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Kring L, Iversen E, Ibsen B, Fehsenfeld M. Exploring the impact of stressful life events on quality of life: meaning making and narrative reconstruction. Int J Qual Stud Health Well-being 2024; 19:2330117. [PMID: 38525819 DOI: 10.1080/17482631.2024.2330117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/08/2024] [Indexed: 03/26/2024] Open
Abstract
PURPOSE Stressful life events have the capacity to disrupt an individual's worldview and life goals, leading to existential questions and identity loss. The subjective perception of identity is intricately linked with quality of life (QoL), and how individuals derive meaning from these stressful life events significantly influences their well-being. This article explored the impact of stressful life events on individuals' QoL, and examined the potential for enhancing QoL through meaning making and narrative reconstruction. METHODS Qualitative interviews were conducted with 11 individuals reporting diminished QoL and analysed using thematic analysis. RESULTS The study reveals that stressful life events confront interviewees with the vulnerability of their values in life and the limits of their control, leading them to question their own beliefs and purpose in life. Consequently, these events prompt individuals to reconstruction their narratives to adapt to new life circumstances. CONCLUSIONS The study suggests that "securing the base," including strong social relations and security in economic and housing conditions, is a prerequisite for enhancing QoL. The insights on "the base" have profound implications for QoL. Recognizing their fundamental importance, policymakers, healthcare professionals, and social service providers can support mechanisms to enhance these foundations, improving overall well-being for individuals and communities.
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Affiliation(s)
- Lotte Kring
- The Faculty of Health Sciences, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Evald Iversen
- Centre for Sports, Health and Civil Society (CISC), Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Bjarne Ibsen
- Centre for Sports, Health and Civil Society (CISC), Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Sanders T, Fryer K, Greco M, Mooney C, Deary V, Burton C. Explanation for symptoms and biographical repair in a clinic for persistent physical symptoms. SSM. QUALITATIVE RESEARCH IN HEALTH 2024; 5:100438. [PMID: 38915733 PMCID: PMC11195018 DOI: 10.1016/j.ssmqr.2024.100438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 04/18/2024] [Accepted: 04/19/2024] [Indexed: 06/26/2024]
Abstract
Introduction Biographical disruption describes the process by which illness impacts not just on a person's body and their participation in activities, but also on their sense of self. Biographical disruption is often followed by a process of biographical repair in which identity is reconstructed and a new normality is restored. People with persistent physical symptoms (sometimes referred to as medically unexplained symptoms) experience biographical disruption. This can be complicated by lack of explanation and the implication that if the problem is not medical, then it might be the person/psychological. We aimed to examine this tension in people attending a novel "Symptoms Clinic" for people with persistent physical symptoms. Methods This study reports an embedded qualitative study in a UK based randomised controlled trial. Data were collected by audio recordings of consultations and semi-structured interviews with patients. We used theoretically informed thematic analysis with regular coding and discussion meetings of the analysis team. This analysis explores the role of intervention components in facilitating biographical repair. Results The lack of acceptable explanation for persistent symptoms acted as a block to biographical repair. In the clinic, multi-layered explanations were offered and negotiated that viewed persistent symptoms as understandable entities rather than as indicators of something still hidden. These explanations allowed study participants to make sense of their symptoms and in turn opened new opportunities for self-management. The result was that participants were able to reframe their symptoms in a way that enabled them to see themselves differently. Even if symptoms had not yet improved, there was a sense of being better. This can be understood as a process of biographical repair. Conclusion Explaining persistent physical symptoms enables biographical repair.
