mo anu or bestfriend panu mo siya tutulungan I: Ipapagpray ko R: Dadalawin mo ba siya anung pang gagawin mo nun I: Tutulong lang po R: Nandito na tayo sa chemotherapy alam mo naman yung gamut yung chemo therapy kumusta naman yun I: Ok naman po R: Anu I: Ok lng po R: Ok lang natakot ka ba dati I: Opo R: Sa anung bagay ka nataakot I: Dun po sa turok R: Sa turok anu anu nga pag nasa ospital wala na kaming ginawa kundi magturok anu di ka ba napapagod na ako di or oo I: Naiisip po R: Naiisip mo din san ka nahugot ng enerhiya “kaya koto ” kunwari nalulungkot ka I: Kay Jesus po R: At kaninu pa I: Kay mama po R: Hidi kahit akoy takot natakot kailanagn kong ituloy , dun na tayo sa cancer warriors, alam mo na nun na anu , kumusta naman sila nakausap mo sila , pati yung kanilang parets din kumusta namn I: Mabuti po R: Dati ba naisip mo na bakit ganun R: Nag question ka bas a sarili mo na bakit ako I: Opo R: Yan ah may pag kakataon ba na yung nasa iyo lang ba yung problema yung ang laki laki ng problema ko eh kabata ko pa naisip mo yun I: Opo R: Naisipi mo rin ba yung parang bakit ako at lahat kami or yung sarili naming pero nung nakilala mo yung mga yun M, G, anu naisip mo anu napagtanto mo nun na yung nakausap mo sila I: Masaya R: Anung pagkakataon na naging Masaya si I , kahit ganito na ang kalagayan mo I: Meron po kagaya R: Kung sa amin yung narasan nya I: Nararanasan ko rin po R: At yung nararanasan eh alam mo na yung mangyayari anu , so mas gumagaan ba iyong lkalooban nung meron pala akong kagaya Meron din palang may ALL na grumagrauate Nodding R: Di ba tayo nung naron ako may grumaduate si K di ko killa yung iba kahit panu ay I: gumaling Oo R: so anu dapat ang kailangan gawin I: Magdarasal po R: At anu pa R: Sa sarili mo anu dapat mo gawin anung kailangan gawin na sa sarili mo lang kaw lang makakagawa I: Kumain ng masustanysan at disiplina R: Nakahanda ba sarili o ,kaw eh mahilig sa chichiria I: Dati po R: Nag pupuyat ka ba I: Dati po R: Anung pinapanuod mo I: PBB opo, dati po R: Ngaun alam mo na bawal na, yan gagawin mo pa I: Di na po R: May pag pagkakataon ba na nag pasalamat ka pa dahil may sakit ka I: Opo R: Anung sitwasyon na nag pasalamat ka pannag mmag kaganito ka , ganito ang kalagayan , na meron mabuting nangyari na may napansin kang nag kasakit ako pero napansin ko kahit sa anung aspeto ng iyong buhay , dati nung wala akong sakit akoy sakit ganito kami I: Naaalaga po R: Naging bonded ba kayo ng family I: Opo R: Sabay sabay na ba kumain ,nag lalaro kayo I: Opo R: Yan nakakausap mo na mami si dadi dati ba di kayo ni mami at dadi I: Opo R: Nagun ba mas close or closer I: Opo R: Naintindihan mo na nmn or nararnasan mo na ang sakripisyo nila I: Opo R: Sakripisyo , eto pa lang itong ginagawa natin nung nandito kayo mag kahiwalay kau , yung alam kong masakit ito pareho pero sa iyo sa mami ,dadi at sa iyo na pero titiisin mo ba ito para san ? I: Opo, para sa ikagagaling ko R: So matapang ba si I I: Opo R: Talagang kakaharapin mo pangyayari I: Opo R: At yung susunod pa I: Opo R: Handa ka bas a maging resulta nito I: Opo R: Para sa iyong sarili at para san I: Mga magulang ko po R: Para sa mga magulang at sa mga kapatid I: Opo R: Ok so yun lang naman aking maipapayo yun mga anung pinagbabawal ng doktor huwag nating gawin pag sinabing uminun gamut ng gatas ,kumain ng gulay I: Susundin po R: Sabi ko sa iyo I ang kalaban natin di ga ay ang ating sarili , di mo kalaban ang mami mo , di mo kalaban ang dadi mo , di mo kalaban kalaban ang kabarkada mo at yung members ng org yung kalaban mo ang iyong sarili mo. Disiplina “kung gusto mo manuod tv dapat alam mo sa sarili mo na naku dapat matulog ako maaga masya ka nag nandito mami at ate mo” I: Opo R: Si ate M, kahit papanu ay suporta excitd ka bang umuwi ng malvar, I: Super excited R: Anung gagawin mo pag nakauwi ka na I: Mag lalaro po R: Mag lalaro ulit mag kukulitan kau ng kabarkada mo ,papupuntahin mo ba sila I: Opo R: Salamat I ,
Informant G
R: Good afternoon , ako si Mignodel Morales, a student of Golden Gate Colleges, , ang study ko ay tungkol sa cancer po, good afternoon I: Good afternoon R: Anung pangalan mo I: Ako si G R: Anu pong apelyido I: G R: Taga saan ka I: San Salvador, Lipa City, Mabuhay (Laughing) R: Ilang taon ka na I: 17 R: Napasok pa si G I: Stop na po R: Kung napasok pa anung year na I: Incoming 1st year po R: Saang school I: Lasal po R: Sa lasal anung course I: Management technology R: Management technology, ah yun ba talaga yung gusto mong course I: Hindi R: Anung gusto mong course I: HRM R: Bakit mo gusto HRM I: Hilig kong magluto R: Wow, oo narinig ko nga sa tita mo I: Wala lang R: Saan ka nag high school I: Doon din po sa Lasal R: Wow sosyal, sa Lasal , grade school I: Sa san Fernando airbase elementary school R: Kumusta naman dito sa family I: Ayus naman sa barkada mo, musta naman mga kabarkada mo R: Ok naman din R: Kinukumusta ka naman nila I: Oo I: Lagi lagi I: Araw araw R: Araw araw talaga, yan yung relationship ninyo magkakapatid I: Ok naman (laugh) speechless R: Nagsalita speechless , tapos punta tayo sa pinaka main anu, pag ba sinabi mog cancer anu napasok sa utak mo? I: Kung hanggang kalian na lang (laugh) R: Kung hanggang kalian na lang so , bakit mo nasabing ganyun I: Kasi di ga siyempre nagpapagamot, kasi pagnagpapagamot ka parang, anu iniintay mo na gumaling ka o hinihintay mo hanggang saan ka na lang R: Ok I: Nawala na sakit ng ulo ko R: Pwedeng bang ikuwento mo yung nangyari sa iyo yung buong anu baka ako’y abutin ng hapon o gabi yung pinaka significant na nagyayari, yung una pacheck up, bakit nag pacheck up, hanggang diretso hanggang ngaun I: Nung una R: Anung napansin mong pagbabago na anung date yun I: March 1, 2012 R: Anung nangyari I: Namutla muna, menstruation bumabaha ng menstruation (laugh) R: Malakas talaga as in I: “gush” sound effect I: 2 days na ganun R: 2 days na ganun I: Nung pangatlo nawalan na naman ng dugo, yun check up tapos sabi mag pa blood smear daw , geh takbo dun mag papablood smear kamahal mahal dun (laugh) tapos may pagkatapos nun ang results ay nung Friday, diretsong confine kami R: Oo I: Saan medix, yun , di naman , nila sinasabi sa akin maingay lang ang doctor dun kaya nalaman yun, tapos March 12, 2012 nagbone marrow pati kaluluwa dala (laugh) Laugh san ka bone marrow R: Sa medix I: Masakt kasi rin eh R: Pagkalabas natin , yun parang wala lang parang walang nangyayari I: Malakas na ulit March 20, 2012 Medix na ulit kami masyado kaming mahal sa Medix,nagdudugo ang ilong , as in buo ang nalabas, sa gums, tapos 7 days March 27 lumabas, tapos April 16, 2012 nag pa blood smear ulit kami negative naman, tapos sunod duon yung pumasok na ulit, naka duty na ulit ako sa lasal gawa nang sa scholoraship, tapos nung tapos nung naospital na ulit May 31, 2012. May 16, 2012 lumabas yung cancer cells daw dito Sabi ninyo parang beke daw,malaki I: Malaki siya, ganun di na ako makalakad ng isang Linggo, UTI naman ayaw ko mag pa ospital sawa na ako eh,tapos sunod dun ay sa BRH na ayaw ko dun mag padala. Ayaw ko naman talaga dun (laugh) (mother) si dokotra ang may gusto I: Sa malaking ospital mga kung anu anu nakikita dun nakapasak sa ilong sa bibig panu pag duon pa (laugh) tapos I: Ayaw ko nga dun mga padala wala sige payag na di ako makalakad sakit na sakit na talaga, pinainum ako ng cotri. Wala naming anti biotic na itinuturok sa akin dun , yung cotri lang ang iniinum ko umihi na ako ng umihi dun d yun bago kami lumabas ng Regional lakad na ako pag labs ng ospital (mother) doon nagsimula yung chemotherapy I: May 31, 2012 kamiy nagchemo na , June 3, 2012 lumabas , sunod dun yun nag pataas ng aking sugar , tumaas ng tumaas ng pagkatapos ang aking sugar parang nag iikot lang tapos , ilang araw tayo dun 2 araw lang pag katurok ng insulin bumaba agad di naman yung biglang baba talaga kung baga’y unti unti lang kaya yun sabi ni dra eh makakalabas pag daw di na tumaas ulkit at imomonitor na lang baka daw diabetic or au un daw epekto ng leuconase sa katawan. Yun pag katapos nuon nag diretsodiretso na nag chemo hanggang nagyon. R: Haba pala tinahak mo (Laugh) R: Unang una yung menstruation sinasabi mo agad “mami are” I: Natuwad tuwad na nga ako R: Pag anu ang lakas , anu nararmdaman mo nun I: Nung una may sumasakit sa likod ko parang nangangalay na di mo maintindihan tapos nung mga nakaraang araw yung menstruation yun aking patuwad tuwad na dine ayaw ko ng uupo ng uupo R: Sige, ah so alam mo talaga ang sakit mo I: Bago lumabas ang result alam ko na (laugh) R: Anu iyong sakit I: Gawa ng internet R: Napaka advance anu diagnosis mo I: Acute Lymphocytic Leukemia R: Anu daw yun ang Acute Lymphocytic Leukemia I: Sa blood cancer sa blood R: Oo I: Nung una kasi di ako makapaniwala mens lang na lumakas , gayon, gayon, tapos internet internet hanap dun tapos yung ibang sintomas na nandun , yung mga red red na ganun, pag ata ang term dun tapos di ko sinasai dine, tapos din a naman nila din sinasabi sa akin, yung result nung blood smear, kaya ko nalaman gawa ng doctor , masyadong maingay R: Nung kaw ay nadiagnosed anu una mong ginawa I: Umiyak ,siyempre di ga si Francis Magalona kaya namatay dahil sa Leukemia R: Bakit ka umiyak R: Anu iniisip mo nun I: ang buhay mo ay mag papagamot na lang na pwede kang gumaling R: Pero parang inisip mo na nung na parang iniisip mo na parang wala na I: May ganun nung di pa ako binobone marrow R: Anu nga iniisip mo I: Okay lang tutusok tusok lang naman eh, nung ako’y binone marrow eh sabi ko ayaw ko na R: Ayaw