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Stewart H, Ashmore L, Kragh-Furbo M, Singleton V, Hutton D. Ghosts in the machinery: Living with and beyond radiotherapy treatment for gynaecological cancer. Health (London) 2024; 28:90-107. [PMID: 35900050 PMCID: PMC10714697 DOI: 10.1177/13634593221114749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper explores post-treatment experiences of women who have had radiotherapy for gynaecological cancer. Drawing on data from a project which explored post-treatment wellbeing, conceptual metaphors of ghosts/haunting are used to engage with enduring legacies of cancer and 'neglected matters' in post-treatment trajectories. Current arrangements of care contribute to the idea that participants are 'out of the other side of cancer' once active treatment completes. Despite broader ambitions for holistic cancer rehabilitation, fragilities of body and mind persist, even when the outward representation is one of health, of looking well, of moving on. We show how neglected matters of cancer (visceral late effects, psychological suffering and lives not lived) are part of living with and beyond cancer. These 'ghosts' manifest in chronic states of unsettledness that are temporarily relieved by individualised 'fixes', such as mobilisation of 'mind over matter' discourse and mindfulness. This discourse and its associated tools are a powerful yet impoverished framing of approaches to living with and beyond cancer. We argue for the need to attend to 'neglected matters' of post-treatment trajectories differently.
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Affiliation(s)
| | - Lisa Ashmore
- Lisa Ashmore, Lancaster Medical School, Lancaster University, Sir John Fisher Drive, Bailrigg, Lancaster LA1 4YW, UK.
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2
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Zhou X, Guo S, Wu H. Research on the doctors' win in crowdsourcing competitions: perspectives on service content and competitive environment. BMC Med Inform Decis Mak 2023; 23:204. [PMID: 37798708 PMCID: PMC10557239 DOI: 10.1186/s12911-023-02309-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/27/2023] [Indexed: 10/07/2023] Open
Abstract
Medical crowdsourcing competitions can help patients get more efficient and comprehensive treatment advice than "one-to-one" service, and doctors should be encouraged to actively participate. In the crowdsourcing competitions, winning the crowdsourcing competition is the driving force for doctors to continue to participate in the service. Therefore, how to improve the winning probability needs to be revealed. From the service content and competitive environment perspectives, this study introduces doctor competence indicators to investigate the key influence factors of doctors' wins on the online platform. The results show that the emotional interaction in doctors' service content positively influences doctors' wins. However, the influence of information interaction presents heterogeneity. Conclusive information helps doctors win, while suggestive information negatively affects them. For the competitive environment, the competitive environment negatively moderates the relationship between doctors' service content and doctors' wins. The results of this study provide important contributions to the research on crowdsourcing competitions and online healthcare services and guide the participants of the competition, including patients, doctors, and platforms.
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Affiliation(s)
- Xiuxiu Zhou
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China
| | - Shanshan Guo
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Hong Wu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
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3
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Weick L, Ericson A, Sandman L, Boström P, Hansson E. Patient experience of implant loss after immediate breast reconstruction: An interpretative phenomenological analysis. Health Care Women Int 2023; 44:61-79. [PMID: 34427538 DOI: 10.1080/07399332.2021.1944152] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Immediate breast reconstruction (IBR) is an integral part of modern breast cancer treatment. Our aim was to investigate patient experience with implant loss after IBR by using interpretative phenomenological analysis (IPA). We conducted semi-structured interviews with eight informants. We analyzed data according to the IPA flexible seven-stage process and four main themes were developed: immediate breast reconstruction as the indisputable choice, a difficult experience, an altered body: redefining normality, and trying to cope. The experience of implant loss appears to affect women for many years and might overshadow some of the benefits of IBR.
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Affiliation(s)
- Linn Weick
- Department of Plastic and Reconstructive Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Alice Ericson
- Department of Psychology, Gothenburg University, Gothenburg, Sweden
| | - Lars Sandman
- National Centre for Priorities in Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Västra Götaland Region, Gothenburg, Sweden.,Faculty of Police Work, department of Campus Police Education, Borås University, Borås, Sweden
| | - Petra Boström
- Department of Psychology, Gothenburg University, Gothenburg, Sweden
| | - Emma Hansson
- Department of Plastic and Reconstructive Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Clinical Sciences, Gothenburg University, Gothenburg, Sweden
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4
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Salvadé H, Stiefel F, Bourquin C. "You'll need to settle your affairs": How the subject of death is approached by oncologists and advanced cancer patients in follow-up consultations. Palliat Support Care 2022:1-9. [PMID: 36354030 DOI: 10.1017/s147895152200147x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES This qualitative study aimed to investigate communication about death in consultations with patients undergoing chemotherapy with no curative intent. Specifically, we examined (i) how the topic of death was approached, who raised it, in what way, and which responses were elicited, (ii) how the topic unfolded during consultations, and (iii) whether interaction patterns or distinguishing ways of communicating can be identified. METHODS The data consisted of 134 audio-recorded follow-up consultations. A framework of sensitizing concepts was developed, and interaction patterns were looked for when death was discussed. RESULTS The subject of death and dying was most often initiated by patients, and they raised it in various ways. In most consultations, direct talk about death was initiated only once. We identified 4 interaction patterns. The most frequent consists of indirect references to death by patients, followed by a direct mention of the death of a loved one, and a statement of the oncologists aiming to skip the subject. SIGNIFICANCE OF RESULTS Patients and oncologists have multiple ways of raising, pursuing, addressing and evacuating the subject of death. Being attentive and recognizing these ways and associated interaction patterns can help oncologists to think and elaborate on this topic and to facilitate discussions.
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Affiliation(s)
- Hélène Salvadé
- Psychiatric Liaison Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Friedrich Stiefel
- Psychiatric Liaison Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Céline Bourquin
- Psychiatric Liaison Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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5
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Higuita-Gutiérrez LF, Estrada-Mesa DA, Cardona-Arias JA. The Relation of Ideology of Positive Thinking with the Perception of Cancer Risk and Ways of Treating It in Medellin, Colombia. Psychol Res Behav Manag 2022; 15:3329-3345. [DOI: 10.2147/prbm.s380641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/13/2022] [Indexed: 11/17/2022] Open
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6
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Shook AG, Tordoff DM, Clark A, Hardwick R, St. Pierre Nelson W, Kantrowitz-Gordon I. Age, Autonomy, and Authority of Knowledge: Discursive Constructions of Youth Decision-Making Capacity and Parental Support in Transgender Minors’ Accounts of Healthcare Access. JOURNAL OF ADOLESCENT RESEARCH 2022. [DOI: 10.1177/07435584221115351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
While access to care is known to improve health outcomes for transgender youth, these youth often face challenges in accessing care related to decision-making capacity and the legal limitations regarding age of consent. In this study, we utilize discourse analytic methods to identify how notions of age, autonomy, and authority of knowledge influence transgender youths’ ability to make agentic decisions about their bodies and health, and better understand the power dynamics present in youths’ relations with parents and providers. We conducted 11 one-on-one interviews with transgender youth between the ages of 13 to 17 and one focus group with high school-age trans youth ( n = 8) in the Seattle-Tacoma area of Washington state. We identified two sets of discourses: (1) discourses of autonomy, which included self-determination, confidentiality, and authority of knowledge and (2) discourses of support, which included role ambiguity, trust/mistrust, and good and bad parents. Findings from this study highlight power dynamics present in trans youths’ relations with parents and providers.
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Affiliation(s)
- Alic G. Shook
- Seattle University, College of Nursing, Seattle, WA, USA
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7
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Heinsch M, Cootes H, Wells H, Tickner C, Sampson D, Kay-Lambkin F. "It's Hard, but We Could Kind of Laugh About It": Exploring the Role of Humor in Brain Cancer Caregiving. QUALITATIVE HEALTH RESEARCH 2022; 32:744-754. [PMID: 35152801 DOI: 10.1177/10497323211069339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Research exploring the benefits of humor for caregivers is limited and, to date, no qualitative studies have explored the role of humor in brain cancer caregiving. To address this gap, we analyzed transcripts from twenty-one in-depth telephone interviews conducted with brain cancer caregivers from a strengths perspective. Thematic analysis using Braun and Clarke's method revealed that humor functions as (1) an innate element of the self and relationship, (2) an expression of mutual connection and understanding, (3) a way of managing difficult or awkward moments, (4) a form of avoidance or a welcome distraction, and may be (5) helpful, or unhelpful, depending on where someone is in the brain cancer trajectory. Findings suggest that humor represents an important yet complex individual and family strength for health service providers to identify and build upon.