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Affiliation(s)
- Tom Sanders
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Northumbria Building, Newcastle upon Tyne, NE1 8ST, UK
| | - Kate Fryer
- Division of Population Health, Sam Fox House, Northern General Hospital, University of Sheffield, Sheffield, S5 7AU, UK
| | - Monica Greco
- Department of Social and Policy Sciences, University of Bath, Claverton Down, Bath, BA2 7AY
| | - Cara Mooney
- Clinical Trials Research Unit, School for Health & Related Research, University of Sheffield, Innovation Centre, Sheffield, S1 4DA, UK
| | - Vincent Deary
- Department of Psychology, Northumbria University, Northumbria Building, Newcastle upon Tyne, NE1 8ST, UK
| | - Christopher Burton
- Division of Population Health, Sam Fox House, Northern General Hospital, University of Sheffield, Sheffield, S5 7AU, UK
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Mroz EL, Collette T, Keefe K, Gil H, Monin J, Sharma S. Trajectories of Purpose in Life Across Diagnosis of Alzheimer's Disease or Related Dementias in Older Adulthood. J Aging Health 2024:8982643241257559. [PMID: 38816276 DOI: 10.1177/08982643241257559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Objectives: Sense of purpose serves as a psychological resource for late-life health. Limited research has examined how purpose changes across chronic illness diagnoses, including a diagnosis of Alzheimer's disease and related dementias (ADRD).Method: This study leverages data from the National Health and Aging Trends Study (NHATS; N = 831) to establish trajectories of purpose across ADRD diagnosis using three-year (pre-diagnosis, year of diagnosis, post-diagnosis) timespans and two comparison groups (heart disease diagnosis, no diagnosis). Results: We observed a longitudinal decrease in purpose in the ADRD diagnosis group, t = 3.85, p = .003, d = -0.258. This contrasts with heart disease diagnosis and no diagnosis groups, where purpose did not change over time. Discussion: Older adults who receive an ADRD diagnosis may be vulnerable to a decreasing sense of purpose across their diagnosis experience. We consider social, psychological, and clinical antecedents for this trend.
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Affiliation(s)
- Emily L Mroz
- Section of Geriatrics, Yale School of Medicine, New Haven, CT, USA
| | - Tyler Collette
- Department of Psychological Science, Kennesaw State University, Kennesaw, GA, USA
| | - Kate Keefe
- Live Well Institute, Southington, CT, USA
| | - Heidi Gil
- Live Well Institute, Southington, CT, USA
| | - Joan Monin
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Shubam Sharma
- Department of Psychological Science, Kennesaw State University, Kennesaw, GA, USA
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Boydell K, Lupton D. Bearing witness poetically in a pandemic: documenting suffering and care in conditions of physical isolation and uncertainty. MEDICAL HUMANITIES 2024; 50:52-59. [PMID: 38164553 DOI: 10.1136/medhum-2023-012768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 01/03/2024]
Abstract
The COVID-19 crisis is still affecting millions of people worldwide. However, government and mass media attention to the continuing loss of life, severe illness and prolonged effects of COVID-19 has subsided, rendering the suffering of those who have become ill or disabled, or who have lost loved ones to the disease, largely hidden from view. In this article, we employ autoethnographic poetic inquiry from the perspective of a mother/carer whose young adult daughter became critically ill and hospitalised after becoming infected while the mother herself was isolating at home due to her own COVID-19 diagnosis. The first author created a poem from notes she had made in a journal from telephone conversations and messages with the healthcare providers caring for her daughter. The second author responded to the poem, identifying the feelings and meanings it surfaced. Together, the authors draw on scholarship discussing concepts of uncertainty, liminality, moral distress, bearing witness and illness narratives to reflect on how autoethnographic poetic inquiry can document and make visible COVID-19-related suffering.
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Affiliation(s)
- Katherine Boydell
- Black Dog Institute, University of New South Wales, Sydney, New South Wales, Australia
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Giorgi F, Fanali A, Tramonti F. A critical evaluation of choice negotiation for patient-centred medicine and psychotherapy. J Eval Clin Pract 2024. [PMID: 38308615 DOI: 10.1111/jep.13968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 01/11/2024] [Indexed: 02/05/2024]
Abstract
STUDY AIMS The present paper aimed at discussing how the process of decision-making should be taken care of in healthcare services. METHODS This is a position paper based on a review of the relevant literature about meaning-making processes in medical encounters and psychotherapy. DISCUSSION Authors argued that choice options could be perceived as meaningful by patients if their uncertainties were taken into account and grounded on mutual understanding and reciprocal trust. To this end, any decision-making process should satisfy the patient's legitimate expectations by making choices and habits compatible. CONCLUSION In depht analysis of meaning-making processes is crucial for better refining good practices of shared decision-making.
