ABSTRACT
Background
Advanced ovarian cancer patients face profound psychosocial challenges in maintaining hope amidst terminal illness and treatment uncertainty. Understanding mechanisms supporting adaptive hope could inform psychosocial interventions.
Methods
Phenomenological qualitative study of 16 women with advanced ovarian cancer receiving platinum-based and/or targeted therapies at a tertiary center in southern China. Semi-structured interviews conducted across 11-month observation period; thematic analysis guided by Leventhal’s Common-Sense Model (CSM).
Results
Participants demonstrated a triphasic psychosocial adjustment process organized around three interdependent themes: (1) Cognitive Reappraisal of Chronicity: Patients progressively reconceptualized ovarian cancer from acute crisis to manageable chronic condition, anchored in biomedical evidence (stable disease scans) and analogized to familiar chronic illnesses (diabetes). This cognitive restructuring enabled milestone-based temporal orientation replacing survival countdown framing; (2) Therapeutic Alliance as Hope Anchor: Quality of patient–clinician relationships functioned as relational scaffolding enabling cognitive reappraisal through shared decision-making, emotional attunement, continuity of care, and hope-framed honest prognostic communication. Family members facilitated this process through co-construction of illness identity, milestone tracking, and selective information mediation (81.3% of participants); (3) Strategic Information Management: Patients actively regulated illness-related information engagement, prioritizing actionable biomarkers over distressing epidemiological statistics, protecting the chronic illness cognitive framework while maintaining decision-making capacity. The triphasic trajectory progressed from Phase 1 Crisis Cognition (0–3 months) through Phase 2 Cognitive Negotiation (4–10 months) to Phase 3 Adaptive Integration (11+ months). Platinum-resistant cases reverted to Phase 1, indicating dynamic rather than stable cognitive achievement. All themes directly mapped onto CSM regulatory dimensions (identity, timeline, consequences, controllability, emotional representation), demonstrating empirical alignment between data-derived constructs and established theoretical architecture.
Conclusions
Hope maintenance in advanced ovarian cancer depends on integrated cognitive reappraisal, relational security, and behavioral information management—mechanisms actionable through targeted psychosocial intervention. Family-centered communication and milestone-based temporal scaffolding warrant clinical implementation pending prospective validation.