A longitudinal study on women?s experiences of life with breast cancer in anthroposophical (complementary) and conventional care

Corporeal Posttraumatic Growth As a Result of Breast Cancer: An Interpretative Phenomenological Analysis

Women’s traumatic experience of breast cancer (BC) can result in posttraumatic growth (PTG). Women’s embodied experiences of BC seem particularly pertinent to their experiences of both difficulty and growth. While PTG is usually conceptualized as having five domains, it seems that BC survivors experience a sixth domain—corporeal PTG (CPTG). CPTG was recently defined as a “reclaiming” and renewed connection to the body through increased appreciation of the physical self, a new sense of bodily responsibility, positive health changes, and a new sense of positive identification with the body. This study’s aim was to explore how women experience CPTG due to BC. In-depth interviews were conducted with female BC survivors. Interpretative phenomenological analysis extracted three themes: losing, regaining, and relinquishing ultimate control over the body, reconstructing embodied identity, and a newfound appreciation for the body. Participants spoke of a complicated journey from distress, loss, and fragmentation to a reshaping of their assumptions about their bodies. The findings suggest that the body plays a vital role in women’s traumatic and growth-related experiences of BC. Future research on the embodied experience of BC is recommended as it forms a crucial part of BC recovery.

The power of touch: external applications from whole medical systems in the care of cancer patients (literature review)

PURPOSE

In the context of whole medical systems (WMSs), external applications are manual treatments that stem from complementary medicine and are performed by practitioners, nurses and caregivers through the application of interpersonal touch. These applications work via physiological, psychological and social processes and are intended for holistic healing. In integrative oncology, these applications are used to improve patients' wellbeing. The purpose of the review is to collect and compare research results concerning external applications from WMSs applied to patients with cancer.

METHODS

We conducted a literature review to explore the effects of external applications on patients undergoing cancer treatment. Inclusion criteria were external applications from Anthroposophic Medicine, Traditional Chinese Medicine (TCM) and Ayurvedic Medicine, examined detached from the effect interdependencies of their respective WMSs.

RESULTS

Searches identified 111 publications. Final inclusions were four Shiatsu studies (from TCM), supplemented by two case reports exploring anthroposophic external applications. The literature review suggests that external applications may improve patients' wellbeing during cancer treatment and are associated with physical and psychological effects that potentially enhance supportive cancer care. The number and quality of published studies in the field is limited.

CONCLUSIONS

Future empirical investigations should assess the effectiveness and underlying effects in patients with cancer, adhere to a patient-tailored approach, and investigate the systemic complexity of touch-based applications from WMSs.

Motivation of cancer patients to help others and the relation between posttraumatic growth and helping

Background

Posttraumatic growth (PTG) is related to positive psychological changes following people’s struggle with trauma. The PTG model suggests that one of its possible consequences may be higher motivation towards helping behaviours. The aim of the research was to explore the influence of cancer illness on the motivation to help others, as perceived by participants, and the mechanisms behind such behaviour.

Participants and procedure

Quantitative and qualitative methods were used to explore the main motives to help others among cancer patients. The study also investigated the relation of perceived growth (PTG) and the frequency of providing help. Female cancer patients (n = 100) com-pleted a Polish version of the Posttraumatic Growth Inventory and a questionnaire measuring frequency of providing help to-wards ill and healthy individuals. Some of the subjects (n = 29) were also interviewed to assess the main perceived motives to help others.

Results

Positive rho Spearman correlations between PTG and the frequency of help given towards ill individuals and healthy ones were found. Based on thematic analysis four motives of helping were identified: empathy, self-enhancement, internalized standards of behaviour, searching for the sense of life.

Conclusions

This findings highlight the positive association between cancer patients’ involvement in helping other cancer patients and posi-tive life changes after experience of cancer.

Liminality as a dimension of the experience of living with terminal cancer

Objective

This paper is concerned with the phenomenology of death awareness within the context of being diagnosed with terminal cancer. The objective of the research presented here is to provide a deeper insight into terminally ill cancer patients’ engagement with their mortality.

Method

The analysis forms part of a wider project that involved conducting a metasynthesis of 23 phenomenological studies of the experience of living with the awareness of having terminal cancer published between 2011 and 2016.

Result

The metasynthesis identified four master themes that represent distinct experiential dimensions of living with terminal cancer. This paper focuses on one of these themes, liminality, to provide novel insights into the structure of death awareness whilst living with terminal cancer.

Significance of results

The results suggest that liminality describes an experiential space from within which terminal cancer patients encounter a new relationship with their existence. Liminality offers opportunities for both connection (e.g., with the natural world) as well as disconnection (e.g., from loved ones and others who still have a future) and therefore contains the potential for suffering and distress as well as for joy and a sense of fulfillment. This understanding of liminality can help healthcare professionals provide psychological support for this client group.