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Hulse SB, Balogun Z, Rosenzweig MQ, Marsland AL, Palmer VM. I'm still me, I'm still a person: war metaphor use and meaning making in women with metastatic breast cancer. Support Care Cancer 2024; 32:108. [PMID: 38231307 PMCID: PMC10794408 DOI: 10.1007/s00520-024-08309-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/08/2024] [Indexed: 01/18/2024]
Abstract
PURPOSE The war metaphor is one strategy used frequently in breast cancer to inspire individuals in a "fight" against cancer and assist patients in navigating their illness experience. Despite prominent use, the emotional impact of this language has not been examined in the context of meaning making among women with metastatic breast cancer (MBC). METHODS This study involved a semi-structured interview considering the war metaphor's impact on women's illness experience with MBC. Participants (n = 22) had been diagnosed with MBC for at least 6 months or following 1 disease progression and were undergoing treatment at an NCI-designated cancer center in Western Pennsylvania at the time of interview. Each participant underwent an individual interview exploring the war metaphor's impact on illness experience. Qualitative thematic analysis was performed to assess feelings about the war metaphor and emotional response to the lived experience of cancer. RESULTS Two themes were identified surrounding metaphor use and participants' experiences with meaning making in cancer. First, women with MBC perceive the diagnosis as an "unfair fight" due to its incurable nature. Second, patients use alternative language of "living life" and communicate resistance to being defined by their cancer diagnosis. CONCLUSION War metaphors are one collection of terminology people use to understand their diagnosis. However, their use may apply pressure to prioritize positivity in the face of diagnosis and treatment, in a unique clinical context where this may not be adaptive. These findings affirm a need to consider patients' lived experiences to best facilitate psychological adjustment to illness.
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Affiliation(s)
- Sarah B Hulse
- Department of Psychology, Kenneth P. Dietrich School of Arts and Sciences, University of Pittsburgh, Pittsburgh, PA, USA.
- Division of Breast Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Zainab Balogun
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Anna L Marsland
- Department of Psychology, Kenneth P. Dietrich School of Arts and Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Vanessa M Palmer
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
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van Sambeek N, Franssen G, van Geelen S, Scheepers F. Making meaning of trauma in psychosis. Front Psychiatry 2023; 14:1272683. [PMID: 38025479 PMCID: PMC10656619 DOI: 10.3389/fpsyt.2023.1272683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Background Finding new meaning and identity in the aftermath of trauma has been identified as a key process of mental health recovery. However, research indicates that this meaning-making process is compromised in people with psychosis. Considering the high prevalence, yet under-treatment of trauma in people with psychosis, it is urgent to gain insight into how their meaning-making process can be supported. Aim To gain insight into how people with psychosis make meaning of trauma and identify barriers and facilitators in their meaning-making process. Methods Qualitative inquiry of N = 21 interviews transcripts from the Dutch Psychiatry Storybank. We included interviews of people who (a) lived through multiple psychotic episodes, and (b) spontaneously addressed traumatic experiences in a low-structured interview. Storyline analysis was performed to gain insight into the meaning-making of trauma within their self-stories. Psychosocial conceptualizations of narrative identity were used to inform the analysis. A data-validation session with four experts-by-experience was organized to check and improve the quality of our analysis. Results We identified four different story types: (1) Psychiatry as the wrong setting to find meaning; (2) The ongoing struggle to get trauma-therapy; (3) Exposure to trauma as a threat to a stable life, and (4) Disclosure as the key to resolving alienation. Each story type comprises a different plot, meaning of trauma withing the self-story, (lack of) integration and barriers and facilitators in the meaning-making process. Overall, barriers in the meaning-making process were mostly situated within mental healthcare and stigma-related. People felt particularly hindered by pessimistic ideas on their capacity to develop self-insight and cope with distress, resulting in limited treatment options. Their process of adaptive meaning-making often started with supportive, non-judgmental relationships with individuals or communities that offered them the safety to disclose trauma and motivated them to engage in a process of self-inquiry and growth. Conclusion The outcomes illuminate the social context of the meaning-making challenges that people with psychosis face and illustrate the devastating influence of stigma. Our outcomes offer guidance to remove barriers to adaptive meaning-making in people with psychosis, and can help clinicians to attune to differences in the meaning-making of trauma.
