Adaptation of the Illness Trajectory Theory to Describe the Work of Transitional Cancer Survivorship

Purpose/Objectives: Although frameworks for understanding survivorship continue to evolve, most are abstract and do not address the complex context of survivors’ transition following treatment completion. The purpose of this theory adaptation was to examine and refine the Illness Trajectory Theory, which describes the work of managing chronic illness, to address transitional cancer survivorship.

Data Sources: CINAHL, PubMed, and relevant Institute of Medicine reports were searched for survivors’ experiences during the year following treatment.

Data Synthesis: Using an abstraction tool, sixty-eight articles were selected from the initial search (N>700). Abstracted data were placed into a priori categories refined according to recommended procedures for theory derivation, followed by expert review.

Conclusions: Derivation resulted in a framework describing “the work of transitional cancer survivorship” (TCS work). TCS work is defined as survivor tasks, performed alone or with others, to carry out a plan of action for managing one or more aspects of life following primary cancer treatment. Theoretically, survivors engage in 3 reciprocally-interactive lines of work: (1) illness-related; (2) biographical; and (3) everyday life work. Adaptation resulted in refinement of these domains and the addition of survivorship care planning under “illness-related work”.

Implications for Nursing: Understanding this process of work may allow survivors/co-survivors to better prepare for the post-treatment period. This adaptation provides a framework for future testing and development. Validity and utility of this framework within specific survivor populations should also be explored.