mo na mag pagamot dahil sa I: Masakit masakit gawin yung bone marrow. R: Ilang araw bago gumaling, I: Nalala siya yun pagkatapos pag tatayo at uupo parang mahihigit yung anu mo R: Ah masakit talaga nag BMA din kami sa regional I: Nung BMA ako dami pa nanunuod (mother) walang naiyak kay dra pag nag BMa ditto sya nakuha ditto sa buto na ito R: Ah ito dito sa likod I: Tapos ang haba haba ng karayom nagamit , binalda na ako dun R: Balik tayo ng konti sa mga barkada at mga ginagawa mo dati bago ka magkasakit, active ka ba dati I: opo R: Panu mo nasabing active ka I: Sa school kasi maraming mga club club parang un yung mga kabarkada ko ah may utak salihan ng salihan ako naman nadadala ako R: Anung sinalihan mo dati I: Lectors and the Acolytes , yung sa Sidoku R: Anung Shidoku I: Parang arts , parang walang matripan naming , pag di naming nagustuhan yung instructor ay mga nag aanu eh mag quit kami R: Hehe pinag titripan nyo pala, pagkatapos, meron po sa sports I: Soft ball R: Soft ball talaga , sabado at lingo wala ka ditto sa bahay I: Depende minsan kasi lingo , sa bado at linggo kami ay nasa alabang maikling season lang kasi yun kokonti ang kasali , di un sabado at lingo nandun kami umuulan at umaraw ay nandun di gat iba ang inti duon. Sobrang init dun tapos balot na balot pa yung uniform , para kang sinusunog , pagkatapos ng season na yun di kami nanalo dun mga kalaban namin duon ay as in mga taga bukid walang pakialam kung tamaan ng bola kung sasabay tuloy tuloy ,pag katapos ng season na yun mga PTBF kami sumunod un naman ay sa Manila, mas mainit dun , sabado at lingo, Linggo dun binalda ko na sarili ko dun R: Dito anman sa community ditto I: Dito ay fiesta R: Kaw daw ang miyembro ng kabataan anu ginagawa, ang inyong function I: Kabataan Wala lang parang simpleng , kasi nasanay ang mga tao sa mga ganung ganun pag fiesta alay R: Anu ginagawa ninyo , anung mga projects I: Pag may piyesta mag papa disco, tapos yung sa tapusan kahit naulan ikot ditto ikot dun R: Iba kayo sa SK I: Oo R: Active na active ka dito,kumusta naman yung mga kabarkada mo dito sa community I: Ayos naman nung nasa ospital ako padalaw dalaw kahit ayaw kong ako’y dinadalaw pinupuntahan R: Bakit ayaw mo kaw ang dinadalaw , dinadalaw ka na nga I: Ayaw ko ng ganun para kayang R: Anung narramdaman mo pag nandyan yung iyong teacher and classmate sa HS I: Dati yung mga kaklase ko dumalaw sila punong puno ang ospital parang may mag check ng attendance na dun , di ko lahat sila kinausap gawa ng anu ayaw ko talaga ayaw ko ng ganun R: Anu nararamdaman mo pag agnun I: Kasi dati nasanay na ako ang dumadalaw ayaw ko nung ako’y dadalawin or punatahn (mother) naiisip nya na may sakit siya I: Oo R: Ah parang lalung I: Nakakirita lalu na , ah parang dib a pwedeng ako’y umali R: parang kaw yung pinaka center I: Uu ayaw ko ako’y ginaganyan ganyan R: Balik tayo tungkol sa cancer , base sa research m anung nalaamn mo dun parang wala end na ito nasabi mo ba dahil sa iyo I: Pero anu nag reresearch naman ako dun bigla bigla na lang nalabas na may survivors pala ganun R: So anung naramdamn mo nung biglang I: May gumaling na R: Tulad ng tayo nandun may naka graduate na ng ALL oops may I: Grumadutae na R: Anung nararamdaman mo nun I: Wala naman , kung isa dalawang taon gusto ko yung akin mas maikli doon R: Ah,ilan daw ba taon ang gamutan I: 2 years pero yung first 6 months yun parang sobra R: Sobrang anu, ilang months ka na I: mag 3 months na R: naku malapit na 3 months, anung naramdaman mo nung nakonfine then bumalik then naconfine then bumalik nung nasa ospital ahm, yun nga di ba malapit ka na grumaduate nun , gragraduate ka na nun nung high school I: gragraduate na ako nun R: anung naramdaman mo nun malapit ka na grumaduate I: wala naiyak ako kasi baka di ako makagraudate R: anung ginawa mo nuon , 1 week or 2 weeks before I: 1 week before R: 1 week before pero naka attend ka I: Oo nakaatend ako nag lakad ako R: Anung ginawa mo nuon I: Bale nung last practice nay un nandun na lang kami nanunuod R: Pero umakyat ka din sa stage I: Oo, dalawa kasi yung graduation, so di ga dami ng studyante di ga mahirap isa isahin pa yun , kaya dun nung isang araw dun ginanap yung Recognition,parang sa college din R: Yun hiwalay R: Diploma na lang din ibibigay ,may award ba si G I: Sa sports lang R: Wow , anung sa sports atheletic of the year I: Best in soft ball R: Wow , R: Nagventure ba kayo sa alternative medicine , saan pa kayo nagpagamot I: Sa albularyo R: Tapos sa albularyo, naniniwala ka ba dun I: Oo R: Tapos, anung ginawa sa iyo dun I: Parang pinupulsuhan R: Tapos I: Di ga may mga albularyo na nababasa nila yung anu , halimbawa may gumagawa sayo , yung mag kandila ganun , marami na siyang nasabing napagaling , may napagaling daw siyang ganun din , sabi nung doktor eh tatlong buwan na lang daw na lang ang itatagal yung ginamot niya ngaun eh buhay pa mag dadalwang taon na , yung ginamot nya , di yun , kaya akoy nag pagamot din dun simula nagpagamot kami dun at nag pa blood smear kami yun yung nag negative R: Ah I: Yun yung nag negative, yun pinaghanda pa di yan , dahil lang nuon R: Dahil parang nag negative na May ininum ka nuon under nung manggamot Herbal daw un mga herbal R: Anung tawag nga dun bulaklak ng milagrosa (mother) R: nilalaga tapos iniinum I: wala naman siyang lasa R: walang lasa R: anu yun every day R: halimbawa ngaun , or bukas dapat ubos na yun I: yung 1.5 I: oo R: ah ah nilalaklak mo yun laugh R: tapos umo K naman , nung ininum mo yun , this day or this week I: oo malaking pinagbago ko R: anung pagbabago I: feeling ko ay ako ay lumakas lalo , yung sa tonsil ko kasi di ga kakalabas ko lang ng ospital dahil sa tonsillitis , nung luamabas kami sa ospital di pa rin magaling yung sa tonsils ko nung ganun hinawakan lang niya tapos di naman siya masakit , tapos kakainin na ako di ga syempre di na masakit pero pag kakain ulit ako pag katapos kumain saka lang siya sasakit R: hmm I: kaya yun nag pagamot na dun R: anu yun isang buwan I: bale 3 days lang siya (mother) R: 3 days lang 3 days siyang araw araw ginagamot (mother) R: Tapos yung herbal 5 days na inum yung herbal (mother) I: Sinabihan nya kami pag anu daw mag patingin na daw ng dugo pero nung time na yun wala pa kaming pera papautangin daw niya kami di ga ang blood smear naman eh mahal din naman , yun nga negative nga , kaya lal8ung duamji ang nag pagamot sa kanya R: Nung nalaman mong naging negative na na dati’y positive anung naramdaman mo nuon I: Papasok na ako R: Ayun pumasok ka na I: Pumasok siya naexpose ulit siya sa mga mikrobyo sa labas , umaga’t hapon nagbyahe sya (mother) R: Anung oras ka ba napasok I: 8 am, pero mga 7 na alis R: Tapos anung oras ka ba nalabas I: 5 pm R: Tapos makarating ka dito gabi na tapos buaks madaing araw ka na ulit, di ka pa rin nuon SA I: SA na ako nuon , yun na nga yung , wish ko nga nuon eh di ako mapaasign sa summer , tapos paapat pa lang na pangalan eh tinatawag na ako ,ako na agad R: Hmm I: Ako na agad ang magduty sa summer, butit ang nadutihan namin ay college registrar , di yun inuna pa kaming ienrol , nung mismong anu para daw di maubusan ng slot R: Ah oo I: Tapos yun pala akoy unang magwithdraw R: Anung naramdaman mo di ga kaw eh grumaduate na sana maging HRH or MT , management technologist panu mo nacope yung di ka na papasok muna I: Wala, eh nandun na eh kung pwede nga lang nag papagamot habang napasok nga ba hindi R: Tulad nung mga nakikita mo I: Di ga’t anu , late na nga ko grumaduate , 5 years ako sa high school , tapos late na naman papasok R: Pero talagang anu gusto mo talagang pumasok I: Oo kahit hindi ko gusto yung course na yun R: Bakit hindi gusto, kasi dun lang ang papatakan ng iyong scholarship I: Ang scholarsip ay psychology education , mantecth , anu pa ga yun R: Di kasama ang hrm I: Dati meron pero ngaun di na , masyado nang mahal kaya di na inofer R: Oo mahal kasi , ang nursing nga di pwede gawing scholar R: Tapos panu ka naka adjust , dati nag alalro ka ng softball tuwing Saturday I: Yun nga naiinis , kapag aalis , di ga siyempre , di ga di ka pwedeng mag gala ng mag gala R: Kaw ba nagtanggal ka bang communication ,o wag ninyo muna ako itetexxt , na may tournanment I: Nung isang araw nag text nung may bagyo, yung kaklase kong yun sa BSU napasok R: BSU lipa or sa main I: Sa main I: Simula nung high school yun lagi naman yun nag tetext mga gayon gayon, nag gm siya na walang pasok I: Niloloko ko mga are wala daw kayong mga pasok R: Parang anu bayan , consideration , panu kanaka adjust dun sa point na yun kasi dati , halos wala ka naman pahinga tapos bigla stop , anu yun mabilisan or nag lalaro ka pa dati ulit or biglang I: Bigla nalang I: Bigla nung natapos yung tournamanent , nagawa ng theiss simula nuon R: Yun panu ka naka adjust dun I: Kasi lagi gusto ko lagi nasa lumabas, minsan pag aalis sila nandun ako sa labas sama ako R: ah I: Di pag aalis sabayan na ng gala (laugh) daan daan Kailangan (mother) R: Pagkalabas eh I: Kung kaya nya eh after chemo ikot mo muna ng konti ,sama sa mall (mother) I: Gala muna bago uwi R: Dito naman sa anu sa kasapi, nga tawag sa kanila I: Wala naman silang activities R: Pero dati nung tapusan Nagpunta siya hanggang 11 (mother) I: 11 lang ng gabi R: 11 ng gabi I: Natulog na lang ako R: Kasi mapupuyat ka ,masasabi mo bang malaki ang pagkakaiba I: Oo sobra R: Saan aspeto saan malaking pinag kaiba kung babalikan mo dati tapos ngaun anung major mo na pinagkaiba I: School R: School talagang gustong gusto mo I: Naiiyak ako sa iyo (crying ) mga tanung mo eh R: Yun nga rin eh kahit ako nahihirapan magtanung , sa skul sa family ,may napansin ka bang nag iba Nag ka special treatment (mother) R: Nung anu naman , nung nagsimula nung nadiagnose na ako ayaw ko na umalis dito Ah Lahat ng atensyon nasa kanya (mother) I: Kahit ako’y yayain eh ayaw ko (crying) ayaw na ayaw ko na umalis na dito na are , san ka pa pupunta R: Kumusta naman yung sa mami mo at kaw , sa kapatid mo at kaw I: Di na nga kami nag hihiwalay , di na kami nag hihiwalay , pupuntang clinic kami mag kasama , mag papacbc kami pa din , oh san ka pa , ang punta lang lagi sa clinic , sa ospital sa laboratory sa halip na naiipon ay test paper eh ay ang result ng CBC (laugh) R: Aray ko I: Sari sari na eh R: Sige tapos na tayo, nung anu anung tawag dito , nung nalaman ng kapit bahay pumunta ba sila dito kinausap ka ba o di kinausap Nawindang ang buong san Salvador (mother) R: Kaw kasi ay isa din sa kilala din dito sa boung zone 2 or zone 3 barangay Lakas mo naman I: Laugh R: Layo ata ng zone 3 I: Yung dulo na R: Papanu ,alam mo na mga chismosan or chismisan dine ,may pagkakataon ba na naglalakad ka diyan tapos biglnag kukumustahin ka Di naman parang anu R: May nakikita ka lang na parang opss I: Ah wala , nabati naman R: Ah nabati naman I: Oo pasan ka gala ka ng gala diyan baka mamaya kaw eh matumba , wala naman akong naririnig na oy wag kayo lalapit diyan , hehe sampalin ko sila R: Hahha I: Yung sa rob kasi , yung lady guard , parang bago palang yun , diga di namn lagi may lady guard dun ,eh nakabonet ako nuon , pinapatanggal , na pa ha na pa ganun ako eh sabi nung lalaki hindi po hindi po parang hiyang hiya yung lalaki , nakakainis I: Hindi pa sila aware Hindi pa sila aware (mother) R: Minsan nga po kasi Naka mask ka na nga ,nakabonet ka pa di ba nila naintindihan (mother) R: May ganung mga tao po na di nila alam R: Anung pangarap ni G I: Yung aking hotel (laughing) Ah yun, yun nga gusto mo pag patayo ng restaurant I: Pag natupad na ang una nyang papatikim ng luto nya ay taga Cancer warriors (mother) R: Anu pa anu pa , meron ka pa isang pangarap I: Yun dati kasi, inimbitahan kami ng world series sa Canada R: World series yung sa soft ball I: Oo, nag kataong walang pera, kaya di kami napadala dun R: Wow I: Isang talon na lang, di na nga kami nag champion, eh lalaban na agad R: Ah I: Kahit di na pang championship eh , tapos di pa tinuloy Di na natuloy (mother) R: Yun pa yung isa mo pang frustration R: Bakit mo nalaman I: Kasi yung mga forms R: Ah oo I: Pag may mga training kami dala dala nila yung mga forms , na fifill upan naming pag may mga laro , eh kami parang barkada namin ang coach namin , hanapin mo na lang dyan , yun nakita naming yung forms , as in inimail lang sya tapos , print na lang dito , inemail dun sa coach ko Yun nga din ang isa mo pang frustration mo I: Sobra talaga akong nainis R: Na lumaban sa Canada I: Kasi parang di patas, kasi yung ibang sports dinadala nila ng Thailand R: Uu R: Anu pa yung motivation mo para ipag patuloy mo ang anu , yung gamutan natin I: Kakaiin R: Saan ka nakuha ng lakas , kung nbakikita mo dun tayo sa cancer warriors , san ka rin nakuha ng lakas para pag patuloy yung anu , mag papabone marrow ka lagi pa cbc I: Yung sa mga graduate na R: Bakit anung masasabi mo dun I: Kasi napasok na sila eh R: Tapos ay, madasalin ka ba I: Oo, simula nung , di ga catholic school ang lasal R: Talagang anu I: Oo simula nun R: Oo I: Nung binobone marrow nga ako ,nag dadasal na kami nuon (laughing) , tapos St. John Baptist de La Salle, nagulat ako nung sumagot ng forever yung anu yung doktor , yun pala ang anak niya lasal din napasok R: Anung mga hiling mo , pag ikaw ay nag dadasal I: Sanay anu mag dirediretso na, walang nang ek ek pa , na kailangan mong maconfine na naman , ganun ayoko na kasi sa ospital. R: Gusto mo na matapos I: Gusto ko na mag December na agad R: Parang gusto mo na siyang matapos I: Tapos na agad, parang isang tusok dine eh wala na (laughing) R: Eto eto mabibigat na tanung din R: Anung mga pagbabagong naramdaman mo , nung nag chechemo ka , or pamula nung ikaw eh nadiagnose , naconfine hanggang ngayon , anung mga nag iba, sa pisikal sa emosyunal I: Eto namayat sobra, 51 kilos ako dati Nag 28 kgs (mother) I: Yung nag sugar tumaas , nag 38 tapos ngayon nasa 45 na , simula nun tinamad na akong kumain R: Ah I: Kasi pagkumain ka feeling mo, masusuka ka lagi R: Ah , kasi minsan effect yun ng gamut I: Oo, kakalabas palang ng clinic R: Parang I: “oohlk” (laughing) R: Tapos regarding dun sa pisikal talaga, yan sa buhok mo, panu mo I: Ah ah diyos ko R: Talagang I: Iniyakan nya (mother) Kasi naman R: Pero alam mo I: Oo R: Na explain naman na ang ganitong gamut eh I: Yung unang doctor R: Na sinabi ba nya I: Sinabi Sabi nya eh R: Anu daw gamut ang nakaka anu I: Wala ako na rin nag nagreresearch dun R: Anu daw yun I: Vincristine , ah at tsaka yung doxorubisin R: Doxorubisin R: Ah yun mga ilang days bago totally nanlagas , yung mga pang anung days pa lang panu mo na anu I: Wala pa nun, pero habang ako’y nagsusuklay unti unti nang nanlalagas , nag puyod ako nuon , dalawang araw na di ko siya sinuklay, kasi nga natatanggal na nga , pag ka gising ko nakapatong na lang , ganun ginupit na lang R: Yun talaga yung pinaka nakaklungkot I: Oo, di nga ako natingin s asalamin R: Yun talaga I: Ayaw ko talagang tumingin sa salamin R: Eto na yung tanung namahirap , R: Kunwari wala kang sakit, pero meron kang best friend na may ALL , panu mo siya aanuhin, talagang best friend mo , magkasama kayong lumaki, parang kapatid mo na rin siya I: Meron din naman nung sa lasal R: Pero wag naman I: Pero di ko siya kaklase nung 1st year , mga 3rd year ganun R: Kunwari di kaw kung di siya ,papanu I: Kami ganito talaga , misan dun na ako pinapatulog sa kanila , tapos nung nga birthday siya ako lang pala ang bisita , siya ang una kong sinabihan , siyempre kung anu ang ginagawa nya sa akin R: Anu bang ginagawa nya sa iyo I: Nung malaman niya I: Takbo agad sa ospital , nandun siya , nung una, hindi pa daw alam ng mga kaklase namin na nasa ospital ako R: Siya talaga I: Siya talaga ang may alam nuon , nanduon siya nag tatanung siya anung nangyari, nung sinabi ko eh, bigla siyang tumalikod, sabi ko anu ga ito parang engot ah siya pa tumalikod I: Ah kami kasi wala talaga kaming plastikan, kung anu ayaw, dati pag may ayaw ako sa kanya di ko tinatago, kahit mismong anu nga ,kahit mga kaklase namin tuwang tuwa ,, kahit kami’y nagbabarahan na eh di nagagalit R: Ah mag kaklase kayo I: Oo,pag sa skul parehas kamng kakainin nun , sa groupings hinding hindi kami magkasama R: Kunwari tayo ay nag negative na so anung una mong gagawin I: Mag eenrol R: Anu pa I: Kasi nadelay na nadelay , butit ang chemo di nadedelay , eh ang pasok (laughs) R: Pangarap mo sa iyong sarili I: Alin R: Bahala ka , yung nakikita mo sa future I: Restaurant ko R: Anu pa, sama mo naman yung family or yung lahat I: Kasama din naman yun di ga siyempre, kaya ka nga mag aral, di para sa sarili mo, pag gumaling ka lalung gaganahan kang pumasok, yung wala ka na sa age ng ganito gagraduate ka na matanda ka na , yung hindi mo na iisipin nag sarili mo pag pumasok ka , yung mga tao na lang na nagpalakas ng loob mo nung nalaban ka
R: Talagang nagpapasalamt kasa mga taong yun I: Oo R: Kahit anu ay nandiyan sila (teary eyed) yung nabili nga ng platelet R: Yung nasa santa cruz I: Kakawawa eh Mag tetext tapos , sya ang napunta Di naming kilala yun Inusap lang nung kapatid ko (mother) R: Grabe Kahit umulan or umaraw, gabi panama sila na alis (mother) R: Kunwari ako , may kaharap ka na bagong diagnosed na ALL anung sasabihin mo sa kanya Hold on R: Bakit hold on I: Kasi kahapon, yung bagong diagnosed R: May bagong diagnosed I: 2 years old I: Yung kanyang ina I: Ako nga nanibago dito eh kasi daw di nainum ng gatas I: Nung kaw ba ganun ka din ba dati opo I: Di nila alam kung san nakuha yung gayun I: Buti nga kayo diretsong diagnosed na akin eh dami pang pinuntahan R: Bakit mo nasabing hold on I: Kasi ang tagal , biruin mo dalawang taon , dapat second year college na ako nuon R: Two years ba talaga or may I: Ah mga 5 years na dapat walang relapse R: Napansin mong may nag bago sinong kasama mo I: ang mami at si God R: Napansin mo ba may nag bago sa inyo mag ina I: Dati di ako natabi matulog, ngayon di na kami mapaghiwalay R: Ah maraming salamat po Informant N