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Affiliation(s)
- Nienke van Sambeek
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - Gaston Franssen
- Faculty of Humanities, University of Amsterdam, Amsterdam, Netherlands
| | | | - Floortje Scheepers
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
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Weeseman Y, Scherer-Rath M, Christophe N, Dörr H, Helmich E, Sprangers MAG, van Poecke N, van Laarhoven HWM. The expression of ultimate life goals in co-creative art processes with palliative cancer patients. BMC Palliat Care 2023; 22:169. [PMID: 37919685 PMCID: PMC10621214 DOI: 10.1186/s12904-023-01294-2] [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: 08/14/2023] [Accepted: 10/19/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Co-creation, characterized by artists and patients creating a joint work of art, may support patients with the integration of disruptive life events into their life story, such as living with cancer. Focusing on experiences of contingency and life goals could support this process. The research questions are: (1) 'how are patient's ultimate life goals and experiences of contingency expressed in the work of art as created in a process of co-creation?'; (2) 'how do the four phases of integration of experiences of contingency unfold during co-creation?' METHODS Ten patients who were in a palliative stage of cancer treatment completed co-creation processes. Audio recordings of these co-creation processes were imported in Atlas-Ti and analysed by applying directed content analysis. We searched for life goals and experiences of contingency in the four phases of co-creation; Art communications, Element compilation, Consolidation, Reflection. RESULTS Patients used 4-8 sessions (median 5 sessions) with a duration of 90-240 min each (median duration 120 min). All patients expressed their experience of contingency and their ultimate life goals within the four phases of co-creation and in their work of art. A case description is presented illustrating the co-creation process. CONCLUSIONS During co-creation, patients move through four phases in which experiences of contingency and ultimate life goals can be made explicit through art making and can be expressed in the work of art, supporting integration of experiences of contingency into one's life narrative.
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Affiliation(s)
- Yvonne Weeseman
- Department of Medical Oncology, Amsterdam University Medical Centers, University of Amsterdam, De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands.
- Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands.
| | - Michael Scherer-Rath
- Faculty of Philosophy, Theology and Religious Studies, Radboud University, Nijmegen, The Netherlands
| | | | - Henny Dörr
- HKU University of the Arts Utrecht, Utrecht, The Netherlands
| | - Esther Helmich
- Amsta Healthcare Organization, Amsterdam, The Netherlands
| | - Mirjam A G Sprangers
- Amsterdam UMC location, Medical Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands
| | - Niels van Poecke
- Department of Medical Oncology, Amsterdam University Medical Centers, University of Amsterdam, De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
- Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands
| | - Hanneke W M van Laarhoven
- Department of Medical Oncology, Amsterdam University Medical Centers, University of Amsterdam, De Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
- Cancer Center Amsterdam, Treatment and Quality of Life, Amsterdam, The Netherlands
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Raeder R, Clayton NS, Boeckle M. Narrative-based autobiographical memory interventions for PTSD: a meta-analysis of randomized controlled trials. Front Psychol 2023; 14:1215225. [PMID: 37829075 PMCID: PMC10565228 DOI: 10.3389/fpsyg.2023.1215225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/25/2023] [Indexed: 10/14/2023] Open
Abstract
Introduction The aim of this systematic review and meta-analysis is to evaluate the efficacy of narrative-based interventions (NBIs) for individuals with post-traumatic stress disorder (PTSD). Investigating the efficacy of NBIs should yield insight on autobiographical memory (AM) phenomena implicated in PTSD onset and recovery, leading to improved intervention protocols. Furthermore, by analyzing how NBIs influence maladaptive AM distortions, we hope to shed light on the theorized narrative architecture of AM more generally. Methods A systematic literature search was conducted according to PRISMA and Cochrane guidelines in MEDLINE, EMBASE, PsychINFO, and PubMed. Additional studies were then also identified from the reference lists of other relevant literature and considered for inclusion. Studies were then evaluated for adherence to the inclusion/exclusion criteria and assessed for risk of bias. Various meta-analyses were performed on included studies to understand how NBIs may or may not influence the overall effect size of treatment. Results The results of the meta-analysis of 35 studies, involving 2,596 participants, suggest that NBIs are a viable and effective treatment option for PTSD, yielding a statistically significant within-group effect size and