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Affiliation(s)
- Milena Heinsch
- Centre for Brain and Mental Health Research, 5982University of Newcastle, Callaghan, NSW, Australia
| | - Hannah Cootes
- Centre for Brain and Mental Health Research, 5982University of Newcastle, Callaghan, NSW, Australia
| | - Hannah Wells
- Centre for Brain and Mental Health Research, 5982University of Newcastle, Callaghan, NSW, Australia
| | - Campbell Tickner
- Centre for Brain and Mental Health Research, 5982University of Newcastle, Callaghan, NSW, Australia
| | - Dara Sampson
- Centre for Brain and Mental Health Research, 5982University of Newcastle, Callaghan, NSW, Australia
| | - Frances Kay-Lambkin
- Centre for Brain and Mental Health Research, 5982University of Newcastle, Callaghan, NSW, Australia
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8
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Traversa R. Thanatos Revised: What Psychology May Look Like with Positive, Enduring Attitudes Towards Death and Dying. HUMAN ARENAS 2021. [DOI: 10.1007/s42087-020-00182-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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9
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Gustafsson AW, Hommerberg C, Sandgren A. Coping by metaphors: the versatile function of metaphors in blogs about living with advanced cancer. MEDICAL HUMANITIES 2020; 46:267-277. [PMID: 31409656 DOI: 10.1136/medhum-2019-011656] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/17/2019] [Indexed: 06/10/2023]
Abstract
Living with a life-limiting cancer illness can entail a turmoil of feelings such as constant fear of loss, suffering and dying. Because patients live longer with life-limiting illness, there is a need for enhanced understanding of how people make sense of and cope with the complicated aspects that this life situation brings on. In this article, we explore how bloggers with advanced cancer use metaphors as ways of making sense of their experiences. Our study is theoretically grounded in Conceptual Metaphor Theory, where metaphors are seen as a powerful phenomenon that both reflects and affects our thinking. The data consist of a corpus of blogs written in Swedish by individuals with advanced cancer, and the findings from our linguistic metaphor analysis are consistently interpreted against the backdrop of literature on coping. Our study thus highlights the intersection of linguistic metaphor analysis and psychological theories of coping by illustrating the many and complex functions metaphors can have as part of sense-making processes. Our hermeneutic approach enables us to show some differences among the three most pervasive metaphor domains in our material, battle, journey and imprisonment: the journey and imprisonment domains are more flexible than the battle domain in terms of the different kinds of coping strategies that are actualised by the bloggers' use of metaphors. One particular finding from our analysis is the way in which the bloggers make use of metaphors to compartmentalise experiences and emotions. Our contention is that careful attention to the metaphors used by patients can improve communication in healthcare and enhance understanding of the complex role language use plays in coping processes more generally. By highlighting the relation between metaphor use and coping, our analysis also provides a way to discuss coping strategies based on the patient's own use of language.
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Affiliation(s)
| | | | - Anna Sandgren
- Department of Health and Caring Sciences, Center for Collaborative Palliative Care, Linnaeus University, Växjö, Sweden
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10
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O'Callaghan C, Brooker J, de Silva W, Glenister D, Melia Cert A, Symons X, Kissane D, Michael N. Patients' and Caregivers' Contested Perspectives on Spiritual Care for Those Affected by Advanced Illnesses: A Qualitative Descriptive Study. J Pain Symptom Manage 2019; 58:977-988. [PMID: 31404641 DOI: 10.1016/j.jpainsymman.2019.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 08/02/2019] [Accepted: 08/05/2019] [Indexed: 10/26/2022]
Abstract
CONTEXT Spiritual care refers to practices and rituals addressing spiritual/religious concerns. It supports coping with loss and finding hope, meaning, and peace. Although integral to palliative care, its implementation is challenging. OBJECTIVE To understand an Australian cohort of patients' and caregivers' perspectives about experiencing and optimizing spiritual care in the context of advanced illness. METHODS Patients and caregivers of patients with ≤12 month prognosis were recruited from a broader spiritual study via criterion sampling and agreed to opt-in interviews. Participants from an Australian, metropolitan health service received a spiritual care definition and were interviewed. Transcripts were analyzed using qualitative description. RESULTS 30 patients (17 male; mean age 70 years) and 10 caregivers (six male; mean age 58.9 years) participated. 27 identified as Christian, and 10 had no religion. Participants described multifaceted and contested beliefs about spirituality. Many queried the tangibility of spirituality, but all valued respectful staff who affirmed personhood, that is, each individual's worth, especially when care exceeded expectations. They also resonated with positive organizational and environmental tones that improved holistic well-being. Participants stressed the importance of the hospital's welcoming context and skilled care, which comforted and reassured. CONCLUSION Although many patients and caregivers did not resonate with the term "spiritual care," all described how the hospital's hospitality could affirm their values and strengthen coping. The phrase "spiritual care and hospitality" may optimally articulate and guide care in similar, pluralist inpatient palliative care contexts, recognizing that such care encompasses an interplay of generalist and specialist pastoral care staff and organizational and environmental qualities.
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Affiliation(s)
- Clare O'Callaghan
- Palliative and Supportive Care Research Department, Cabrini Health, Malvern, Victoria, Australia; Institute for Ethics & Society, The University of Notre Dame Australia, New South Wales, Australia; Departments of Psychosocial Cancer Care and Medicine, St. Vincent's Hospital Fitzroy, The University of Melbourne, Victoria, Australia.
| | - Joanne Brooker
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - William de Silva
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - David Glenister
- Centre for Clinical Pastoral Education, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Adelaide Melia Cert
- Palliative and Supportive Care Research Department, Cabrini Health, Malvern, Victoria, Australia
| | - Xavier Symons
- Institute for Ethics & Society, The University of Notre Dame Australia, New South Wales, Australia
| | - David Kissane
- Palliative and Supportive Care Research Department, Cabrini Health, Malvern, Victoria, Australia; Szalmuk Family Psycho-oncology Research Unit, Cabrini Health, Malvern, Melbourne, Victoria, Australia; School of Medicine, The University of Notre Dame Australia, New South Wales, Australia
| | - Natasha Michael
- Palliative and Supportive Care Research Department, Cabrini Health, Malvern, Victoria, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia; School of Medicine, The University of Notre Dame Australia, New South Wales, Australia
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11
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Anderson AB, Jorgenson J. Making work visible in a breast cancer support business. JOURNAL OF ORGANIZATIONAL ETHNOGRAPHY 2019. [DOI: 10.1108/joe-05-2018-0028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Breast cancer support businesses, retail stores selling mastectomy-related products, are playing an expanding role within healthcare in the USA. As commercial spaces separate from the medical settings where most cancer treatment occurs, these businesses have been largely overlooked in studies of medical care providers and their experiences. The purpose of this paper is to seek to bring to light the meanings and dimensions of the care work provided by breast cancer support staff to newly diagnosed patients.
Design/methodology/approach
This project employed an ethnographic approach centered on the workers at one breast cancer support business. The first author carried out participant observation over a 20-month period and supplemented the observations with staff member interviews.
Findings
The analysis of field notes and interviews revealed two themes or purposes as central to the employees’ understanding of their work: defining the organizational setting as a nonmedical space and balancing image enhancement with comforting care. The findings show how values of client-centered care can be enacted in a for-profit healthcare setting.
Research limitations/implications
This study is limited to one for-profit support business in the southeastern USA.