R: Magandang hapon ako nga pala si Mignodel Morales studyante ng Golden Gate ngaun eh nag aral ng masteral at currently nagreresearch tungkol sa cancer Magandang hapon po ulit anung pangalan ninyo I: Informant N R: Taga san po kau I: Taga dayapan , lemery batanags R: Ilang taon na po si N I: 14 po R: Napasok pa po si N I: Di na po R: Pero kung kaw eh papasok anung year ka na I: Second year high school R: Kumusta naman yung sa family ilang kau mag kakapatid I: anim po R: Pang ilan ka sa anu I: tatlo R: Kumusta naman ang family mo I: Kakamatay lang po ng tatay ko R: Condolence kalian sya naawala I: This june 18 R: Anung kinamatay I: comatose po R: ah may sakit na siya dati I: wala po , aksidente po R: ah naaksidente , so ngaun ang tumataguyod na lang sa inyo ay inyong mami I: at saka ka po ung kua ko R: may trabaho na sila nung ikaw eh nag aaral pa kumusta nmn ang pag aaral mo san ka nag aral I: Governor Feliciano Leviste memorial high school R: byahe ka dun malau un ah byahe ka dun I: opo R: di ga un eh padulo na, may nasasakyan pa dun I: opo meron pa R: kumusta naman sa pag aaral dun sa skul nung dati nung elememtary kumusta naman pag aral mo san ka ba nag elementary I: sa dyapan po R: nung kaw eh nag first year kumsuta naman I: aus naman po R: sa mga kaibigan , may mga kabarkada ka ba I: opo R: pag weekdays or weekends sat and sun nalabas ka ba I: opo R: san kayo napunta , kunwari ngaun eh Friday saan kayo punta bukas I: ngaun po di na kami masyadong close ngaun R: bakit di na ngaun close kasi nga po di na nga ako napasok , at malalau po din ang bahay nila I: ah di sila taga dayapan , R: may pag kakataon dinalaw ka nila I: opo R: may pagkakataon ba na naospital ka I: opo R: mga ilang beses, at bakit ka naospital I: nung unang beses po eh yung sa paa ko po R: anung nagyari sa paa mo I: anu po namaga po R: as in malaking malaki I: di naman po masyado , naconfine po R: nakakalakad ka ba I: di po di ako makalakad R: nung anu po ina nu ako sa taal R: san ka nag paospital nung namaaga ang paa I: sa taal po R: sa taal poly medic , I: tapos po inadmit po ako sa st Patrick R: bakit ka inilipat I: para po sa anu ni Dra para mabone marrow po R: so alam mo n aung sakit mo I: leukemia po R: anung type daw po I: ALL po R: Pagba sinabi mo leukemia or cancer anu yung biglang napasok sa utak mo , nung kaw eh wala pang sakit anu naisip mo dati I: Di po malala noon po akala ko po R: Nung dati tapos ngaun , anu naman nung kaw na nakaranas I:Anu po mahirap po pala R: Panu mo nasabi mahirap I: Kasi po dahil po anu po dahil po kalian kumuha pa po ng pera para sa pag papachemo tapos po paparito ka pa tapos ginagabi nauwi mahirap din po R: Mahirap I: Mahirap din po R: Sinu nag sabi sa iyo na yung pinaka diagnosis I: Si dra po at ang nanay ko R: Ah kaung tatlo tapos nag sabi,nung sinabi ngaung araw na ito anung nangyari nung sumunod na araw napasok ka na nun I: Di na po , dahil po nakaadmit na po ako sa St.Patrick R: Nung sinabi sa iyo anung naging reaksyon mo I: Wala po akala ko po nun eh ayus lang yung di na po chenichemo akala ko basta sakit lang parang pang karaniwang sakit , di po pala R: Sige parang ubo lang I: Opo R: Sige sinong nag decide na tumigil sa skul I: Nanay ko po, nung dito dito ka pina admit sa St.Patricks R: Anung sinabi niya na parang I: Gusto ko pong pumasok pero ayaw po niya kasi daw po bawal daw po. baka sa next year pa R: Nung kaw eh nasa ospital may dumalaw ba I: amm di po, di po nakadalaw mga kaklase ko po dahil nga po malalayo po ang Batangas R: Pero nung kaw eh bumalik na sa inyo I: Opo R: Anu nararamdaman mo pag may nakkita kang may dumalaw sa iyo I: Wala po R: Wala I: Anu po, un po tulad po ng mga kaibigan ko masaya po R: Tapos eh nung tulad ng facebook or nagtettext ba kinukumusta ka b a I: Opo , sa cellphone po R: Active ka ba N dati sa school I: Nag kakaTop po R: Nag kakatop I: Minsan po top 7 R: Nung 1st year top anu ka I: Top 7 po R: Top 7 ka sa buong batch I: Di po sa isang section R: Nasali ka bas a sports I: Di po R: Ung sa gimik san ka napunta dati , tulad ng kayo kayong magkakabarkada lalunat ngaun I: Friday tapos tapos Saturday bukas anu gagawin mo I: Un din po kc pag minsan di na rin po ako nakakasama dahil dami din pong ginagawa sa bahay R: Nung nalaman mong di ka na papasok ,anung parang naging reaksyon panu ka nakaadapt dun I: Anu po umiyak po ako , kasi gustong gusto ko po pumasok tapos nung second year pumasok po ako ng one week tapos di na din po ako naipagpatuloy R: Bakit di na nagpatuloy I: Dahil nga po lumala R: Sa anung pamamaraan bakit lumala I: Nag karoon po ng kulani ung ganito ko R: Nahirapan kang kumain I: Huminga R: Sa bahay ok naman I: Opo R: Dati ba kau eh anim kumusta naman nung kayo eh anu pa napasok pa I: Ok naman po R: Eh ngaun nag chechemo ka na anung nagbago I: Wala po dahil po di naman po lagi ako kulong sa bahay nagala din po ako kasama ng barkada R: Kahit ngaun pinapayagan ka ng mami mo lumabas I: Opo R: May napansin ka bang pag babago sa pisikal na anyo I: Hmm, Opo R: Anu ung nasa ospital ka anu ung una mong naramdaman , kung gusto mo kwento, I: Minsan po nung nagchemo un nasusuka , minsan nanghihina R: Parang di ka makagalaw o makalakad Narasanan mo na lahat ung nasabi mo I: Opo R: Nung nasabi mo nag ka kulani ka nag kabukol , di ka makalakad or di makahinga anu naramdaman o nun I: Anu po masarap na lang eh , ung pong lagi nalang nakahiga, na pwedeng di na po bumangon R: Gusto mo na lang na mag pahinga, pero may pag kakataon talaga na gusto mo lumabas at mag aral ulit I: Oo R: Pag babago mo sa family wala sa mga kaibigan I: Wala po , mas lalu pang dumami R: Panu mo nasabing lalu pa dumami I: Dati po nuon ung iba kong kabarkada anu po kakaunti , nung nag kaanu ako , di po nila masyadong , tinuturing na may sakit yong parang normal lang po na tao na walang sakit R: Panu mo nasabi na ganyun trato sau , mag bigay ka ng mga sitwasyonn I: Tulad po nang anu , nung anu pero po naintindihan po din nila nung tulad po nung birthday ng barakda ko , mag lolomi ang mga tropa, un nga po di po ako nakasama at di ako pinayagan at naualan po tinake out po nila ako dinala sa amin R: Pinuntahan ka talaga ga nila R: Anu pa ung inyong mga bonding moment yan pag punta sa birthdayan anu pa I: Nung wala pa po akong sakit anu kinukuha po kaming nag sasayaw R: Ah dancer ka sa skul I: Di po sa lugar lugar lang R: May pag kakataon bang ang sakit mo ay humadalang sa pag sasayaw mo I: Opo R: Anung panu nung masakit ang paa mo then sched ng sayaw I: Di na po ako sumama nun , dahil sa sobrang sakit ng paa ko di ko po masyadong maigalaw anu po R: Pero nag rehearse ka o nag praktis I: Di na po , tapos sapul po na nag kasakit na ako di na po ako nagsasayaw R: Pero gusto mo magsayaw I: Opo R: Yung sakit mo ngaun eh nagiging hadlang I: Opo R: Anu pong pangarap ni N I: Maging sundalo R: Wow, san mo gusto maging sundalo I: Sa pilipinas R: San PMA, navy, airforce I: Mas gusto ko po ay sa airforce Sa airbase R: Sa family, anu pangarap mo sa kanila I: Lagi po kaming malalakas ganun po tsaka po kahit wala na po aking ama ay patuloy pa pong lumalaban at sana po laging matatag R: Anung pangarap mo , na may pag kakataon na , madasalin ba si N , Opo R: Lagi lagi nasimba Anung dinadasal ni N I: Na tuloy tuloy na paggaling ko Di na man po masyado R: Oh ngaun pinagaling ka negative ka na sa lahat anung una mong gagawn I: Ah magpapasalamat po ako sa Diyos R: Sunod I: Tapos yung mga tumulong sa akin R: May kailangan ka bang ituloy, tapusin or balikan I: Pag aaral ko , ung gustong gusto kong pagsasayaw R: May pag kakataon ba nung kasama mo mami mo or dadi mo pero alam mo sakit na ganyon , alam mo talaga sakit mo I: Di po nalaman ko po un kay dra , dahil mag chechemo daw po ako , may pag kakataon ba na di mo tinanggap Minsan po ayaw ko namag pa chemo ganun R: Anung dahilan bakit ayaw mo na mag pachemo I: Ung parang tinatamad na rin R: Bakit dumadaan ang katamaran sa iyo I: Dahil po minsan sa isang Linggo 3 days po nag chechemo parang wala nang tym at pera R: So anim kau , so ang mga kapatid mo ay may trabaho ung iba I: Anu po isa pa lang po ang may trabaho R: May pag kakataon ba na nag karoon ka ng denial , hindi hindi ako ito iniisip mo ba nung bakit ako tinanung mo ba yun I: Opo R: Na parang marami kang questions :b akit ako pa nakasakit, yun nga po bakit ako nga po ang nag kasakit , naisip ko nga po , pero naisip ko po na Ibinigay ito ng Diyos at pag subok R: Pero ngaun , mas matibay ang inyong pananalig I: Opo R: Ito ang matinding tanung , kunwari may bespren ka , ah ang nangyari so wala kang sakit sa kanya napapunta , panu as ikaw ay makikibagay o makakatulong I: Sa pag anu po sa pananalig po at pag dalaw sa kanya dahil po dumadalw din po sila sa akin pag po Sunday , eh nag usap po kami nasimba R: So lagi kau nag kikita Tara sumimba sa Sunday I: Lagi po kami mag kakasama R: Pag sinabi nating cancer may pagkakataon na may iba ka bang depinisyon ng cancer di pa nung kanina eh tinanung kita tungkol sa canser bago mo nalaman ang sakit mo normal pa lang pero ngaun I: Eto po pala ay malalang sakit , at dapat agapan upang di lumala ng lumala R: Anu yung mga nasa loob mo ,parang nag urge sa iyo o nag push sa iyo na , di ba sabi mo tinatamad ka na , at malaki din nagagastos nyo anu parang ah wala N ituloy mo ito I: Anu po nung namatay nga po ang tatay ko R: Anu ung bago sya nawala I: Di po matagal na po nagaggamot na anu sabi nya, wag daw po ako tatamadin , R: siya ba lagi mo kasama dito . I: Di po nakakasama , pero sa bahay po pag akoy nagigising nag tatanung po siya kung anu gusto ko kainin nabili po siya nung gusto ko kainin R: Anung sinabi nya sa iyo ng tatay mo I: Wag daw po ako tatamarin at lakasan mo loob mo R: Anu pang mag nag pupursige sa iyo I: At saka po ung kua ko ,para po akoy gumaling , yung kua ko po na malaki laki na nagastos sa akin lagi po nyang sinasabi sa akin na wag mag pabaya sa sarili para di na po umulit ang sakit ko R: May pag kakataon ba na natakot ka lalu na nung labasan nung mga sintomas I: Opo R: Sinabi mo agad nagpacheck up ka agad sinabi mo agad I: Pag po akoy tamlayin , alam po nilang may nararamdaman ako , laging nakahiga alam na po nila na may nararamdaman na ako R: Anung nararamdaman mo nun I: Nag hihina po R: Natatakot ka nung di ko maigalaw nung dati di I: Nakapasok pa nga po ako nung, sabi po nung sa emergency sa amin , UTI lang daw po , akala nga po UTI lang nung anu , namaga ang paa di ka makalakad I: Pumasok po ako ulit , nakailang pasok na nuon I: Nung gabi po nun nung ay nag pasa pasa at anu nagging brown daw po dila ko , then dinala na po ako sa taal R: Natakot ka ba nun