"I-We" Boundary Fluctuations in Couple Adjustment to Colorectal Cancer and Life with a Permanent Colostomy: A Qualitative Validation Study

Abstract

This study aims to validate a classification system of couple adjustment to cancer, developed with breast and prostate cancer patients. The classification proposes that couples undergo fluctuations between togetherness (“We”-ness) and separateness (“I”-ness) during their cancer experience, which may affirm or erode their mutual identity. The application of the classification system to couples coping with colorectal cancer (CRC) and permanent colostomies served as a novel approach to member checking as a means of validation. Nine couples were interviewed. Transcripts were coded for “I-We” shifts in couples’ adjustment, either as these were implicitly described within their dialogue, or as they were explicitly self-identified by the couple. With the exception of four “We”-eroding shifts, all of the previously identified shifts within the “I-We” classification system were observed. One new “I-We” shift was developed from this analysis. Implications to colorectal cancer patients with colostomies and theories of couple resilience emphasizing “We”-ness are discussed.