Insights into the use of social comparisons within an advanced cancer setting

Background The PROACT (Patient Reported Outcomes in cancer, impact of Age and Carer role demands associated with Treatment) study had the primary aim of developing two scales measuring the impact of cancer on wellbeing and caregiving responsibilities, for people with cancer and the individuals supporting them. The project consisted of four consecutive studies; the first stage was the collection of qualitative narratives to understand the patient/caregiver experience. This paper reports on an incidental finding from these narratives. Methods The researchers conducted semi-structured interviews exploring participants’ views on the impact cancer had on their quality of life. They interviewed 24 people with stage III/IV cancer from three tumor groups, Lung (n=6), Melanoma (n=9) and Ovarian (n=9), and 23 informal caregivers. Interviews were recorded and transcribed verbatim and a framework was developed through open coding. A framework approach to thematic analysis was employed. Results Twenty themes and 33 sub-themes were identified including topics such as impact for caregiving and employment. There was an unplanned finding of participants recurrently using concepts of ‘luck’ or good fortune when describing their situations. While not a theme itself this narrative was present across the framework, occurring when individuals made comparisons to ‘other’ groups of people perceived as facing more difficulties. Conclusions This analysis provides insight into the use of language by both patients and informal caregivers in the advanced disease setting, laying the foundation for future research exploring any effects this has on dyadic wellbeing. These interpretations form a basis to explore whether this language can be harnessed by healthcare professionals to deliver information in line with an individual’s conceptualization of their situation.