Practical implications
Mastectomy supply businesses appear to offer a kind of support that patients may not be finding elsewhere or at the particular time they need it. Thus the study holds relevance for practitioners and health policy makers who are seeking to develop more comprehensive care for surgical patients within the established healthcare system.
Originality/value
This study gives a detailed picture of breast cancer support work, including the value premises and meanings it holds for support workers.
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12
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Hainsworth EG, Shahmanesh M, Stevenson F. Insights into the social context of living with a dual diagnosis of HIV and cancer: a qualitative, thematic analysis of popular discourse in London newspapers. AIDS Care 2019; 32:793-799. [PMID: 31405294 DOI: 10.1080/09540121.2019.1653444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
As growing numbers of people living with HIV also develop cancer, a holistic understanding of their experiences is essential to the provision of patient centred care. Both conditions are linked to powerful beliefs in our society that may affect experiences. This study explored how HIV and cancer were represented in UK newspapers to gain insight into the social context of living with a dual diagnosis. We performed an initial content analysis of HIV articles and of cancer articles published in the free London newspapers, The Metro and The Evening Standard between 2012 and 2017, followed by qualitative thematic analysis and in-depth analysis of selected articles of exemplar cases. Both conditions were presented very differently. The underlying subtext was that cancer could happen to any of us. HIV was framed as a potentially dangerous, stigmatising phenomenon affecting "others". Popular discourse about HIV within news media remains largely negative and stigmatising. People living with a dual diagnosis of HIV and cancer may choose to prioritise the sharing of the more socially acceptable condition, cancer, in order to access support. The negotiation of cancer healthcare services is likely to be adversely influenced by the social burden of HIV related stigma.
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Affiliation(s)
- Emma G Hainsworth
- Research Department of Primary Care and Population Sciences, Royal Free and University College London Medical School, London, UK
| | | | - Fiona Stevenson
- Research Department of Primary Care and Population Sciences, University College London, London, UK
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13
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Taylor KA, Knibb JN. Don't give US pink ribbons and skinny girls: Breast cancer survivors' evaluations of cancer advertising. Health Mark Q 2019; 36:186-202. [PMID: 31294675 DOI: 10.1080/07359683.2019.1618007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Breast cancer related promotions, advertising, and pink ribbons are now ubiquitous in October, yet comparatively little is known about how this advertising impacts breast cancer survivors specifically. The present research uses an embodied knowledge perspective to explore the impact of cancer advertising on female breast cancer survivors. Five focus groups were conducted with 42 participants, and the discussions were analyzed to find common themes. The survivors expressed a desire for cancer advertising to be representative, informative (particularly regarding detection and treatment options), hopeful, and transparent about the organization's motivation and support. Implications and recommendations are also discussed.
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Affiliation(s)
- Kimberly A Taylor
- a Department of Marketing and Logistics, College of Business, Florida International University , Miami , FL , USA
| | - Jana N Knibb
- b Community College of Rhode Island , Warwick , RI , USA
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14
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Sidenius A, Mogensen O, Rudnicki M, Møller LMA, Hansen HP. Feeling lucky: hierarchies of suffering and stories of endometrial cancer in a Danish context. SOCIOLOGY OF HEALTH & ILLNESS 2019; 41:950-964. [PMID: 30740754 DOI: 10.1111/1467-9566.12875] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Illness stories are a prime analytical way of understanding patient perspectives on cancer. Nevertheless, limited studies have focused on stories of endometrial cancer. An ethnographic study including participant observation and interviews among 18 Danish women with endometrial cancer was conducted to examine prevalent stories and the ways the women responded to them. In this article, the analysis focuses on two exemplary cases, which present a line of issues related to the kinds of experiences that suffering includes. Findings illustrate that feelings of luck were central to the experience of being diagnosed, treated and cured, which was related to the way health professionals framed endometrial cancer as favourable through notions of curable/incurable, trivial and gentle/invasive and brutal, and aggressive/non-aggressive. Drawing upon the concept of a 'hierarchy of suffering', we exemplify how women tended to scale own experiences of suffering against others', leading some to believe they were not in a legitimate position to draw attention to themselves nor seek help and support, despite adverse physical, psychosocial effects. Thus, feelings of being lucky were intertwined with a sense of ambivalence. We conclude by discussing how suffering arises within a moral context, suggesting that the ways we speak of cancer may make some experiences unspeakable. This calls for increased clinical attention to more diverse narratives of cancer.
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Affiliation(s)
- Anne Sidenius
- Research Unit of General Practice, Department of Public Health, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Department of Gynaecology and Obstetrics, University Hospital of Zealand, Roskilde, Denmark
| | - Ole Mogensen
- Research Unit of Gynaecology and Obstetrics (RUGO), Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Division of Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Martin Rudnicki
- Department of Gynaecology and Obstetrics, University Hospital Odense (OUH), Odense, Denmark
| | - Lars M A Møller
- Department of Gynaecology and Obstetrics, University Hospital of Zealand, Roskilde, Denmark
| | - Helle P Hansen
- Research Unit of General Practice, Department of Public Health, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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15
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Trevino KM, Prigerson HG, Shen MJ, Tancredi DJ, Xing G, Hoerger M, Epstein RM, Duberstein PR. Association between advanced cancer patient-caregiver agreement regarding prognosis and hospice enrollment. Cancer 2019; 125:3259-3265. [PMID: 31145833 PMCID: PMC6717015 DOI: 10.1002/cncr.32188] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 03/12/2019] [Accepted: 04/23/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Patients with advanced, incurable cancer who understand their illness is incurable are more likely to prefer hospice care at the end of life compared with patients who believe their illness is curable. To the authors' knowledge, it is unclear whether patient-caregiver agreement regarding perceived prognosis is associated with hospice enrollment. METHODS The current study examined the prospective relationship between patient-caregiver agreement concerning perceived prognosis and hospice enrollment in the last 30 days of life. Data were collected during a cluster randomized controlled trial examining a communication intervention for oncologists and patients with advanced cancer and their caregivers. At the time of study entry, patients and caregivers (141 dyads) were categorized as endorsing a "good" prognosis if they: 1) reported a >50% chance of surviving ≥2 years; or if they 2) predicted that the patient's quality of life 3 months into the future would be ≥7 on an 11-point scale. RESULTS Approximately one-fifth of dyads agreed on a poor prognosis whereas approximately one-half disagreed regarding prognosis. In approximately one-third of dyads, patients and caregivers both believed the patient's future quality of life would be good (34%) and that the patient would live for ≥2 years (30%). Patients in these dyads were less likely to enroll in hospice compared with patients in dyads who disagreed and those who agreed on a shorter life expectancy and poor future quality of life. CONCLUSIONS Dyadic understanding of patients' projected life expectancy and future quality of life appears to be predictive of care received at the end of life. Improving rates of hospice enrollment may be best achieved with dyadic interventions.
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Affiliation(s)
- Kelly M Trevino
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Holly G Prigerson
- Department of Medicine, Weill Cornell Medicine, New York, New York.,Department of Medicine, New York Presbyterian Hospital, New York, New York
| | - Megan Johnson Shen
- Department of Medicine, Weill Cornell Medicine, New York, New York.,Department of Medicine, New York Presbyterian Hospital, New York, New York
| | - Daniel J Tancredi
- Department of Pediatrics, University of California at Davis, Davis, California
| | - Guibo Xing
- Department of Pediatrics, University of California at Davis, Davis, California
| | - Michael Hoerger
- Department of Psychology, Tulane University, New Orleans, Louisiana
| | - Ronald M Epstein
- Department of Family Medicine, University of Rochester Medical Center, Rochester, New York
| | - Paul R Duberstein
- Department of Family Medicine, University of Rochester Medical Center, Rochester, New York.,Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, New Brunswick, New Jersey
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16
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Abstract
As grassroots user/survivor movements gained traction across the Global North, mental health activists have provided mutual aid for those who consider themselves to be negatively affected by their psychiatrization experiences and for those in search of alternative (non-biopsychiatric) frameworks for understanding mental diversity. In addition to in-person support groups, digital communication has become an integral organizing mechanism for mutual aid actions to support those in mental distress. However, activists have often found both digital and face-to-face communication to be quite taxing to their own well-being-as they negotiate personal capacity to respond to collective needs and practice self-care through limiting their engagements in radical mental health communities. While engaging in an ethnography with a mutual aid community in the United States, I explored the use of "boundary formation" to set parameters for social engagement within digital support and face-to-face encounters. Semi-structured interviews with 14 participants, focus group discussions, participatory observation, and an analysis of digital communication revealed that group members often discussed setting personal boundaries as an act of self-care, a recognition of the pitfalls associated with engaging in group dynamics during times of mental distress, and as a practice to ensure communal longevity. The ways that participants discussed and enacted boundary formation are analyzed in this paper as a way of blocking, redirecting, and restructuring digital and in-person engagements within mutual aid assemblages.