I: Dun natakot ,kala ko po ay anu na R: Bakit di mo nakita sarili I: Di ko po nakita , napansin po ng tito ko , dahil sabi nakain ako nun eh nakain kami ng chocolate , eh tiningnan din ung dila ng kapatid ko , eh iba R: Ah parang allergy, walang pasasapa I: Nag kapasa po ako dito Tapos nanghina R: tapos eh may pagkakataon ba nung nalaman mo sakit mo may pagkakataon na di kanakipag usap , I: Anu po , wala po R: Nung nalaman mo na ba un sinabi mo yun sa iba I: Alam po ng mami ko at ng mga pinsan ko Alam din po sa barangay namin kasi po nahingi po kami tulong , para sa pag papagamot R: Kung may kausap ka din kaedad mo 14 years old natigil din sa pag aaral anu ipapayo mo sa kanila, ung babago palang na diagnose at nalaman anu po I: Tatagan po niya loob nya , Ang pag aaral po ay walang katapusan yan, wag na po kahit po tinatamad eh pilitin po mag pachemo R: Tapos anu sa mga parang walang mag sakit na matitigas ang ulo , ung mga nag pupuyat dahil sa FB or nag iinum batang batang pa lang I: Minsan po , dapat po di po nila inaabuso ang katawan nila at swerte po at di sila nag kakasakit ng malala at staka po wag po ung sobrang pag pupuyat at staka po pag iinum nakakasama po iyun R: So anu nga ung pinakapangarap mo Ah R: Gusto ko agad nito sana makuha ko sana I: Yung pag gumaling sana makapag aral na ulit na at staka pag bubutihin ako mag top R: At magsasayaw ulit San ka nag sasayaw? I: Minsan po sa ibat ibang barangay Sakatabi din pong lugar R: Inimbitahan kau Minsan po R: Na miss mo yun I: Namiss ko sabay sabay po nag praktis , at sa ibat ibang bahay nag praktis , Ung nag perform nag showdown eh Eh wala po magagawa eh Un di na rin sila nag sasayaw R: Bakit daw di na sila nag sasayaw I: Ewan po , sapul po na nagkasakit ako tumigil na din po sila Parang nawala ung isa un nawala R: Anung ginawa nila I: Busy po sila sa skul R: Kung kaw eh mag college sang skul I: BSU po ,pero mag mimilatry ka R: Sa second choice mo ng course I: Gusto ko po teacher R: Education anung major secondary/ highschool I: Grade school R: Specialization mo I: Filipino R: Napakatagalog naman R: Anu tawag sa inyo , sa gov felicaino leviste I: Anu tawag sa inyo R: Akoy taga disctrict IV di ba malapit ung Morales , tapos un sa may sabungan sa bayan ung barkong bahay ung may sabung may barko ang itsura lolo ko may ari , dun ako nauwi I: Taga lipa ako Nauwi kami pag may tym R: May nakita kang maganda nung nag kasakit ka I: Uhm yung advantages , nung disadvantegs eh ung hadalng , may kakaibang nangyari I: Sinusunod po nila yung gusto ko , tapos po ung mga accessories ko , at hilig ko mga doll shoes , R: So pag sinabi mo kua pahingi ng anu I: Opo pero po minsan po ako po nabili R: Binigyan ka nalang budget I: Opo R: May nakita ka pang kakaiba pa , nakita mo ung bonding ng mag kakapatid , dati na bang nag aaway kau , dati pa I: Lagi nga po ako kinakausap lalu Inaagawan po ako pag kain sa kwarto ko Ganun pa din po R: Bakit inaagawan ka pag kain I: Pag nagugutom sila minsan I: Ako po lagi binibili lagi , kung nag pabili po ako gusto ko po ako lang kakain Kawawa naman kasama , may pag kakataon I: Madali akong mairita di katulad ng dati R: Tulad ng alin . I: Kunwari po nung po tulad ng gora ko eh di na po masyado sinusuot I: Eh kinikuha po kua ko I: Ayaw ko ginagamit , nagkakasalitaan R: Pero dati di ganyan Anu po anung mga major pagbabago I: Wala nmn po Un lang R: Anu nga po hiling mo I: Tuloy tuloy napaggaling ko sa family sana lagi silang nasa mabuting kalagayan at lagi po may nakakain , I: So panu nakakadapt ang family di b a 3 x ka sa isang lingo si kua na nagastos R: Si mommy may work ba I: Ung sumond sa kua ko lalaki din po ang 17 po 19 na po kua R: Anung trabaho nya sa SCAD I: Tinutulungan din po ang nanay ng mga kapatid nya , nasa hongkong , mga supervisor sa HTI R: Tapos anu ngaun nag chechemo ka , may naramdaman kang kakaiba I: Un nga po minsan nag susuka , naghihina minsan , pagkinabukasn namn po nakainum na gamut eh nawawala na po , R: nasasanay ka na opo R: wala namng pamamasa I: wala na po R: bawal ka maexpose kung san sang I: pero pinapayagan kang lumabas R: napunta ka bayan napunta po ang tropa sa citimart pero naka mask R: anu ung mga pag babago mo sa pag kain , dati anu gusto mo kainin I: mga chichira craklings R: anu kasama nun I: coke po R: anung favourite gulay mo R: may pag kaaktaon ba na may pag isisisis I: Wala naman R: so maraming salamt at kung may tanung ako babalik na lang po ako
Informant O
R: Good moring ako nga pala si Mignodel Morales , sa Golden Gate College, nasa thesis na po ako regarding cancer Gud morning ulit I: Gud morning din R: Anung pangalan mo I: Informant O R: Taga san po si O I: Taga Calaca Batangas R: Calaca Batangas ,Malau ba un I: Hindi R: Hindi ka ba napagod sa byahe I: Hindi R: Ilang magkakapatid sina O I: Six R: Pang ilan ka O I: Pang lima R: Napasok pa si O I: Di muna R: San po napasok si O I: Dacanlao elementary school R: kumusta naman mga kaibigan mo sa school I: Ok naman R: Kinukumusta ka ba nila I: Oo R: Ah anung mga ginagawa mo sa bahay I: Wala lang R: Nung dati wal akapang sakit anung gnwga mo sa bahy I: Nag laalro ganun R: Sinung mga kalaro mo I: Ung mga kapatid ko R: San nag simula yung pagkahospital anung naramdaman mo ung una I: Masakit ang hita ko ganun di ako makalakad R: Di ka naman naglaro nun wala ka naman ginagawa I: Wala R: Nung di ka makalakad anung naramdaman mo I: Masakit R: Tapos sinabi mo yan sa mami I: Opo then pinatingnan ako , kinuhan ako sa dugo , nakita nga nababa ang dugo ko R: Nung nakita nababa ang dugo I: Dinala na sa ospital sa taal R: Tapos I: Dinala din ako sa Infant Child Jesus sa Manila R: Ah infant jesus d iba specialization ay pedia dun I: Oo R: Kumusta naman may nagbago dun may nag bago sa iyo I: Di na nasakit nakakalakad na ako R: Nung kaw ay nagpagamot , nung kunwari nung napasok ka anung pag babago nung nag kasakit k a I: Di nga ako napasok ganun R: Anu pa I: Bawal ako mag laro R: Anu ng nararamdaman mo pag sinabing wag ka lumabas, bawal mag laro I: Nalulungkot R: Tapos eh alam mo yung sakit mo I: Leukemia R: Anung mga naririnig mo regarding sa sakit mo I: Ewan ko R: Anu bang anu ng lekemia I: Anung nakita un I: Sa dugo R: Pag ba sinabing leukemia I: Sakit sa dugo cancer R: Pag sinabing cancer anung unang napasok sa isip mo I: Baka masakit pag tinuturukan R: Anung pangarap ni O I: Gumaling ako R: Madasalin ba si O I: Oo R: Anung dinadasal ni O I: Sana gumaling na ako R: Ngaun , kung tayo ay gumaling na anung unang gagawin mo I: Mag papasalamat ako kay jesus R: susunod I: Babalik ako sa skul R: Anung gusto mo course sa college I: Maging doctor R: Anung specialization hema onco cardio or anu I: Di ko alam R: Gusto mo yung katulad ng kay dra mayie hema onco ng mga bata basta doctor I: Uu R: Bakit gusto mo maging doctor I: Matagal ko na yung pangarap kahit nung di pa ako nag kakasakit R: Bakit gusto mo maging doktor I: Para matulungan yung may sakit R: May pag kaka taon ba na naisip mo na sayang sana di muna ako nag kasakit , marami akong magagawa, sayang ngaun akoy nasa skul , nag aaral pag naiisip mo yun I: Nanunuod na lang ako tv , para malimutan ko ganun R: Anung mapapayo mo sa iba na may parehas kau nasakit na ALL na tinatawag na yan nasa harap mo I: Na lagi siyang mag mask ganun , mag ingat R: Mag ingat then anu pa yun bang yung anu wag ka na malungkot panu mo sya kakausapin I: Wag na lang iyon ang isipin niya , isipin na lang nya ang masasaya R: Katulad ng anu , kaw anu ba ung lagi mong masasayang naiisip I: Yung napasok ako skul R: Tapos Ung nakikipag laro R: Dina dalaw ka ng mga classmate I: Dati nung nag simula ako nag kasakit , dinalaw ako ng teacher R: Oh kumusta, dumalaw sila sa ospital I: Nung nasa ospital ka I: Natatakot po ako R: Bakit ka natatakot I: Wala lang R: Basta takot kalang Nung nalaman mo mag chechemo anung naramdaman mo I: Parang masakit yun R: Pero ngaun ok nmn R: Katulad ngaun may besprend ka nag karun ng sakit kahit anung sakit na malala panu mo siya tutulungan , besprend mo , ganito mo sya , mag katabi na kau matulog , ganun parang kapatid mo na sya , nagkaroon siya ng matinding sakit I: Dadalawin ko sya sa bahay nila R: Anu pa I: Sasabihin ko sa kanya wag kang matakot R: May napansin ka ba maraming bad na nangyari nung nag kasakit ka I: Wala naman R: Anung naging advantage nung nagkasakit ka, nung dati ganito ka , nagun , dati nung nag kasakit ka ba may nag iba sa akin may maganda nangyari sa akin I: Wala ganun lang R: Katulad nyan galing ka pa Calaca malayo , anung naiisip mo na nag chechemo nag byahe then byahe ulit sa inyo anu nag pupush sau para mag pagamot pa din I: Para gumaling ako R: Anung pangrap mo sa family mo I: Mabigyan sila ng maayus na buhay R: Sa iyong mga kapatid I: Ganun din R: Kaw anung pangarap mo sa iyong buhay ung tinitibok ng iyong puso I: Makapagtapos ng pag aaral R: Para I: Matulungan sila mama R: Kahit kaw eh panglima eh sabagy , nag tatrabaho na sina ate at kua I: Oo R: Sa bahay ung mga gastusin wala kabang napapansin parang laki ng gastos I: Oo may napansin din R: Pero sa bagay bata pa nmn tayo di tayo anu May pagkakataon na ayaw mo makipag usap I: Hindi R: Nung nalaman mo anung nangyari sa iyo I: Wala nga R: maraming salamt
Informant D