decrease in PTSD symptomatology at both post-treatment [g = 1.73, 95% CI (1.23-2.22)] and 3-9 month follow-up assessments [g = 2.33, 95% CI (1.41-3.26)]. Furthermore, the difference in effect sizes between NBIs compared to active and waitlist controls was statistically significant, suggesting that NBIs are superior. Sub-analyses showed that NET provided a stronger effect size than FORNET, which may be due to the nature of the traumatic event itself and not the treatment protocol. While evidence of small study and publication bias was present, a weight-function model and trim-and-fill method suggested it was not influencing the overall results. Discussion This meta-analysis presents strong evidence supporting the use of NBIs in the treatment of PTSD. Clear similarities can be identified between NBIs included in this analysis that make them distinct from non-NBI interventions, which are reviewed in the discussion. Controlled comparisons between NBIs and non-NBIs would help to further understand AM mechanisms of action implicated in recovery and how various interventions facilitate them. Future research should also aim to elucidate the full range of AM impairment in individuals with PTSD to gain insight on how other memory capabilities, such as the ability to mentally simulate the future, are implicated in the pathogenesis of PTSD.
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Affiliation(s)
- Robert Raeder
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Nicola S. Clayton
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Markus Boeckle
- Scientific Working Group, Karl Landsteiner University of Health Sciences, Krems, Austria
- Department of Transitory Psychiatry, University Hospital Tulln, Tulln, Austria
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Russel S, Westerhof G, Scherer-Rath M, Camuti F, Kamstra S, Bood ZM, van Poecke N, Lutters J, van Laarhoven HWM. Art-Based Learning in the last stage of life: An exploratory study on how cancer patients create meaning in relation to artworks. Palliat Med 2023; 37:1280-1282. [PMID: 37318210 PMCID: PMC10503234 DOI: 10.1177/02692163231180655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Silvia Russel
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
- Department of Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Gerben Westerhof
- Department of Psychology, Health and Technology & Story Lab, University of Twente, Enschede, The Netherlands
| | - Michael Scherer-Rath
- Faculty of Philosophy, Theology and Religious studies, Radboud University, Nijmegen, The Netherlands
| | - Fabiola Camuti
- Department of Art Education as Critical Tactics, ArtEZ University of the Arts, Arnhem, The Netherlands
| | - Sabrina Kamstra
- Department of Art Affairs, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Zarah M Bood
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
- Department of Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Niels van Poecke
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
- Department of Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Jeroen Lutters
- Department of Art Education as Critical Tactics, ArtEZ University of the Arts, Arnhem, The Netherlands
| | - Hanneke WM van Laarhoven
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
- Department of Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
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Weeseman Y, Scherer-Rath M, Christophe N, Dörr H, Helmich E, Sprangers MAG, van Poecke N, van Laarhoven HWM. Co-creative art processes with cancer patients from the artists' perspective: a qualitative study exploring resonance theory. Support Care Cancer 2023; 31:287. [PMID: 37079143 PMCID: PMC10119232 DOI: 10.1007/s00520-023-07744-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/10/2023] [Indexed: 04/21/2023]
Abstract
PURPOSE Co-creation, characterised by artists and patients creating a joint work of art, may support patients with the integration of life events into their life story, such as living with cancer. In the process of co-creation, resonance relationships between patients, artists and material may evolve that support integration. We aim to investigate if and if so, how resonance relationships occur from the perspective of the artist. METHODS We used the first 10 audio recordings of supervision sessions between eight artists and their two supervisors on ongoing co-creation processes with cancer patients. By conducting a qualitative template analysis in AtlasTi, we searched for the presence of resonance, as defined by its four main characteristics, Being affected, touched and moved; Self-efficacy and responding; Moments of uncontrollability; and Adaptive transformation. In addition, two case descriptions are presented. RESULTS We found resonance relationships to be present in the studied co-creation processes where moments of uncontrollability can lead to a next step in the process of co-creation and as such form an important factor within co-creation. CONCLUSIONS The current study suggests focus on elements of resonance relationships within co-creation, specifically practising with uncontrollability while working with art, could strengthen interventions targeting integration of life events in advanced cancer patients.