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Affiliation(s)
- Erica Hua Fletcher
- Hope and Healing Center & Institute, 717 Sage Rd, Houston, TX, 77056, USA.
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17
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Thille P, Gibson BE, Abrams T, McAdam LC, Mistry B, Setchell J. Enhancing the human dimensions of children's neuromuscular care: piloting a methodology for fostering team reflexivity. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2018; 23:867-889. [PMID: 29797172 DOI: 10.1007/s10459-018-9834-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 05/11/2018] [Indexed: 06/08/2023]
Abstract
For those with chronic, progressive conditions, high quality clinical care requires attention to the human dimensions of illness-emotional, social, and moral aspects-which co-exist with biophysical dimensions of disease. Reflexivity brings historical, institutional, and socio-cultural influences on clinical activities to the fore, enabling consideration of new possibilities. Continuing education methodologies that encourage reflexivity may improve clinical practice and trainee learning, but are rare. We piloted a dialogical methodology with a children's rehabilitation team to foster reflexivity (patient population: young people with Duchenne's or Becker's muscular dystrophy). The methodology involved three facilitated, interactive dialogues with the clinical team. Each dialogue involved clinicians learning to apply a social theory (Mol's The Logic of Care) to ethnographic fieldnotes of clinical appointments, to make routine practice less familiar and thus open to examination. Discourse analyses that preserve group dynamics were completed to evaluate the extent to which the dialogues spurred reflexive dialogue within the team. Overall, imagining impacts of clinical care on people's lives-emphasized in the social theory applied to fieldnotes-showed promise, shifting how clinicians interpreted routine practices and spurring many plans for change. However, this reflexive orientation was not sustained throughout, particularly when examining entrenched assumptions regarding 'best practices'. Clinicians defended institutional practices by co-constructing the metaphor of balancing logics in care delivery. When invoked, the balance metaphor deflected attention from emotional, social, and moral impacts of clinical care on patients and their families. Emergent findings highlight the value of analysing reflexivity-oriented dialogues using discourse analysis methods.
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Affiliation(s)
- Patricia Thille
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, ON, M4G 1R8, Canada.
| | - Barbara E Gibson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, ON, M4G 1R8, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Thomas Abrams
- Department of Sociology and Social Anthropology, Dalhousie University, Halifax, NS, Canada
| | - Laura C McAdam
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, ON, M4G 1R8, Canada
- Department of Paediatrics, Division of Developmental Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Bhavnita Mistry
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, ON, M4G 1R8, Canada
| | - Jenny Setchell
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, ON, M4G 1R8, Canada
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Hope-Stone L, Ablett J, Salmon P. Reflections on a Health Psychology Service for Patients with Uveal Melanoma: The Challenge of Psychological Screening and Intervention When Distress is 'Normal'. J Clin Psychol Med Settings 2018; 26:421-429. [PMID: 30465122 PMCID: PMC6851395 DOI: 10.1007/s10880-018-9595-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
We appraise the role of screening for distress as part of health psychology assessment of patients newly diagnosed with cancer. We reviewed records of consecutive patients who accepted a health psychologist’s assessment over 4 years, examining convergence and divergence of the result of screening (whether patients reached threshold as ‘cases’) with the psychologist’s clinical judgment of need for intervention. Of 261 patients, 88 (33.7%) were ‘cases’. Of these, need for psychological intervention was identified in 70 (79.5%). Of the 173 (66.3%) ‘non-cases’, need was identified in 59 (34.1%). Examination of cases where the psychologist’s judgment diverged from screening showed that ‘caseness’ can arise from distress that patients can manage themselves and, conversely, that psychological needs arise in the absence of overt distress. Formal screening may not identify need for psychological intervention. The psychologist’s role is to make expert judgments of patients’ current and future needs. Dialogue with patients should be the vehicle for assessment.
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Affiliation(s)
- Laura Hope-Stone
- Liverpool Ocular Oncology Centre & Clinical Health Psychology Service-Cancer, Royal Liverpool and Broadgreen University Hospital, NHS Trust, Prescot St, Liverpool, L7 8XP, UK. .,Institute of Psychology, Health & Society, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool, L69 3GB, UK.
| | - Janice Ablett
- Liverpool Ocular Oncology Centre & Clinical Health Psychology Service-Cancer, Royal Liverpool and Broadgreen University Hospital, NHS Trust, Prescot St, Liverpool, L7 8XP, UK.,Institute of Psychology, Health & Society, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool, L69 3GB, UK
| | - Peter Salmon
- Institute of Psychology, Health & Society, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool, L69 3GB, UK
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Huss E, Samson T. Drawing on the Arts to Enhance Salutogenic Coping With Health-Related Stress and Loss. Front Psychol 2018; 9:1612. [PMID: 30319472 PMCID: PMC6167555 DOI: 10.3389/fpsyg.2018.01612] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/13/2018] [Indexed: 11/23/2022] Open
Abstract
The connection between art therapy and specific theories of positive psychology such as Antonovsky’s theory of salutogenic sense of coherence (SOC) has been less articulated in the literature. This paper draws a methodological connection between art therapy and SOC, that is, meaning, manageability and comprehensibility, as the components of coping. This theoretical and methodological connection is then explored with a group of participants dealing with the health-stress of cancer. Method: We conducted a large-scale, qualitative study that included fifty transcribed hours of thematically analyzed arts processes and one hundred art works, used to explore salutogenic theory within a support group for recovering oncological patients. Results: The results point to the arts as including mechanisms that enhance meaning, manageability, and comprehensibility in an embodied and synergetic way. The art makes it possible both to separate and to ‘fill’ these three components, while on the other hand, integrating them into a cyclical element. We outline theoretical and methodological implications of understanding art therapy as a methodology to enact and concretize positive psychology theories, as well as presenting a protocol for using arts to enhance salutogenic coping in the context of health-related stress.
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Affiliation(s)
- Ephrat Huss
- The Charlotte B. and Jack J. Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Tali Samson
- The Charlotte B. and Jack J. Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beersheba, Israel
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Staneva AA, Gibson AF, Webb PM, Beesley VL. The Imperative for a Triumph-Over-Tragedy Story in Women's Accounts of Undergoing Chemotherapy for Ovarian Cancer. QUALITATIVE HEALTH RESEARCH 2018; 28:1759-1768. [PMID: 29938608 DOI: 10.1177/1049732318778261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We aimed to examine how women construct their experiences of chemotherapy treatment for ovarian cancer. Through semistructured interviews, we explored the accounts of 18 Australian women about their experiences within a broader cultural imperative-or discourse-to "think positively." By applying a critical realist lens to the analysis, we identified two discursive themes that shaped women's accounts. The "feeling different and managing support" theme highlights the identity challenges women faced because of the lack of formal support for ovarian cancer. Conversely, the theme "women's reconstructions of difficult experiences" illustrates the imperative for women to present a positive story as a way of restoring their position of a lucky and stoic survivor. Such speaking served to mask some of the underlying difficulties that were part of these women's experiences. Health care professionals need to consider looking for the hidden stories of vulnerability that lie beneath the triumphant ones.