R: Gud morning D Ako nga pala si MIgnodel Morales, a student of Golden Gate Colleges , nandito ako para mag interview R: Kumusta naman si D I: Ayus naman R: Ok lang , taga san si D I: Taga Mabini Batangas R: Mabini batangas, ilang taon na si D I: 17 R: 17 years old , napasok pa si D I: Tigil na R: Tigil na, so dapat anung year n a I: Second year R: Second year college R: Anung kinukuha mong course I: BS IT R: Sang School Sa Batangas State University R: Sa bsu , dine sa may I: Sa alangilan R: Kumusta naman mga kaibigan mo I: Ayos lang , nadalaw sila R: San sila nadalaw I: Dito kapag nagchechemo ako R: Dito ? oo nga napapansin ko nga nung isang araw I: Ung last week R: Tapos ay kumusta naman ang family mo I: Ayos naman R: Ayos naman , ilang kayo magkakapatid I: 3 R: Pang ilan ka I: Panganay R: ilang taon ung sumunod sau I: 16 tapos, 10 years old R: Ok then anu pa nung kaw eh napasok pa BSU ,ah , kumusta naman , ok naman pag aaral I: Ayus , naman nakakapasa , sa awa ng Diyos R: Gusto mo talaga ang IT I: Gusto ko sana ay fine arts , kaso eh R: Di ba wala dito nun I: Ang alam ko meron , dito sa BSU R: Bakit daw anu di nag fine arts I: May sign na dumating sa akin na mag IT ako R: Anung sign un I: Secret R: Kumusta naman , active ka ba sa school , san kang sumali na org I: Doon sa department lang namin R: Nu ginagwa nyo dun I: Ala di naman ako nasama R: Basta aatend , mga community extension di ka nasama , nag lilinis I: Di ko naranasang mag linis, ROTC ako R: Ah ROTC ka I: Di ako nag CWATS R: Di ba anung bang pasok mo nun , Monday to Friday? I: Di ko natanda dahil nung nadetect ako eh nag summer na ako R: Ah summer , tapos nung nakaraan anu ginagwa mo , kunwari wala kang pasok ngaun , I: dalawang araw, san napunta si D Ahm, nauwi pagminsan eh R: Ah nag dodorm nag bobording house I: Dati nag boboarding house R: nauwi tapos , anung ginagwa mo dun sa Mabini I: minsan eh nag babasketball, nag DODOTA R: walang kamatayan , napag aralan ko din yan eh ako’y naiyamot eh di ako marunong nung mga ingredients hehe anu ung , kalian nadetect R: nung may patapos na ang summer ko I: itong May na ito , anung una mong naramdaman nung ikaw eh nag susummer second sem pa ng nung inuubo na ako , iniisip ko lang na kaya ako inuubo dahil baka sa mga project naming nag oovernyt nag pupuyat R: pero palagi ka bang nag oovernyt I: nadadalas din R: dahil dun sa mga project I: oo R: tapos I: tapos un inubo na ako , nag karoon ako dito ng kulani R: nung napansin mo yun , wala ka bang napapag sabihan , I: di, alam ng mga kabarkada ko yun R: na anu I: na inuubo ako , nung mga isang buwan , sabi nila mag pacheck up na ako , eh nag susummer kami nuon , sabi ko eh ala saka na , siguro eh , pag katapos na lang ng summer , baka malala na are eh , para may natapos naman ako di un nung patapos na nga, nilagnat na ako nag ka kulani pa ako , dito sa kabila nalaki , yun nag pacheck up na ako R: yun saka mo sinabi sa mami or sa bahay I: kaya ako nag pacheck up kasi sinabi ko na , alam naman nila na parang anu , nalaki or may bukol na maliit I: nung naligo kami sa dagat eh , nilagnat na ako nun R: tapos nung nag pacheck up na kau , sinung nag sabi tungkol sa diagnosis mo I: di , nuon ang kausap nuon ay ang mama ko ang doctor , ung pediatrician dun sa may amin sa Bauan doc R: tapos I: xray palang nuon eh parang may kutob na yung doctor na baa lymphoma nga di un tapos ang mama ko naman ung parang nag pasecond opinion di laang second , di ko alm yun ang alm ko eh 3rd opinion na si dra, pero naka limang opinyon na daw R: di un sinu nga sabi sa iyo I: si dra na R: si dra na siya na talaga mis mo ,kaw lang at mami mo I: oo R: tapos nung nasabi sa iyo, alam mo agad yun I: iniisip ko nun baka TB or tubig sa baga R: kas dig a parang ganun din , parang kung naririnig mo yung iba parang same yung sintomas I: o baka may tama ako sa baga dahil syempre binata ako , di may bisyo then R: yung nasabi sa iyo anung naging reaction mo nun I: wala dahil dun sax ray palang R: nakita mo x ray mo I: oo , medyo malaki yung nasa puso ko , di yun pinalabas ako ni dra , kakausapin lang daw si mama , dun palang parang may kutob na ako , nuon eh nag emote emote na ako R: nung nangyari nun anu ngang nangyari nun R: kaw ba ay di nakipag usap I: sa mama ko R: kahit kaninu anung nagyari nun kinutuban ka na I: kinukulit ko ang mami R: kinulit mo ng kinulit ,sabihin mo na I: ma, anung sabi sa iyo ng doctor oh alam kong meron,anung sabi wala daw I: tapos patawa tawa pa , pero yun nag ka alaman na din R: yung nalaman mo nayun na I: wala parang ayos na sa akin , nakapag emote na eh R: natapos na, ika nga eh natapos na tayo sa stage na ganun , may pag kakataon ga na nagalit ka I: madalas R: bakit ka nagagalit anung dahilan I: tinatago yung avr R: ah nang computer R: bakit ka magagalit avr lang yun I: ah di ako makakapag laro eh , walang libangan sa bahay , yun na lang libangan ko tapos I: tinatago po , kaya yun nagagalit R: anu ba ang sakit mo I: lymphoma R: anu sa tingin mo ang lymphoma , anu bang sakit yun I: kanser sa kulani un lang R: ngaun pag ba sinabing cancer anu napasok sa utak mo I: makakalbo R: makakalbo yun agad ang pumasok sa iyong isp R: naimpluwensyahan ka ban g napapanuod mo sa TV or naririnig I: dati ang alam ko sa cancer nanalalagas agad ang buhok un pala ay dahil sa chemo R: may pag kaaktaon ba , maraming nag bago nung nalaman mo , anu yung mga una mong I: ungang nakita mong pag babago I: secret R: tulad nung sa pag babasket ball may nagbago ba I: yun di na pwede , di na ako nakaakpagbasketball R: yung pag labas labas I: bihira R: hanggang san ka na lang para lumabas I: nakakalabas ako kaso takas R: takas saan , san ka pupunta I: sa computer shop madalas R: yun tapos eh nakamask ka namn nuon I: di na bawas pogi points eh R: yun (laughs), yung sa barkada ok naman I: ok naman R: dati eh pasama sama ka sa gimik I: ngaun eh sila na nagimik sa akin R: astig un , at least di ga R: may mga tanung ako na, nung bang nag karoon ka ng ganitong sakit , masasabi mong naging hadlang sya I: oo R: hadlang saan I: sa pag aaral , pamumuhay gaya ng dati R: pamumuhay gaya ng dati anu yun I: yung nakakalabas ako kasama ang barkada , nag overnyt ,saya saya ngaun eh hindi na sila naman ngaun ang nadalaw R: kaso may limit kasi nauwi sila , di kagaya ng dati overnyt dun tara, nagun eh hindi n a I: hindi na masyado , may pagkakataon ba na, madasalin ba si D, I: di masyado R: katulad nyan nung nag rorosary , anung napasok sa isip mo I: di ako marunong mag rosary R: kunwari nag dadasal tayo or mga kasama mo anung napasok sa isip mo anu yung hinihiling mo as ikaw I: syempre gumaling n aako R: kunwari gumaling ka na , anung una mong gagawin I: di ko alam I: makiki hang out R: mang chichicks agad (laugh) I: syempre un ang napabyaan eh R: talagang di nakalimutan may pag akaktaon ba na , ibahin natin ang sitwasyon , meron ka bang best frend as in talagang ganito kayo , dati kunwari lang , baliktarin natin siya yung nag ka lymphoma , anung iyong gagawin I: pupuntahan sa clinic pag may tym ako , lagi ko siyang dadalawin para malibang siya R: panu mo malilibang sya I: mag kukuwentuhan , dahil baka mag isa lang siya R: oo tama, bakit nasabi mo dati , anung nangyari I: ah nag ka affair , may boy friend sya may girlfriend ako R: ah ok so babae, mahirap nga yun anu , ika nga eh don’t love your best friend , masasabi mo ba na may magandang naiduot yang sakit mo pamula nung ikaw ay naconfine hanggang ngaun I:,o parang may advantage may nakita kang ganun I: palagay ko meron R: share mo nga sa akin I: advantage na di ako makatulog sa gabi R: tapos I: kasi siyempre pag gumaling na ako , makakahang out na ako , kaya ko nang mapuyat eh R: yun talaga ang iyong iniisip , grabe kang bata ka , anu pa I: wala pa , joke lng un R: yung sa disadvantage , I: parang nakulong R: grabe ka naman , panu mo nasabi na nakulong I: parang nasa campo ako ng mga military R: ayaw mo nun military , PMA I: lahat may limit R: pagkain limitado I: di naman , yung mga gusto ko R: anu bang gusto mo laging kinakain I: pancit canton R: yun nga rin eh I: pero kasi bawal R: sa sports pag ba pa kalabas mo sa skul basketball agad sa may boarding house I: uu madalas kahit naulan , R: yan na nga dadali ka na naman , tapos yung DOTA , may limit na ba ang DOTA I: nag kalimit R: dati I: may limit pa din syempre , wala kang pera wala kang DOTA R: napaka mahal namn , bumili ka ng sarili mong computer I: pag nasa bahay nag kakalimit din R: o masama din yun sa mata mo barkada , sa kapatid , kumusta naman yung relasyon mo sa iyong kapatid , may nag bago ba, wala R: wala naman I: di naman nag tatanung yung 16 at yung 9 years old na anu R: bakit si kua laging wala , di sila nag tatanung I: dati eh yung kapatid ko yung 16 pansin nya na lahat ng atensyon ay na sa akin , pero ang totoo ay di naman , tapos ang sinabi ko ay R: anu ang tunay I: di ah pantay pantay lang kami , mas lamang pa nga sila sa akin R: kinausap mo kapatid mo I: ang mama ko ang kumausap R: bakit bubugbugin mo anu gayun babae or lalaki I: lalaki R: halos isang taon lang tanda mo , parang nag taka lang sila I: sabi nya eh R: may sinabi talaga sya I: bakit ang kuay ay gayon , sana nag kaganung sakit na yun eh nagalit ang mama , hiniling mo pa ang ganyan mag pa bone marrow ka na lng R: masakit talaga I: masakit R: ung mga naranasan mo dito yung pag chechemo at pag bobone marrow anu di mo makakalaimutan nakakaiba I: bone marrow at biopsy R: talagang anu I: magaling pa yung tinurukan ka na palabas , kaysa yung sa pahigop , pag yung pahigop I: masakit talaga R: talagang ahh, dahil ako sa regional kita ko kung paano BMA , talagang kahit papanu namn ay R: kaya naman , Bone marrow and biopsy , I: mas masakit pa sa tuli grabe naman yun R: oo nga may naesthesia namna yun ah I: oo