Aesthetic Engagements

Living with advanced cancer can present an overwhelming challenge. It may impact the everyday life of the individual with respect to an array of psychological, physical, social, and existential issues. We focus on ways in which people with advanced cancer experience and use their engagement in daily activities when confronting nearing death. Through a phenomenological analysis based on Heidegger’s thinking, we illuminate the complexities of “being toward death” and the human striving for authentic being through engagement in daily living. The main findings demonstrate how sensory experiences support being through an appreciation of everyday aesthetics. Furthermore, the making of material things was identified as a means to express the value of self and others in relation to the involved individual’s past, present, and future.

A Methodological Framework for Evaluating the Evidence for Complementary and Alternative Medicine (CAM) for Cancer

In spite of lacking evidence for effects on cancer progression itself, an increasing number of cancer patients use various types of complementary and alternative medicine (CAM). There is disagreement between CAM practitioners, researchers and clinical oncologists, as to how evidence concerning effects of CAM can and should be produced, and how the existing evidence should be interpreted. This represents a considerable challenge for oncologists; both in terms of patient needs for an informed dialogue regarding CAM, and because some types of CAM may interact with standard treatments. There is a need for insight into which kinds of CAM may work, for whom they work, what the possible effects and side-effects are, and in what ways such effects may come about. The present article presents a framework for evaluating effects of CAM by suggesting a taxonomy of different levels of evidence related to different types of research questions and discussing the relevance of different research methodologies for different types of effects.

Anthroposophic health care in Sweden - a patient evaluation

This study surveyed patients and their satisfaction with an integrative anthroposophic hospital. The patients were followed up by questionnaires up to six months after a stay in a Swedish clinic. Satisfaction with the care, life satisfaction, and health-related quality of life were measured for 53 patients, 48 women, 5 men, with cancer, pain diseases, and psychosomatic problems. Sampling was consecutive and due to regional reasons. The evaluation of patients' satisfaction from the anthroposophic clinic (AC) was compared to similar questions of patients using conventional hospital care. The stay lasted 7-21 days and was paid by the patients' county councils. Causes for choosing AC were predominantly a positive attitude towards a holistic health view and expectations on being cared for. Less frequently noted was dissatisfaction with conventional care. Satisfaction with health care given after one month by the AC was sample scored more positively than the highest unit in the conventional clinic. This is important because women in conventional clinic report lower satisfaction. The AC sample consisted of 91% women with an average age of 54 years and a higher level of education compared to the sample from the conventional hospital. Health-related quality of life and life satisfaction was, if not significant, moderately increased during the following six months. The AC initiated a new attitude and change in life habits that stimulated the patients into improving their life style habits and hence their overall health. Still challenging is the gender question. Why do middle-aged, well-educated women experience a need for and a satisfaction in complementary and integrative health care?

Reframing: psychological adjustment of Chinese women at the beginning of the breast cancer experience

In this article, we present findings from a larger study that explored how Chinese women cope with breast cancer. We report on the process of early psychological adjustment, along with contextual factors and how they influence the women's coping mechanisms at the beginning of the cancer experience. Twenty-four women with diagnoses of breast cancer were interviewed. The grounded theory method was adopted in data collection and analysis. "Reframing" was the core category of the early adjustment process. Focus and approach were the two contextual conditions. Women adopted "fighting," "following the natural course," "struggling," and "bearing" modes in coping with the disease. These findings highlight the significance of focusing on coping and realizing the role of the self in creating a subjective positive interpretation, which subsequently enhances acceptance of the disease at the beginning of the cancer experience. Characteristics of the Chinese people with respect to coping include the collaborative meaning of control and the philosophy of acquiescence to fate.

Post-traumatic growth and life threatening physical illness: a systematic review of the qualitative literature

Post-traumatic growth (PTG) is the phenomenon of positive change through the experience of trauma and adversity (O'Leary & Ickovics, 1995). Research suggests that the type of trauma sustained could have differing processes and outcomes from each other (Demark-wahnefried et al., 2000; Sabiston, McDonough, and Crocker, 2007). The aim of this study was to synthesize qualitative data on PTG and illness related trauma. Fifty-seven published journal articles dating from before November 1st, 2007 in PsychINFO, MEDLINE, EMBASE, Web of Knowledge and from the authors own knowledge of the area were reviewed. Key words included PTG; benefit finding; thriving and positive changes. Key themes included: 'reappraisal of life and priorities'; 'trauma equals development of self'; 'existential re-evaluation'; and 'a new awareness of the body'. Findings suggest that there are unique elements to illness related PTG and a need for additional research into the processes and outcomes of physical illness related trauma.