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Affiliation(s)
| | | | - Penelope M Webb
- 1 QIMR Berghofer Medical Research Institute, Brisbane, Australia
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Stiefel F, Saraga M, Bourquin C. Enjeux futurs de la communication et de l’enseignement de la communication en oncologie. PSYCHO-ONCOLOGIE 2018. [DOI: 10.3166/pson-2018-0019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Lockhart KL, Keil FC. I. INTRODUCTION: UNDERSTANDING MEDICINES AND MEDICAL INTERVENTIONS. Monogr Soc Res Child Dev 2018; 83:7-32. [PMID: 29668058 PMCID: PMC5912670 DOI: 10.1111/mono.12361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
We live in an increasingly pharmacological and medical world, where children and adults frequently encounter alleged treatments for an enormous range of illnesses. How do we come to understand what heals and why? Here, 15 studies explore how 1,414 children (ages 5-11) and 882 adults construe the efficacies of different kinds of cures. Developmental patterns in folk physics, psychology, and biology lead to predictions about which expectations about cures will remain relatively constant across development and which will change. With respect to stability, we find that even young school children (ages 5-7) distinguish between physical and psychological disorders and the treatments most effective for each. In contrast, young children reason differently about temporal properties associated with cures. They often judge that dramatic departures from prescribed schedules will continue to be effective. Young children are also less likely than older ages to differentiate between the treatment needs of acute versus chronic disorders. Young children see medicines as agent-like entities that migrate only to afflicted regions while having "cure-all" properties, views that help explain their difficulties grasping side effects. They also differ from older children and adults by judging pain and effort as reducing, instead of enhancing, a treatment's power. Finally, across all studies, optimism about treatment efficacy declines with age. Taken together, these studies show major developmental changes in how children envision the ways medicines work in the body. Moreover, these findings link to broader patterns in cognitive development and have implications for how medicines should be explained to children.
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Alsaleh M, Lebreuilly R, Tostain M, Lebreuilly J. La puissance des répétitions des phrases des pensées positives (RPPP) : un outil efficace de traitement contre les troubles psychologiques (dépression, anxiété et stress). Une étude pilote contrôlée et randomisée. ANNALES MEDICO-PSYCHOLOGIQUES 2018. [DOI: 10.1016/j.amp.2017.01.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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REFERENCES. Monogr Soc Res Child Dev 2018. [DOI: 10.1111/mono.12368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Larsen DJ, Stege R, King R, Egeli N. The hope collage activity: an arts-based group intervention for people with chronic pain. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2018. [DOI: 10.1080/03069885.2018.1453046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Denise J. Larsen
- Department of Educational Psychology, University of Alberta, Edmonton, Canada
| | - Rachel Stege
- Department of Educational Psychology, University of Alberta, Edmonton, Canada
| | - Rachel King
- Department of Educational Psychology, University of Alberta, Edmonton, Canada
| | - Natasha Egeli
- Department of Educational Psychology, University of Alberta, Edmonton, Canada
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Godfrey M, Price S, Long A. Unveiling the Maelstrom of the Early Breast Cancer Trajectory. QUALITATIVE HEALTH RESEARCH 2018; 28:572-586. [PMID: 29281944 DOI: 10.1177/1049732317746378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Length and complexity of illness and treatment in early breast cancer mean that the acute phase may extend over months. Employing concepts of "trajectory" and "work" from chronic illness, we explored the temporality of the illness experience for women as it unfolded from diagnosis through acute treatment. We performed multiple, qualitative interviews with 14 women at critical points in their first year postdiagnosis. We differentiated between subphases of the acute breast cancer trajectory: becoming a person with breast cancer: a turning point; first steps in treatment: struggling to protect self-concept; being and feeling ill: "cure" as suffering; and conditional "recovering": an uncertain future. Each subphase represented the distinctive context in which illness management took place with consequences for the work women and those close to them engaged in, to manage the practical, emotional, relational, and existential demands of an illness that intruded every aspect of their lives.
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Affiliation(s)
| | - Sarah Price
- 2 Independent Researcher, Edinburgh, Scotland
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Coyle LA, Atkinson S. Imagined futures in living with multiple conditions: Positivity, relationality and hopelessness. Soc Sci Med 2018; 198:53-60. [PMID: 29276986 PMCID: PMC5884318 DOI: 10.1016/j.socscimed.2017.12.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/29/2017] [Accepted: 12/16/2017] [Indexed: 11/28/2022]
Abstract
Hope serves as an overarching concept for a range of engagements that demonstrate the benefits of a positive outlook for coping with chronic conditions of ill-health and disability. A dominant engagement through medicine has positioned hope as a desirable attribute and its opposite, hopelessness, as pathological. In this engagement hope is individual, internally located and largely cognitive and able to be learned. Attaining hope reflects a process of coming to terms with the losses associated with long-term conditions and of imagining new meanings and purposes for the future ahead. This process is characterised by a set of linear temporal stages, from loss and denial to acceptance and reappraising the life-course, by an emphasis on the morally desirable exercise of self-care and by a desired outcome that, in the absence of cure, is hope. Through interviews, we aim to unsettle the privileged status given to a positive outlook through examining the expressions, contexts and negotiations of hopelessness of people living with multiple conditions of ill-health and/or disability. These narratives of hopelessness disclose the ways in which realistic imagined possibilities for the future are constrained by external structures of time and function that demand complex negotiations with places, bodies and other people. As a situated and relational narrative, hopelessness draws our attention to the need to rebalance the exclusive attention to individual, internal resources with a renewed attention to contexts and settings. Moreover, hopelessness can be generative for those living with multiple conditions in shaping alternatively framed priorities with respect to their temporal and interpersonal relations.
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Affiliation(s)
- Lindsay-Ann Coyle
- Durham University, Department of Geography and the Centre for Medical Humanities, Lower Mountjoy, DH1 3LE, United Kingdom
| | - Sarah Atkinson
- Durham University, Department of Geography and the Centre for Medical Humanities, Lower Mountjoy, DH1 3LE, United Kingdom.
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Husson O, Zebrack B, Block R, Embry L, Aguilar C, Hayes-Lattin B, Cole S. Posttraumatic growth and well-being among adolescents and young adults (AYAs) with cancer: a longitudinal study. Support Care Cancer 2017; 25:2881-2890. [PMID: 28424888 PMCID: PMC5527055 DOI: 10.1007/s00520-017-3707-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 04/10/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE This study examines posttraumatic growth (PTG) among adolescents and young adults (AYAs) with cancer, as well as its correlates and trajectories over time. The study also explores the buffering role of PTG on the associations between posttraumatic stress (PTS), health-related quality of life (HRQoL), and psychological distress. METHODS A multicenter, longitudinal, prospective study was conducted among AYA cancer patients aged 14-39 years. One hundred sixty-nine patients completed a self-report measure of PTG (PTGI) and PTS (PDS) 6, 12, and 24 months after baseline (within the first 4 months of diagnosis). At 24-month follow-up, HRQoL (SF-36) and psychological distress (BSI-18) were also assessed. RESULTS Among participants, 14% showed increasing PTG, 45% remained at a stable high PTG level, 14% showed decreasing PTG, and 27% remained at a stable low PTG level. AYAs who remained high on PTG were more often younger, female, and received chemotherapy. PTG level at 6-month follow-up was predictive of mental HRQoL (β = 0.19; p = 0.026) and psychological distress (β = -0.14; p = 0.043) at 24-month follow-up when corrected for PTS and sociodemographic and clinical covariates. No relationship between PTG and physical HRQoL was found. The interactive effects of PTS and PTG on outcomes were not significant, indicating that buffering did not take place. CONCLUSION This study indicates that PTG is dynamic and predicts mental well-being outcomes but does not buffer the effects of PTS. Psychosocial interventions should focus on promoting PTG and reducing PTS in order to promote the adjustment of AYAs diagnosed with cancer.