pero masakit pa rin , yung turok pag papasaok ng karayom eh di masakit yung pag higop or pag sisipsipin na dun mo mararamdaman mo na parang hinigit na ang kaluluwa bone marrow nga din sabi R: anung pangarap pa ni D I: siyempre makatapos ng pag aaral R: yung pangarap mo sa family samam mo naman ang family I: di ko alam R: kaw ang pangay anu , I: makatapos R: anu pa I: gumaling syempre R: anu yung parang nag uurge sayo o nag pupush sa iyo namag pa bma pa , gusto ko pa mag pachemo , bakit ka nag babalikan ang layo anu pa yung nag tutulak pa , san ka nahugot ng lakas I: alam mo na yun kanina ko pa sinasabi alam mo na yun R: kaninu nga , ang kulit san ka pa nahugot ng anu I: sa pamjlya ko at sa mga friends R: at talagang meron kang mga close frends I: di ako nawawalan ng mga kabarkada dito R: ang nakita ko nga last last week yung taga BSU kapatid mo ba yun taga BSU naka uniform , I: yun ang aking pinakamamahal wow kaya pala maypinag huhugutan hindi R: di naman joke lng (laugh )nang enerhiya I: hugot agad (laugh) joke lang R: Dumating ba na sa point na ang bigat bigat ng damdamin mo , yung nalaman mong may sakit ka yung di ba ang community , pag naun eh iba agad ang sinasabi nila I: Di naman R: Hindi naman I: Wala akong naencounter naganun R: Pag nandito ka kasama sila , mga bata , mas ba parang nagaan ang pakiramdam I: Ayus naman normal lang din R: Sabagy nandyan naman mga kabarkada mo nandyan namn sila , at nariyan ang iyong one ang truly I: Bihira lang naman makapunta yun dito R: At least yung bihirang yon napakahalaga , di ga tapos kunwari may nakaharap ka na iyung ka barkada na nalaman mo na may leukemia sya , panu mo aaproach I: Sabihin ko kaya mo yan , gumaya ka sa akin think positive , sasabihin ko na nandito kaming kabarkada mo R: Nakasuporta I: Walang iwanan R: Oo talaga walalng iwanan R: Yung sa iba sa may bata sa iyo anu massabi mo , nung nag ka run sila ng lymphoma , di ba kanin a kabarkada mo kausap mo nagun ito ibang tao I: Syempre mahihiya ako , oo ibang tao eh , di ko makakausap , mga bata dito di ko maakusap R: Sabi ko nung una naku parang mahihirapan ako kausapin si D , di kita makausap I: Pag bata kasi kwuan di pa nila naiisip yun ang iniisip nila yung masakit na ginawa sa kanila , di nila naiisip kung anu yung sakit nila parang R: Masasabi mo ang sakit na ito eh di lang pisikal I: Oo R: Sayong tingin naapektuhan pa ba ang ibang aspeto ng buhay I: Hindi ang ibig kong sabihin eh , kunwari naiyak sila di marahil dahil sa sakit nila , pero naiyak sila dahil sa ginagawa sa kanila , tinuturukan ganun R: Parang sa pisikal ang nasasaktan sa emosyunal ay di pa nila maintindihan I: Oo R: Yung sa pamilya , di nakakapasok yun sa malalaki na dun sila napapaiyak , pwera lang sa BMA at biopsy yun yung masakit R: Yung lang naman salamat sana makapunta ako sa mabini
Informant E
R: Magandang hapon ako nga pala si Mignodel Morales Anu nga pala pangalan mo I: Infromant E Saan ka nakatira I: Lipa City Batangas Nga aral pa ba si E I: Di na naman po tigil R: Anu dapat grade ni E , I: grade 4 R: San po nag aaral I: Cipriano Andal Memorial Elementary School R: Haba naman Kumusta naman sa bahay I: Ok naman po R: Mga kaibigan I: ok naman din po R: so alam mo ang kalagayan mo ngaun I: opo R: alam mo yun , yung sakit mo I: opo R: alam mo , ok anu siya , anu daw sakit mo I: osteosarcoma R: osteosarcoma R: anu daw yung osteo sarcoma I: bukol po sa , cancer po R: pag ba sinabi nating cancer anu yung nasa isip mo , anu sa tingin mo yung cancer I: anu po kabado lang po kasi po akala ko po nun eh ay isang oras lang po eh mag chemo ah nung pag kasabi sa iyo R: opo I: gagamutin na agad R: ah ngaun nung nag chechemo ka na anu na sa iyo ang cancer I: para hong nakakatakot po eh , kasi po eh yung iba po dun eh naanu po eh nawawala na lang po eh R: hmm so , san ka natatakot I: dun po sa sakit ko R: hmm , so ok nung nalaman mo yung sakit kailan yun I: bale November 9 po R: 20 and anu I: 2011 po R: Last last year R: Nung nalaman mo sinung nagsabi I: Si dra po R: Nung sinabi sa iyo anung naramdaman mo I: Medyo natakot po R: Natakot ka R: Anung pangarap ni E I: Sana po eh engr po sana , kaya lang po nag kaganito eh teacher na lang po ng science R: Wow teacher sa science so may nakikita ka bang halos nung ilang buyan or halos mag one year na tayo anung mga nakikita mong pagbabago sa iyong katawan bago mag November. I: Yun nga ho parang um ok namn po siya, yung tuwing pag kalabas ko dito sa ospital , nanghihina po ako tapos halos one week umo ok na po ang pakiramdamm ko R: Hmm san nag simula yung sakit , nung nov, bakit di ka pumasok I: Nung august pa ho R: August yun R: Anung nangyari nung August kung kaya mo ikuwento kung ok lng or kung di ok lng din I: Nung august po kasi , albularyo albularyo lang po hanggang nag pa doctor R: Bakit kayo nagpalbularyo anung pinapagamot nyo dun I: Akala po namin kasi po eh nunu lang po eh , lamig lamig lang po na akala po ng papa ko po kaya nang punta punta po kami R: So anu pong pinapagamot ninyo sa albularyo I: Yun pong paa ko , yung bukol po sa paa ko R: Hmm so anu yun di ka makalakad I: Di po ako makalakad R: Masakit sya I: Oho , nag simula po talaga sya nung August po eh R: Tapos yun nag pagamot ng pagamot na hanganng dumating tayo sa mga doktor sa pamilya mo may nag bago ba nung kaw eh nag kasakit I: Bale wala naman po R: Ah wala naman R: Ilan ka sa magkakapatid I: Panganay po ako R: Ilan kayo magkakapatid I: Tatlo po R: May pagkakataon wala talaga nagbago di katulad ng dati , anung napansin mo may napansin ka I: Bale po di na po ako masyadong nakakapag laro sa kanila ngaun R: Ilang taon yung sumunod I: 5 po R: Yung sumunod I: 2 po R: Wala naman sumunod , tatlo kayo I: Opo R: Di naman nagtatanung si bunso I: Wala naman po kasi di pa nagsasalita R: Ah hindi yung pangalwa,yung pangalwa po , di naman nag tatanung ? I: Wala naman po minsan po nag aaway po kami R: Bakit kayo nag aaway I: Magkagalit po kasi kami,nag aaway po kasi kami minsan po dahil sa laruan R: Kaw ang panaganay , nung sa , lagi ka bang nasa labas , nagala sa inyo , lagi ka ba nag lalaro sa labas I: Opo R: Nung nalaman nila or napansin nila na nag kasakit ka anung nag bago sa kanila I: Bale wala naman po R: Dumalaw ba sila mediatrix or medix I: Di p oeh R: Ah check up check up lang, dito may dumadalaw I: Konti konti lang po konti lang R: yung mga kaklase mo grade 3 to fgrade 4 may nakaaalm bang mga kakalase I: Nung nakaraan po bale lahat po sila ay nag punta po sa bahay R: Anung ginawa sa bahay I: Di kinumusta lang po ako R: Ah anung sinabi nila sa iyo I: Yun bakit daw , at nagulat po sila R: Nagulat sila , kung bakit nagkaganyan,nung sa pag aaral nung kaw eh grade 3 mag incoming grade 4 sana mag grade 4 kana I: Ipinasa na po ako R: Naisipi mo na itigil mo muna school I: Opo R: Sa iyong sarili may nagbago ba , sa iyong pagkain , sa kung san san ka nag pupunta I: Opo R: Nagun anu napapansin mo I: Ah wala naman po minsan lang naman po eh , minsan na lang po ako nakakapag laro kasi po dati lagi nag lalalro R: Sa pag lalaro , sa pag kain may nagbago ba I: Katulad po naman po nung dati R: Meron lang na anu I: Lagi naman po ako nakain R: May mga bawal ba ga I: Opo R: Anung mga di pwede kainin I: Mga chichiria , lollipop po R: Hmm oo anu pa I: Yung maaalat po at yung maatamis po R: Nung nalaman mo kalagayan mo , ngaun nalaman mo siya anu yung parang paanu mo siya kinabagayan ,panu mo nacope up yun panu nagun anung gagawin ko anung ginawa mo nun kahit papanu dirediretso I: Para pong isip ko po kasi na para pong puputulan po kasi un po dati , puputulan po ako , gayun na nga po nangyari , wala na po , kinabahan na lang po R: Parang nagready ka nalang sa iyong sarili R: Madasalin ba si E I: Di naman po masyado R: Anung hinihiling ni E I: Gumaling na laang po tayo R: Anung pangarap po ni E I: Engr po sa na eh R: Sa pamilya anung pangarap mo sa pamilya I: Maging normal na ang buhay R: Bakit mo nasabi na di normal ang buhay I: Kasi ho ngaun po lagi ako nasa ospital , kasi po nuon nakakapaggala po ako sa amin R: Ngaun nag dasal tayo , then wow instant galing natayo , negative na tayo sa lahat ng test so , anung unang una mong gagawin I: Pag anu po R: Pagnegative ka na sa mga results I: Mag aaral R: Mag aaral na agad I: So anung nag pupursige sa iyo para mag chemo, mag pa admit anu nagtutulak sa iyo E sige tuloy natin eh I: Ah bale po ako na laang po eh R: Sa iyo talaga , sa iyo kaw nakuha ng lakas ng loob , pati po sa mga magulang ko R: maraming salamat E
Informant L