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Affiliation(s)
- Yvonne Weeseman
- Amsterdam University Medical Centers, Department of Medical Oncology, University of Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands.
| | - Michael Scherer-Rath
- Faculty of Philosophy, Theology and Religious Studies, Radboud University, Nijmegen, The Netherlands
| | | | - Henny Dörr
- HKU University of the Arts Utrecht, Utrecht, The Netherlands
| | - Esther Helmich
- Amsta Healthcare Organization, Amsterdam, The Netherlands
| | - Mirjam A G Sprangers
- Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Medical Psychology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Mental Health, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Niels van Poecke
- Amsterdam University Medical Centers, Department of Medical Oncology, University of Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Hanneke W M van Laarhoven
- Amsterdam University Medical Centers, Department of Medical Oncology, University of Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
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Valentine K, Smith AKJ, Persson A, Gray R, Bryant J, Hamilton M, Wallace J, Drysdale K, Newman CE. The freighted social histories of HIV and hepatitis C: exploring service providers' perspectives on stigma in the current epidemics. MEDICAL HUMANITIES 2023; 49:48-54. [PMID: 35710625 DOI: 10.1136/medhum-2022-012382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
A virus has a social history. In the case of the hepatitis C virus (HCV) and HIV, this history is one involving stigma and discrimination, advocacy and activism, and recent dramatic improvements in treatment. These social histories influence the experience of people who live with the viruses, and those who work with them. One aspect of this is the impact of social changes on the biographical disruption and integration brought about by illness. Healthcare practitioners who see significant improvements in the effectiveness of treatment for a condition over the course of their professional life will incorporate those changes into their own history and their relationship to that condition.This article is based on a study of the experiences of serodiscordance, or mixed infection status, in families living with HIV and two types of viral hepatitis, hepatitis B and hepatitis C. The article explores the perspectives of healthcare workers who work with people affected by these viruses, who were asked about their experiences in working with serodiscordance in families. Interviews revealed that changing social meanings given to bloodborne viruses, and changes to treatment over time, held a significant place in the accounts that service providers gave of their work. In asking them to describe their work with HIV and HCV, we were also asking about work that has been shaped by changing patterns and sources of stigma, and recently reshaped by changes in treatment and outcomes. While typically the experiences of patients and their families are used to investigate the social histories of diagnosis and stigma, the professional perspectives and life stories of the service providers who work with them are also revealing. We heard accounts in which histories as well as current regimes were prominent, illuminated further by insights from the sociology of health on narrative and biographical disruption.
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Affiliation(s)
- Kylie Valentine
- Social Policy Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Anthony K J Smith
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Asha Persson
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Rebecca Gray
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Joanne Bryant
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Myra Hamilton
- Work and Organisational Studies, University of Sydney Business School, The University of Sydney, Sydney, New South Wales, Australia
| | - Jack Wallace
- Burnet Institute, Melbourne, Victoria, Australia
| | - Kerryn Drysdale
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Christy E Newman
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
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Patwardhan N, Kulkarni M. Life’s Ups and Downs: Expressive Writing and Health Outcomes. PSYCHOLOGICAL STUDIES 2023. [DOI: 10.1007/s12646-022-00701-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
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Dortmans A, Thölking TW, van Wijngaarden EJ. Turning grey is not a black-and-white experience: A phenomenological study on the lived experience of old age among Dutch Franciscan friars. J Aging Stud 2022; 61:101004. [DOI: 10.1016/j.jaging.2022.101004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 11/24/2022]
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15
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Weeseman Y, Scherer-Rath M, Christophe N, Dörr H, Bood ZM, Sprangers MAG, Helmich E, van Laarhoven HWM. Co-creative art processes with patients: A theoretical framework and qualitative study among artists. PLoS One 2022; 17:e0266401. [PMID: 35390040 PMCID: PMC8989196 DOI: 10.1371/journal.pone.0266401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/20/2022] [Indexed: 11/30/2022] Open
Abstract
A cancer diagnosis may be experienced as a contingent life event. Co-creation—in which artists together with patients create a work of art reflecting on aspects of the patients’ life story—may be used to support patients to integrate such a contingent life event into their life story. We conducted a qualitative study in which we interviewed 10 professional artists to explore if co-creative art processes could facilitate integration of experiences of contingency in patients. Template analyses were performed in AtlasTi. We identified co-creation as a specific form of support to the process of integration of experiences of contingency. In the formation of a new life narrative, patients transcend the boundaries of their previous life narrative by changing their perspective. Self-transcendence forms a pivotal point in co-creation, which may be helpful for patients to integrate experiences of contingency into their life narratives.