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Affiliation(s)
- O Husson
- Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands.
| | - B Zebrack
- University of Michigan School of Social Work, Ann Arbor, MI, USA
| | - R Block
- MNR Analytics, Portland, OR, USA
| | - L Embry
- Pediatric Hematology/Oncology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - C Aguilar
- Pediatric Hematology/Oncology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - B Hayes-Lattin
- Oregon Health and Sciences University, Portland, OR, USA
| | - S Cole
- HopeLab Foundation, Redwood City, CA, USA
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Trusson D, Pilnick A. Between stigma and pink positivity: women's perceptions of social interactions during and after breast cancer treatment. SOCIOLOGY OF HEALTH & ILLNESS 2017; 39:458-473. [PMID: 27577849 DOI: 10.1111/1467-9566.12486] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study explores women's perceptions of social interaction during and after their treatment for early stage breast cancer. An analysis of interviews with 24 women between 6 months and 29 years post-diagnosis reveals that interactions can be influenced by conflicting public discourses surrounding breast cancer. For example, there is the continuing association of cancer with death and the resulting potential for a stigmatised identity. In contrast is the ultra-positive discourse around cancer survivorship, with breast cancer in particular being associated with pink campaigning and a push towards positive thinking. Participants described managing conversations during treatment; sometimes playing down their private suffering and presenting a positive (public) image rather than risk alienating support. After treatment they were encouraged to move on and get back to 'normal'. While other breast cancer patients and survivors were often good sources of support, there was also a danger of assuming that all experiences would be the same. We present data to illustrate that women often present public accounts that are driven by an expectation of positivity and fear of stigmatisation at all stages of breast cancer treatment and beyond.
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Affiliation(s)
- Diane Trusson
- School of Sociology and Social Policy, University of Nottingham, UK
| | - Alison Pilnick
- School of Sociology and Social Policy, University of Nottingham, UK
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Gilbert É, Savard J, Gagnon P, Savard MH, Ivers H, Foldes-Busque G. To be or not to be positive: Development of a tool to assess the relationship of negative, positive, and realistic thinking with psychological distress in breast cancer. J Health Psychol 2016; 23:731-742. [PMID: 27923883 DOI: 10.1177/1359105316681062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
There is a widespread belief that positive thinking is a key strategy to cope with cancer. While dispositional optimism is associated with lower psychological distress, the literature supporting the efficacy of cognitive-behavioral therapy indirectly suggests that realistic thinking is also effective. This article describes the development of the Thoughts and Anticipations about Cancer questionnaire designed to directly compare the effect of realistic thinking versus positive thinking on adjustment to cancer. Preliminary data on its relationships with psychological distress gathered in 10 breast cancer patients are promising. The validity of the Thoughts and Anticipations about Cancer questionnaire will need to be confirmed in larger studies.
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Affiliation(s)
- Émilie Gilbert
- 1 School of Psychology, Université Laval, Québec, Canada
- 2 CHU de Québec-Université Laval Research Center, Québec, Canada
- 3 Université Laval Cancer Research Center, Québec, Canada
| | - Josée Savard
- 1 School of Psychology, Université Laval, Québec, Canada
- 2 CHU de Québec-Université Laval Research Center, Québec, Canada
- 3 Université Laval Cancer Research Center, Québec, Canada
| | - Pierre Gagnon
- 1 School of Psychology, Université Laval, Québec, Canada
- 2 CHU de Québec-Université Laval Research Center, Québec, Canada
- 3 Université Laval Cancer Research Center, Québec, Canada
| | - Marie-Hélène Savard
- 2 CHU de Québec-Université Laval Research Center, Québec, Canada
- 3 Université Laval Cancer Research Center, Québec, Canada
| | - Hans Ivers
- 1 School of Psychology, Université Laval, Québec, Canada
- 2 CHU de Québec-Université Laval Research Center, Québec, Canada
- 3 Université Laval Cancer Research Center, Québec, Canada
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Kang H, Stenfors-Hayes T. Feeling Well and Having Good Numbers: Renal Patients' Encounter With Clinical Uncertainties and the Responsibility to "Live Well". QUALITATIVE HEALTH RESEARCH 2016; 26:1591-602. [PMID: 26130653 DOI: 10.1177/1049732315591484] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Individuals living with chronic kidney disease (CKD) must be mindful of their diet and exercise, take multiple medications, and deal with other compounding illnesses. We observed renal patients' encounters with health professionals at a renal clinic for tensions and gaps in patients' and health professionals' understandings of "living well" with CKD. We found that the renal patients at the clinic become emotionally invested in the fluctuations in the numbers on their blood work. Narrative practices of health professionals greatly affect how patients emotionally deal with the possibility of dialysis, transplant, death, or aging. Expectations to "live well" can become a moral burden to be a "good" patient. The gaps between the priorities of patients, their caregivers, and health professionals complicate the notion of "living well" with CKD. Trust, rapport and the practice of listening appear to have the greatest impact in addressing these gaps.
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Affiliation(s)
- Helen Kang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
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Abstract
In this study, we link together moments of discrimination described by young bisexual women. We do so in order to theorize about associations between negative stereotypes heard early in one’s life and later minimization of personal discrimination. Using interviews with 13 young women, we sought to understand the types of negative messages participants heard about “bi/sexuality” as well as the ways that they perceived or did not perceive themselves as having experienced discrimination related to their sexuality. We found that family members and friends often described participants’ bisexuality as “disgusting,” “difficult to understand,” or “hot,” and participants described their own experiences with discrimination as “no big deal.” We use this analysis to build on previous research concerning microaggressions, sexual stigma, and denial of discrimination to discuss how familial, social, and political environments create a set of conditions in which later injustices are imagined as normative and inevitable. Finally, we discuss the methodological dilemmas facing feminist psychologists who aim to analyze discrimination and the challenges in documenting individuals’ experiences of stigma, which may be imagined as no big deal to individuals, but are in fact unjust. It is imperative to develop strategies to recognize, document, and critically assess how injustice becomes all too normal for some and the role that feminist psychology can play in changing this. A podcast conversation with the author of this article is available on PWQ 's website at http://pwq.sagepub.com/site/misc/Index/Podcasts.xhtml
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Affiliation(s)
- Sara I. McClelland
- Departments of Psychology and Women’s Studies, University of Michigan, Ann Arbor, MI, USA
| | - Jennifer D. Rubin
- Departments of Psychology and Women’s Studies, University of Michigan, Ann Arbor, MI, USA
| | - José A. Bauermeister
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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Michael N, O'Callaghan C, Clayton JM. Exploring the utility of the vignette technique in promoting advance care planning discussions with cancer patients and caregivers. PATIENT EDUCATION AND COUNSELING 2016; 99:1406-1412. [PMID: 27021780 DOI: 10.1016/j.pec.2016.03.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 01/26/2016] [Accepted: 03/19/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE We aimed to specifically examine patients' and caregivers' perspectives about the use of the vignette technique (VT) integrating clinical scenarios, as a potential tool for facilitating advance care planning (ACP) discussions. METHODS Secondary analysis of data from three studies that incorporated the VT, focusing on statements specific to use of the VT and using a qualitative descriptive design informed by grounded theory. RESULTS Data from 85 participants were analyzed. Participants varied in their personal identification with scenarios, with caregivers being more accurate. Scenarios prompted consideration and participation in ACP discussions, sometimes steering conversations in directions that participants were ready to consider. However, scenarios also risked evoking distress in participants who may have chosen to avoid discussions. CONCLUSIONS For some patients, scenarios of possible clinical outcomes may provide a neutral platform to promote ACP conversations in a non-threatening manner and allow for exploration of ACP domains to greater depth. PRACTICE IMPLICATIONS Vignettes may be used in staff training through role-play or case discussions; as part of face-to-face interventions to improve knowledge and information processing and to facilitate the initiation of sensitive conversations. Its use in audio-visual formats may further enhance end-of-life dialogue and warrants further consideration.
