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Communication Patterns of Marital Dyads Experiencing the Life- Threatening Crisis of Cancer

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Communication Patterns of Marital Dyads Experiencing the Life- Threatening Crisis of Cancer University of Montana ScholarWorks at University of Montana Graduate Student Theses, Dissertations, & Professional Papers Graduate School 1982 Communication patterns of marital dyads experiencing the life- threatening crisis of cancer Mary Zartman-Nelson The University of Montana Follow this and additional works at: https://scholarworks.umt.edu/etd Let us know how access to this document benefits ou.y Recommended Citation Zartman-Nelson, Mary, "Communication patterns of marital dyads experiencing the life-threatening crisis of cancer" (1982). Graduate Student Theses, Dissertations, & Professional Papers. 8699. https://scholarworks.umt.edu/etd/8699 This Thesis is brought to you for free and open access by the Graduate School at ScholarWorks at University of Montana. It has been accepted for inclusion in Graduate Student Theses, Dissertations, & Professional Papers by an authorized administrator of ScholarWorks at University of Montana. For more information, please contact [email protected]. COPYRIGHT ACT OF 1976 Th is is an unpublished m anuscript in w hich c o pyr ig h t sub ­ s is t s . Any further r e p r in t in g of it s contents must be approved BY THE AUTHOR, MANSFIELD L ibrary U n iv e r s it y of Montana Date : 19 8 2 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. COMMUNICATION PATTERNS OF MARITAL DYADS EXPERIENCING THE LIFE-THREATENING CRISIS OF CANCER By Mary Zartman-Nelson B.S., Northern Montana College, 1969 Presented in partial fulfillm ent of the requirements for the degree of Master of Arts UNIVERSITY OF MONTANA 1982 Chairperson, Board of Examiners DeaTT, Graduate School Date Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. UMl Number; EP39500 All rights resen/ed INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. UMT OiSMTtstion Publishing UMl EP39500 Published by ProQuest LLC (2013). Copyright in the Dissertation held by the Author. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code ProOuest ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Mi 48106 - 1346 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. DEDICATION Thyùt pAOj'ect-16 decUcate.d to aJUi thu pattenti and icmtJLidit who le tme enteA. tnto theUA ttvsLi and 6hoAz tn th tv i b tau tlial Qt^tM o^ Looa, couAag&, and in^tght. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ACKNOWLEDGMENTS My thanks and gratitude go to the following people who have helped to make this research endeavor a reality: Dr. Joyce L. Mocker advised, counseled, encouraged and supported me through these past three years. Her excitement about and belief in the project's value and worth kept me going through many d iffic u lt times. Dr. William Wilmot's expertise about relational communication was invaluable as were his observations about the research process and the frustrations that result from i t . Helen Watkins provided me with therapeutic outlets as well as her personal knowledge about and experi­ ence in cancer counseling. Her insight and objectivity truly enhanced the research process and findings. To these three people go my heart­ felt thanks, appreciation and gratitude. Special thanks also goes to Dorothy (Dot) Thiel R.N. (hospice director), Audrey Foroszowsky R.N. and Charles Dannaher, M.D. for help­ ing me to find respondents for the project. They, along with the Columbus Hospital administration, pastoral care department and Director of Volunteers, Betty Sullivan, were instrumental in encouraging and directing me in my involvement with cancer patients and their families. My appreciation also goes to Dr. John Watkins for stepping in at the last minute to "help out" the thesis committee and to Berta Piane for taking on the overwhelming task of typing this project. Finally, my special thanks goes to my husband, Charles Nelson, for putting up with my highs and lows during the past three years, and whose patience (which was pushed to the lim its, at times), love and support remained my most important reasons for continuing on and finishing the project. To my family and friends who have supported me and pushed me to continue, thank you so very much. m Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. TABLE OF CONTENTS Page ABSTRACT................................................................................................. ii ACKNOWLEDGMENTS................................................................................. i ü LIST OF TABLES..................................................................................... vii Chapter 1. PURPOSE AND RATIONAL .......................................................... 1 RESEARCH QUESTIONS .............................................................. 8 REVIEW OF RELATED LITERATURE ON DEATH AND DYING . 11 Death and D ying ........................................................... 11 The Patient And Family: A Systems Approach .... 19 Systems Theory .................................................................. 21 Key Concepts Of Systems Theory ................................... 22 Communication Principles And Family Functioning . 44 Communication And The Dying Process ........................... 50 Reverberations Throughout The Family System .... 63 Communication And The Marital D y a d .................... 70 Chapter 2. METHODOLOGY....................................................................... 77 THE QUALITATIVE RESEARCH PROCESS ................................... 77 REVIEW OF RELEVANT QUALITATIVE STUDIES: CONTENT AND METHODOLOGY ...................................................... 84 THE PILOT STUDY: DESCRIPTION OF PROCEDURES ................ 95 THE PILOT STUDY: A LEARNING EXPERIENCE ....................... 101 PROCEDURES FOR GATHERING DATA.................................... 105 Specific Techniques For This Study ........................... 108 S u b je c ts ....................................................................... 113 Respondents ................................................................... 114 M a te ria ls ....................................................................... 115 Special Problems .............................................................. 115 iv Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Chapter 2 continued Page ANALYSIS OF DATA.................................................................. 117 METHODOLOGICAL CONCERNS .................................................. 120 Reliability ...................................................................... 120 Threats To Internal Validity In The Present S tu d y ............................................................. 123 External Validity .......................................................... 129 Threats To External Validity ....................................... 130 Chapter 3. PRESENTATION OF RESULTS.................................................. 134 THE RESPONDENTS FOR THE STUDY....................................... 135 /^THE INDUCTIVE PROCESS...................................................... 143 JUDGE A'S INDUCTIVE TESTING: PROCESS AND RESULTS . 145 Additional Comments on Judge A's Inductive Process and R e s u lts ...................................................... 158 JUDGE B'S DEDUCTIVE TESTING: PROCESS AND RESULTS . 158 THE CATEGORICAL RESULTS .................................................. 161 The Discovery And Confirmation Of A Cancer Diagnosis (Major Category I) ....................................... 161 In itia l Responses (Major Category I I ) ................... 170 The Further Coping Responses Of The Dyad (Major Category I I I ) ...................................................... 188 Denial As A Coping Pattern ........................................... 201 Other Adaptive Coping Patterns ................................... 220 Final Comment On The R esu lts ....................................... 229 - COMMUNICATION CHARACTERISTICS....................................... 229 Chapter 4. DISCUSSION OF RESULTS...................................................... 243 Implications And Practical Applications ................ 243 Integration With Existing Literature ....................... 255 Implications For Future Research ............................... 256 '• Critique Of The S tu d y ................................................... 260 Threats To R eliability ................................................... 263 V Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Chapter 4 continued Page Threats To Internal Validity .......................................... 263 Threats To External Validity .......................................... 265 SUMMARY...................................................................................... 266 BIBLIOGRAPHY .............................................................................
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