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Affiliation(s)
- Yvonne Weeseman
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- * E-mail:
| | - Michael Scherer-Rath
- Faculty of Philosophy, Theology and Religious Studies, Radboud University, Nijmegen, The Netherlands
| | | | - Henny Dörr
- HKU University of the Arts Utrecht, Utrecht, The Netherlands
| | - Zarah M. Bood
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Mirjam A. G. Sprangers
- Department of Medical Psychology, Amsterdam Public Health, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Esther Helmich
- Amsta Healthcare Organization, Amsterdam, The Netherlands
| | - Hanneke W. M. van Laarhoven
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
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16
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Bood ZM, van Liemt F, Sprangers MAG, Kobes A, Weeseman Y, Scherer-Rath M, Tromp JM, van Laarhoven HWM, Helmich E. This is what life with cancer looks like: exploring experiences of adolescent and young adults with cancer using two visual approaches. Support Care Cancer 2022; 30:3353-3361. [PMID: 34988705 PMCID: PMC8730754 DOI: 10.1007/s00520-021-06775-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/18/2021] [Indexed: 11/02/2022]
Abstract
INTRODUCTION Talking about illness experience can be challenging for adolescents and young adults (AYAs) with cancer. Visual tools, in addition to spoken language, might make this easier, such as rich pictures and photovoice. We aimed to obtain a comprehensive view of the cancer experience of AYAs by using rich pictures and photovoice. METHODS AYAs (18-35 years old) who had any type of cancer, or were in remission from cancer, were eligible. AYAs drew rich pictures about their experience of living with cancer and explained these during subsequent interviews. Some of the AYAs also participated in photovoice and spent two days with a photographer to make photos about their illness experience. Rich pictures and photos were first analyzed separately, using open coding, after which the identified themes were compared. RESULTS Twelve AYAs made rich pictures (RPs), of whom seven also participated in photovoice. The two most predominant themes emerging from the data were struggles related to the future and defining one's identity. The AYAs expressed concerns for the future related to relationships, education, and employment. Relating to defining one's identity, many AYAs expressed that the cancer had a negative impact on their body- and self-image. The main themes were visible in the RPs as well as in the photovoice; however, subtle differences in sub-themes were found. CONCLUSIONS We found that cancer has an effect on many aspects of AYAs' lives. Further research on how the identified themes play a role in the lives of AYAs with cancer is needed.
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Affiliation(s)
- Zarah M Bood
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, VU Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
| | | | - Mirjam A G Sprangers
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Annita Kobes
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, VU Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Yvonne Weeseman
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, VU Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Michael Scherer-Rath
- Faculty of Philosophy, Theology, and Religious Studies, Radboud University-Nijmegen, Nijmegen, The Netherlands
| | - Jacqueline M Tromp
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, VU Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Hanneke W M van Laarhoven
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, VU Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Esther Helmich
- Amsta Healthcare Organisation, Amsterdam, the Netherlands
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17
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Nkoana S, Sodi T, Makgahlela M, Mokwena J. Cancer Survivorship: Religion in Meaning Making and Coping Among a Group of Black Prostate Cancer Patients in South Africa. JOURNAL OF RELIGION AND HEALTH 2022; 61:1390-1400. [PMID: 34468928 PMCID: PMC8967772 DOI: 10.1007/s10943-021-01406-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/20/2021] [Indexed: 06/01/2023]
Abstract
The purpose of the study was to explore the role of religion in meaning making and coping among a group of black patients receiving some form of prostate cancer treatment at a public hospital in Limpopo Province, South Africa. A sample of 20 prostate cancer survivors, with ages ranging from 67 to 85 years (meanage = 76yrs; SD = 5.3) selected through purposive sampling. Data were collected through in-depth, semi-structured individual interviews and analysed using interpretative phenomenological analysis (IPA). The findings demonstrated that religion is an important factor in meaning making and coping by prostate cancer survivors. The findings suggest that healthcare practitioners need to pay close attention to the meanings that cancer patients assign to their illness to provide the appropriate care and support.