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Affiliation(s)
- Natasha Michael
- Palliative Care Service, Cabrini Health, Melbourne, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia.
| | - Clare O'Callaghan
- Palliative Care Service, Cabrini Health, Melbourne, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; St Vincent's Hospital, University of Melbourne, Melbourne, Australia
| | - Josephine M Clayton
- HammondCare Palliative and Supportive Care Service, Greenwich Hospital, Sydney, Australia; Sydney Medical School, University of Sydney, Sydney, Australia
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Adams E. VI. `You Get on a Rollercoaster Where you Can't Get Off': Treatment Decision Making and `Choice' in the Context of Infertility after Breast Cancer. FEMINISM & PSYCHOLOGY 2016. [DOI: 10.1177/0959353507079087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Since the introduction of antiretroviral drug treatments, there has been increased interest in the psychological aspects of living with HIV and a growth of related research and therapeutic literature. While there has been concern about the ‘remedicalization’ of HIV, there is apparently less concern about its ‘psychologization’. This article considers how the expansion of psychological discourse about HIV impacts on the lives of HIV-positive people in the era of contemporary treatments. Through analysis of group discussions with HIV-positive gay men, we examine how psychological strategies and terminology are adopted or reworked to cope with the uncertainties of living with HIV. We consider both the enabling and constraining effects of psychological modes of regulation, as they are taken up and reworked by HIV-positive people. Our analysis suggests a need for greater scrutiny of the ways in which psychological techniques are employed as solutions to the ambiguities of living with HIV.
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Abstract
Since the introduction of antiretroviral drug treatments, there has been increased interest in the psychological aspects of living with HIV and a growth of related research and therapeutic literature. While there has been concern about the ‘remedicalization’ of HIV, there is apparently less concern about its ‘psychologization’. This article considers how the expansion of psychological discourse about HIV impacts on the lives of HIV-positive people in the era of contemporary treatments. Through analysis of group discussions with HIV-positive gay men, we examine how psychological strategies and terminology are adopted or reworked to cope with the uncertainties of living with HIV. We consider both the enabling and constraining effects of psychological modes of regulation, as they are taken up and reworked by HIV-positive people. Our analysis suggests a need for greater scrutiny of the ways in which psychological techniques are employed as solutions to the ambiguities of living with HIV.
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Affiliation(s)
- Martin Holt
- National Centre in HIV Social Research, University of New South Wales, Australia.
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37
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Wilkinson S. Breast Cancer: Feminism, Representations and Resistance – a Commentary on Dorothy Broom’s ‘Reading Breast Cancer’. Health (London) 2016. [DOI: 10.1177/136345930100500207] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this commentary, I identify two sets of coercive ‘discourses and practices’ which typically oppress women with breast cancer: the imperative of concealment and the notion of personal blame and responsibility for their illness. I examine how a feminist analysis can support and encourage resistance to such coercive ‘discourses and practices’, and I argue for a thoroughgoing feminist approach to breast cancer more generally.
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38
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Bishop FL, Yardley L. Constructing Agency in Treatment Decisions: Negotiating Responsibility in Cancer. Health (London) 2016; 8:465-82. [PMID: 15358899 DOI: 10.1177/1363459304045699] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
People belonging to cancer patient support groups participated in focus groups concerning their experiences of orthodox and complementary medicine. Their accounts of treatment decisions for cancer were analysed through discourse analysis. Accounts of both complementary and orthodox medicine addressed an ideological dilemma concerning the positioning of individuals as active or passive. Active positions were congruent with the everyday value of autonomy and responsible individuality, but conflicted with the established expertise of the medical profession in cancer and entailed being accountable for one’s health. Passive positions reversed this situation. Complementary medicine provided an opportunity for people with cancer to negotiate active positions in a limited domain of health care. The responsibility for health associated with taking active treatment decisions was problematic in accounts of both orthodox and complementary medicine.
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Peel E, Parry O, Douglas M, Lawton J. Taking the Biscuit? A Discursive Approach to Managing Diet in Type 2 Diabetes. J Health Psychol 2016; 10:779-91. [PMID: 16176956 DOI: 10.1177/1359105305057313] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Adopting and maintaining a healthy diet is pivotal to diabetic regimens. Behavioural research has focused on strategies to modify/maintain healthy behaviours; thus ‘compliance’ and ‘ noncompliance’ are operationalized by researchers. In contrast, discursive psychology focuses on the actions different accounts accomplish—in this case regarding diets. Using thematic discourse analysis, we examine dietary management talk in repeat-interviews with 40 newly diagnosed type 2 diabetes patients. Women in our study tended to construct dietary practices as an individual concern, while men presented food consumption as a family matter. Participants accounted for ‘cheating’ in complex ways that aim to accomplish, for instance, a compliant identity. Discursive psychology may facilitate fluidity in our understandings of dietary management, and challenge fixed notions of ‘compliant’ and ‘non-compliant’ diabetes patients.
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Affiliation(s)
- Elizabeth Peel
- Department of Psychology, Life and Health Sciences, Aston University, Birmingham, UK.
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40
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Wilkinson S. Feminist Research Traditions in Health Psychology: Breast Cancer Research. J Health Psychol 2016; 5:359-72. [DOI: 10.1177/135910530000500308] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This article discusses three key traditions of feminist research: positivist empiricist, experiential and discursive. It explores the ways in which each is used in developing understandings of women’s health and improving health care services, focusing in particular on breast cancer research and activism, including my own work in this area. It is argued that all three research traditions are important for advancing feminist political goals: positivist empiricism enables us to expose the biases of mainstream health research and to develop better (i.e. more objective) research; experiential approaches enable us to engage with the diversity of women’s subjective experiences of health and health care; and discursive research enables us to explore issues related to identity management, accountability of conduct and the moral order of social life surrounding health and illness.
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41
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Lewis S, Willis K, Yee J, Kilbreath S. Living Well? Strategies Used by Women Living With Metastatic Breast Cancer. QUALITATIVE HEALTH RESEARCH 2016; 26:1167-1179. [PMID: 26130655 DOI: 10.1177/1049732315591787] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Metastatic breast cancer is a disease of changing status-once an imminent death sentence, now a chronic (albeit incurable) disease. Medical intervention advances mean women with metastatic breast cancer now have symptoms alleviated and, potentially, life extended. Living with this disease, however, requires more than a medical approach to symptoms. We were interested to know whether women manage, and if so, how, to "live well" with metastatic cancer. We conducted interviews with 18 women. Women differed in the approaches they used. Most common was the attempt to reestablish a sense of normality in their lives. However, a second group reevaluated and reprioritized their lives; and a third group was restricted in their capacity to live well because of symptoms. The findings provide the foundation for future research exploring normalization of experiences of metastatic cancer, and other chronic illnesses, where people are living with knowledge that they have contracted time.
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Affiliation(s)
| | - Karen Willis
- Australian Catholic University, Melbourne, Australia
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D'Abramo F, Goerling U, Guastadisegni C. Targeted drugs and Psycho-oncological intervention for breast cancer patients. J Negat Results Biomed 2016; 15:6. [PMID: 27036549 PMCID: PMC4818528 DOI: 10.1186/s12952-016-0049-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/09/2016] [Indexed: 01/06/2023] Open
Abstract
Personalized medicine is a new field based on molecular biology and genomics in which targeted tumor therapies are administered to patients. Psycho-oncology is a complementary approach that considers social and psychological aspects of patients as part of the treatments for cancer patients. The aim of this mini-review is to weigh clinical benefits for breast cancer patients of both treatments and possibily enhance benefits by modulating the use of both interventions. We have compared and evaluated on the one hand the use of anti Vascular Endothelial Growth Factor and, on the other hand, psycho-oncological interventions in metastatic and non-metastatic breast cancer patients. Both treatments did not increase survival of metastatic breast cancer patients, while in a selected study psycho-oncological interventions extended lifespan of non-metastatic breast cancer patients and ameliorate psychological and social factors of metastatic breast cancer patients. Because the two approaches address completely different aspects of cancer patients, if the comparison is limited to the extension of survival, the value of these two treatments cannot be assessed and compared. It is likely that by comparing patients reported outcomes, possibly by using standardized Quality of Life questionnaires, both patients and health care providers can weigh the benefits of the two treatments. It is therefore important to evaluate the use of cancer patients’ quality of life measures as a mean to improve their experiences about life and treatment, and possibly to extend their survival.