R: Magandang hapon po I: Magandang hapon din R: Ako nga pala si Mignodel M. Morales , student ng Golden Gate R: Anu pong pangalan nila I: Ako po si L R: Taga san po si L I: Taga Lemery, Batangas R: Nag aaral pa ba si L I: Hindi na po R: Ilang taon na po si L I: Sampo R: Sampo (laughs) ahm, ok anu ginagawa ni L ngaun I: Nakonfine R: Naconfine, kumusta naman yung sa bahay, sa iyong mga kapatid, kumusta naman dun I: Mabuti po R: Mabuti naman , sa iyong mga kabarkada , sa community I: Hindi po R: Ha I: Di na R: Bakit naman hindi na, yung magkabarkada mo duon , dapat anung grade ka na I: Grade 5 R: Grade 5, saang school I: Argenturanza R: Argenturanza hmm dapat grade 5 ka na ngaun so kalian nagsimula ang sakit mo I: October po R: October ng anu ng ? I: Di ko po alam kung kalian R: Last year ? 2011 ah, anung una mong naramdamsn nun, bakit ka nag pacheck up I: Sumakit po ang tyan ko R: Sumakit ang tiyan mo ? di ka ba napupupu lang I: Di R: Di hehe, anung pag sakit ng tyan , masakit na masakit I: Opo R: Talagang anung naramdaman mo nun I: Sobrang sakit po R: Tapos I: Pinachechk up po ako , tapo po , makalipas po ng dalawang araw , lumaki po R: Lumaki ang tiyan mo malaking malaki I: Malaki po R: Malaki lang , tapos masakit pa din or hindi na, sunod nuon nung lumaki ang tiyan mo tapos I: Pumunta po kami sa Maynila R: Hmm, san sa Manila I: Maynila po ,sa Philippines Children R: Sa Philippine Children Hospital tapos I: di pa po malaman ang asakit ko , nung binone marrow na ako ay nalaman na R: Saan ka nag pa bone marrow I: Sa Philippine Childrens po R: Sa Philippines children nag pa bone marrow, so nagun alam mo na ang sakit mo I: Opo R: Anu pong sakit mo I: ALL R: ALL, anu yung ALL I: Leukemia po R: Leukemia, anu yung leukemia I: Sa dugo po R: Anu yung sakit sa dugo ? I: Leukemia R: Anung uri ng sakit ang leukemia I: Mababa po R: Mababa nag alin I: Leukemia R: Anung uri siya ng sakit , anung sakit sya I: Hindi ko po alam R: So nung nalaman mo ganun ang sakit mo anung naramdaman mo I: Masakit po R: Sa anung paraan bakit nasakit , anung masakit I: Masakit sa karamdaman R: Ah , so ang leukemia ay under ng anung sakit I: Anu po R: Di ba may mga ubo , sipon , ang leukemia anu siya I: Sumakit po ang tiyan R: Sumakit ang tiyan , so ok anung naranasang mong pag ababgo nung nalaman mong ganyan may sakit ka , yung may ALL ka, yun sa family mo may nagbago ba kay kua sa kapatid mong mas matanda , kay ate may nag bago ba sa inyo I: Wala po R: Wala di naman nag tatanung yung mas bunso , may bunso pa anu , yung mas bunso , na bakit gayun laging nasa ospital si kua , wala namng pagbabago ok Pag babago mo sa mga kakalase mo sa mga kalaro mo sa Lemery may nag bago ba I: Opo R: Anung nakita mong pagbabago I: Di na po ako nakakalaro R: Di na tayo nakakalaro , dati ba nasa labas? Pag kalabas ng school I: Nodding R: Gala din , anung pagbabago sa pag aaral , tumigil ka ba sa pag aral, tumigil? I: Opo R: Dapat anung garde mo na nga I: Grade payb R: Grade five, kumusta naman pag aaral mo dati nung grade four I: Aus naman po R: Ok namn ., tapos yung sa iyong sarili , may nag bago ba , dati , yung kinakain mo or anu may nagbago anung nag bago I: Yung kinakain ko R: bakit dati anung kinakain mo I: mga chichiria R: anu pa soft drinks , ngayon I: di na po R: anu panapansin mo na nagbago , parang may nag bago ata nung akoy nag kasakit I: ah di na po ako makakain ng maalat R: di na , pero yun yung favourite mo I: uu , R: anung maaalat na gusto mo I: yun pong martys R: martys hehe , asin ayaw mo I: favorute ko yun R: hindi asin , maalat (laughs) R: ah nung nalaman mo iyong sakit anu un among reaksyon I: Anu po R: panu mo nalaman namay ALL ka I: sa bone marrow po R: kaninu mo nalaman I: sa dade R: ang dade nag nagsabi , anung ginawa mo nun biglang sinabi sa iyo I: wala po , nag iisip isip po R: anu pong inisip ni L I: anu po , ang sakit ko R: iniisip mo yung sakit mo , hmm nung iniisip mo ang sakit mo anung napasok sa isip mo nun na may ALL ka naung inisip mo nun I: Wala po R: wala , ok, anung hinihiling ni L I: sana po eh guminhawa , eh gumaling na po ako R: sana po tayo ay gumaling na R: anung pangarap ni L I: maging seaman R: maging seaman ,magsino talaga ito anu , seaman, bakit gusto mo maging seaman I: para guminhawa ang buhay R: para guminhawa ang buhay , yung pangarap mo sa sarili mo ay maging seaman , yung sa pamilya mo ay I: guminhawa ang buhay R: ok so , anung una mong gagawin kung ngaun ok , nag pa pbs retic na tayo or bone marrow tapos negative na, anung una maong agagwin I: mag aaral po R: mag aral tayo ulit, anu pa ang mga susunod mong gagawin I: mag lalaro po R: maglalaro , lalabas , papasok tayo ulit , tapos yan ten years old ka pa lang anung nag pupursige sa iyo , ituloy mo ang iyong gamutan , L tuloy mo ang chemo , L mag pa admit ka , anung nag uudyok sa iyo , san ka nakuha ng lakas o energy , kailangan ko na uling mag pa bone marrow I: sa mga magulang ko po R: sa mga magulang R: tapos eh , anu yung pinaka masakit mong naranasan nung nagkasakit ka I: malaman ko pong may sakit ako R: yun yung pinakamasakit , di yung pag bobone marrow I: nodding R: hmm ok , pag ba sinabing leukemia anung napasok sa utak mo sa isip mo I: masakit po R: hmm masakit , bakit mo agad nasabing masakit ? nung nasabi s aiyo na binone marrow k or may leukemia ka I: Di na po makakapasok R: dun talaga parang dun ka nasaktan , di dun sa malaki ang tyan mo or anu bakit masakit nung di ka na pumapasko I: mumbling R: bakit ka nasaktan nung di ka na makapasok , l di na ako makakapasok kasi Di na po ako makakapag tapo s R: hm din a tayo makaakpag tapos , kunwari mayron tayong kalaro dati , meron ka bang bestfredn ‘ I: opo R: kahit nung sa atin sa lemery I: opo R: kunyare meron sya din na sakit na ganyan panu mo sya kakausapin I: Wala po R: kunwari ako ako yung bestfrend mo panu mo ako kakausapin I: mag pagaling R: mag pagaling , tapos kunwari ala ayaw ko mag pagamot , anung sasabihin mo I: mag pagamot po siya , para makapasok sya so ok , kaw anu sasabihin mo sa kapwa mo may ALL I: wala po R: wala naman, so napunta ka ba sa cancer warriors , napunta ka ba sa gathering nila I: opo R: kumusta naman mabuti po R: panu mo nasabi na mabuti I: anu po R: may nakakausap ka ba na mga bata I: opo R: may nakakalaro ka dun I: opo R: Masaya ba dun I: Opo R: Bakit mo nasabi na masaya I: Marami pong bata R: Maraming bata Tapos I: Maraming nag alalro R: Naglalaro ka din I: Nakakapag laro ka din , un R: So anu pa , ngaun lagi tayong nasa ospital , anung nararamdman mo I: Naiinip po R: Meron bang pag kakataon , na kaw eh naiiip, di kumain I: Wala naman po R: Ah ok maraming salamat
CURRICULUM VITAE
Mignodel M. Morales, RN Lipa City, Batangas
@yahoo.com
Affiliations
Batangas Regional Hospital
• RN HEALS
Philippine Red Cross
• Volunteer Instructor of Red Cross Youth Service and Safety Service
Rotaractor of Metro Lipa
• Public Relation Officer
Philippine Mental Health Association
• Lifetime Member
AYNLA – Batangas Chapter
• Member
EDUCATION
Primary Education YEAR GRADUATED Canossa Academy 2002 Lipa City, Batangas
Secondary Education Canossa Academy 2006 Lipa City, Batangas
College Education
Bachelor of Science in Nursing 2010 Lyceum of the Philippines University Capitol Site, Batangas City
AWARDS RECEIVED
Cum Laude (April 12, 2010)
Top Outstanding Red Cross Youth (April 7, 2010)
Best Clinical Area (April 7, 2010)
Top 8 – Lyceum Philippines University Award of Excellence 2010 (February 5, 2010)
Top Performing Student (S.Y. 2007 - 2008)
SEMINARS
“Nurses, Advocating, Leading, Caring”, October 19, 2012 at Mary Meadiatrix Medical Center, Lipa City, Batangas
“11th Diabetes Forum”, October 19, 2012 at Ponte Fino, Batangas City
“Understanding Bullying and Its Impact on Children and Adolescents: The Bully and The Bullied”, October 12, 2012 at Blue Sapphire, Brgy. Sico, Lipa City. “One Day Course on Basic Infant and Child Care”, September 12, 2012 at Conference Room, Batangas Regional Hospital, Batangas City
“Trends and Issues in Nursing Practice” June 16, 2012 at Conference Room, Batangas Regional Hospital, Batangas City
“Legal Aspect: Bridge Towards Excellence in Endless Nursing Frontier” April 1,2012 at N. L. Villa Memorial Medical Center, Lipa City Batangas
“Instructor’s Training Course of Standard First Aid Training and Basic Life Support Cardiopulmonary Resuscitation Training ” March 17, 2011 to April 30, 2011 at Philippine Red Cross Batangas Chapter, Capitol Site , Kumintang Ibaba, Batangas City
“Basic Intravenous Therapy” April 15, 16, 17 , 2011 at the Old Conference Hall of Batangas Regional Hospital, Batangas City.
“Automated External Defibrillator Course and Ambulance Operation Training” February 7-10, 2011 at the Philippine Red Cross – Batangas Chapter, Batangas City
“Standard First Aid Training” January 31- February 3, 2011 at PRC Batangas Chapter, Batangas City
“Basic Life Support: CPR Training for HealthCare Providers” February 5, 2011 at PRC Batangas Chapter, Batangas City
“Youth Instructor’s Training Course for Leadership Development ” May 9, 2010 at San Agapito NHS, Isla Verde, Batangas City.
“Nursing Profession: Exploring Global Competence in Field of Health Care and Entrepreneurship” February 15, 2010 at Freedom Hall, SHL Building, Lyceum of the Philippines University, Capitol Site Batangas City
“8th National Conference of Nursing Students” October 16, 2009 at the Fiesta Pavilion, Manila Hotel, Philippines
“Personality and Sexual Disorders” August 22, 2009 at First Asia Institute of Technology and Humanities
“The Ultimate Psychiatric Nursing Seminar: Mental Health Nursing, Concepts and Principles: Diagnosing Personality Disorders” August 2, 2009 at Lipa City Youth and Cultural Center, Lipa City
“The Ultimate Psychiatric Nursing Seminar: Caring for Clients with Schizophrenia ”August 2, 2009 at Lipa City Youth and Cultural Center, Lipa City
“The Ultimate Psychiatric Nursing Seminar: Dealing with ADHD Cases” August 2, 2009 at Lipa City Youth and Cultural Center, Lipa City
“The Ultimate Psychiatric Nursing Seminar: Understanding Obsessive Compulsive Disorders” August 2, 2009 at Lipa City Youth and Cultural Center, Lipa City
“Client Safety, Security and Privacy Requirements in Medical-Surgical Nursing Practice: A seminar Workshop for Nursing Students and New Professionals” January 18, 2009, SMX Convention Center, Mall of Asia Compound, Pasay City
“Drug Abuse Prevention Education and HIV/AIDS Prevention Education” December 14, 2008 at PNRC Batangas Chapter, Batangas City