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Affiliation(s)
- Flavio D'Abramo
- Department of Psychology, Freie Universität Berlin, Hittorfstr. 16, 14195, Berlin, Deutschland.
| | - Ute Goerling
- Charité Comprehensive Cancer Center, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Cecilia Guastadisegni
- Department of Environment and Primary Prevention, Italian National Institute of Health, ISS, V.le Regina Elena 299, 00161, Rome, Italy
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43
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Ross EJ. ‘I think it’s self-preservation’: risk perception and secrecy in early pregnancy. HEALTH RISK & SOCIETY 2015. [DOI: 10.1080/13698575.2015.1091922] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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44
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Riessman CK. Ruptures and sutures: time, audience and identity in an illness narrative. SOCIOLOGY OF HEALTH & ILLNESS 2015; 37:1055-1071. [PMID: 25923981 DOI: 10.1111/1467-9566.12281] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
First-person accounts of the illnesses experienced by sociologists have taken hybrid experimental forms. I add my voice to this growing tradition with a story about the discovery and treatment of a soft tissue sarcoma in my thigh, chronicled in a journal I kept over many months. The fragments scribbled in the journal became the basis of an extended illness narrative. I interrogate features of the narrative itself, including the handling of time and imagined audiences - those I was writing for. The illness narrative traces how cancer transformed the many identities I enact on a daily basis and how the invisible labour of particular health workers enabled the restoration of several prized identities. These workers - radiation, occupational and physical therapists - are typically subordinated in the medical hierarchy and the interactional work that they do with patients to restore and reconfigure ruptured identities after serious illness needs attention in medical sociology.
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45
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Markle GL, Attell BK, Treiber LA. Dual, Yet Dueling Illnesses: Multiple Chronic Illness Experience at Midlife. QUALITATIVE HEALTH RESEARCH 2015; 25:1271-1282. [PMID: 25420479 DOI: 10.1177/1049732314559948] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The prevalence of multiple chronic illnesses is increasing dramatically, especially among those in middle adulthood, yet much prior research has focused on the experience of multiple morbidity among older adults. We examined the online illness narratives (blogs) of 10 men and women aged 36 to 59 to better understand the experience of living with multiple chronic illnesses at midlife. Multiple morbidity presents distinct challenges to those at midlife: (a) diagnosis and management of multiple illnesses, (b) need for information, (c) identity dilemmas and threats to self-image, and (d) stigma and social rejection. Relinquishing the work identity was especially difficult for participants because it threatened to foreshorten middle adulthood and push them prematurely into late adulthood. Participants used their blogs to revise their identities, alleviate isolation, and inform and guide others.
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46
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Egan R, Llewellyn R, Wood S, Doherty J, Albert T, Walsh C, Atkinson K, Kerslake P. The Cancer Stories Project: narratives of encounters with cancer in Aotearoa, New Zealand. Psychooncology 2015. [DOI: 10.1002/pon.3914] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Richard Egan
- University of Otago, Cancer Society Social and Behavioural Research Unit; Department of Preventive and Social Medicine; New Zealand
| | - Rebecca Llewellyn
- University of Otago, Cancer Society Social and Behavioural Research Unit; Department of Preventive and Social Medicine; New Zealand
| | - Sarah Wood
- University of Otago, Cancer Society Social and Behavioural Research Unit; Department of Preventive and Social Medicine; New Zealand
| | | | - Tira Albert
- Mana Wahine, Kokiri Marae Health and Social Services; Wellington New Zealand
| | - Chris Walsh
- Health Quality and Safety Commission; New Zealand
| | - Kelly Atkinson
- Cancer Society of New Zealand; Relay For Life and Community Development; New Zealand
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47
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Ruthig JC, Holfeld B. Positive Thinking and Social Perceptions of a Male vs. Female Peer's Cancer Experience. The Journal of Social Psychology 2015; 156:154-67. [PMID: 25988794 DOI: 10.1080/00224545.2015.1052361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Positive thinking (PT; i.e., sustaining positive thoughts and suppressing negative thoughts to "fight" cancer) is often equated with direct control over one's cancer trajectory. It was determined whether PT exposure enhanced the effort, control, and responsibility attributions ascribed to a peer for his/her cancer trajectory, and whether those ascriptions varied as a function of the peer's or participant's gender. Within a hypothetical online blog, a peer described a personal experience with bone cancer. Undergraduate participants (N = 630) were randomly administered one of 12 experimental conditions that varied in terms of the peer's gender, PT exposure, and cancer outcome. MANCOVA results indicated that PT exposure enhanced the effort, control, and responsibility attributions assigned to the peer for an unsuccessful cancer outcome, regardless of the peer's or participant's gender. Moreover, the male peer was perceived as more accountable for still having cancer but the female peer received more "credit" for being cancer-free. The notion of PT may contribute to overestimating cancer patients' personal influence over their disease trajectory and social perceptions of successful or unsuccessful cancer outcomes vary as a function of the patient's gender.
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48
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Levy A, Cartwright T. Men's strategies for preserving emotional well-being in advanced prostate cancer: An interpretative phenomenological analysis. Psychol Health 2015; 30:1164-82. [PMID: 25871263 DOI: 10.1080/08870446.2015.1040016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study explores men with advanced prostate cancers' own practices for promoting and maintaining emotional well-being using Interpretative Phenomenological Analysis. DESIGN Five men with advanced prostate cancer participated in face-to-face, semi-structured, in-depth interviews. RESULTS Within rich narratives of lost and regained well-being, two super-ordinate themes emerged--'living with an imminent and uncertain death' and 'holding on to life.' Well-being was threatened by reduced sense of the future, isolation and uncertainty. Yet, the men pursued well-being by managing their emotions, striving for the future whilst enjoying life in the present, taking care of their families and renegotiating purpose. Running through participant's accounts was a preference for taking action and problem-solving. Sense of purpose, social connectedness, and life engagement were revealed as concepts central to improving well-being, indicating areas which practitioners could explore with men to help them re-establish personal goals and life purpose. CONCLUSIONS The findings also add weight to the evidence base for the potential value of psychological interventions such as cognitive behaviour therapy and mindfulness in men with prostate cancer.
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Affiliation(s)
- Anneliese Levy
- a Department of Psychology , University of Westminster , London , UK
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49
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Mische Lawson L, Chau J, Schoel A. Thematic analysis of tiles painted by blood and marrow transplant patients during treatment. Eur J Cancer Care (Engl) 2015; 25:1044-1055. [DOI: 10.1111/ecc.12328] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2015] [Indexed: 11/30/2022]
Affiliation(s)
- L. Mische Lawson
- Department of Occupational Therapy Education; University of Kansas Medical Center; Kansas City KS 66160 USA
| | - J. Chau
- Department of Occupational Therapy Education; University of Kansas Medical Center; Kansas City KS 66160 USA
| | - A. Schoel
- Department of Occupational Therapy Education; University of Kansas Medical Center; Kansas City KS 66160 USA
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50
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Norberg M, Magnusson E, Egberg Thyme K, Åström S, Lindh J, Öster I. Breast cancer survivorship--intersecting gendered discourses in a 5-year follow-up study. Health Care Women Int 2015; 36:617-33. [PMID: 25692802 DOI: 10.1080/07399332.2015.1017640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In this article the authors present a follow-up study of women's interview narratives about life 5 to 7 years after a breast cancer operation. The women had taken part in a study during the 6-month postoperation period. Art therapy contributed to well-being, including strengthening personal boundaries. In the new study, interview analysis informed by critical discursive psychology indicated three problematic discourses that the women still struggled with several years after the operation: the female survivor, the "good woman," and individual responsibility. We concluded that many women with a history of breast cancer need support several years after their medical treatment is finished.
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Affiliation(s)
- Monika Norberg
- a Department of Nursing , Umeå University , Umeå , Sweden
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