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Affiliation(s)
- Shai Nkoana
- Department of Psychology, University of Limpopo, Private Bag X1106, Sovenga, 0727, South Africa.
| | - Tholene Sodi
- Department of Psychology, University of Limpopo, Private Bag X1106, Sovenga, 0727, South Africa
| | - Mpsanyana Makgahlela
- Department of Psychology, University of Limpopo, Private Bag X1106, Sovenga, 0727, South Africa
| | - Jabu Mokwena
- Department of Psychology, University of Limpopo, Private Bag X1106, Sovenga, 0727, South Africa
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18
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Due-Christensen M, Joensen LE, Sarre S, Romanczuk E, Wad JL, Forde R, Robert G, Willaing I, Forbes A. A co-design study to develop supportive interventions to improve psychological and social adaptation among adults with new-onset type 1 diabetes in Denmark and the UK. BMJ Open 2021; 11:e051430. [PMID: 34728449 PMCID: PMC8565545 DOI: 10.1136/bmjopen-2021-051430] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To develop supportive interventions for adults with new-onset type 1 diabetes (T1D) to facilitate positive adaptive strategies during their transition into a life with diabetes. DESIGN The study used a co-design approach informed by Design Thinking to stimulate participants' reflections on their experiences of current care and generate ideas for new supportive interventions. Visual illustrations were used to depict support needs and challenges. Initial discussions of these needs and challenges were facilitated by researchers and people with diabetes in workshops. Data comprising transcribed audio recordings of the workshop discussions and materials generated during the workshops were analysed thematically. SETTINGS Specialised diabetes centres in Denmark and the United Kingdom. PARTICIPANTS Adults with new-onset T1D (n=24) and healthcare professionals (HCPs) (n=56) participated in six parallel workshops followed by four joint workshops with adults (n=29) and HCPs (n=24) together. RESULTS The common solution prioritised by both adults with new-onset T1D and HCP participants was the development of an integrated model of care addressing the psychological and social elements of the diagnosis, alongside information on diabetes self-management. Participants also indicated a need to develop the organisation, provision and content of care, along with the skills HCPs need to optimally deliver that care. The co-designed interventions included three visual conversation tools that could be used flexibly in the care of adults with new-onset T1D to support physical, psychological and social adaptation to T1D. CONCLUSION This co-design study has identified the care priorities for adults who develop T1D, along with some practical conversational tools that may help guide HCPs in attending to the disruptive experience of the diagnosis and support adults in adjusting into a life with diabetes.
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Affiliation(s)
- Mette Due-Christensen
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Lene Eide Joensen
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Sophie Sarre
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Ewa Romanczuk
- Steno Diabetes Center Odense, Odense Universitetshospital, Odense, Denmark
| | - Julie Lindberg Wad
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Rita Forde
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Glenn Robert
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Ingrid Willaing
- Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Angus Forbes
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
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19
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Oreel TH, Nieuwkerk PT, Hartog ID, Netjes JE, Vonk ABA, Lemkes J, van Laarhoven HWM, Scherer-Rath M, Henriques JPS, Oort FJ, Sprangers MAG, Verdam MGE. Response shift after coronary revascularization. Qual Life Res 2021; 31:437-450. [PMID: 34159517 PMCID: PMC8847301 DOI: 10.1007/s11136-021-02902-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE The aims of this study were to investigate (1) the extent to which response shift occurs among patients with coronary artery disease (CAD) after coronary revascularization, (2) whether the assessment of changes in health-related quality of life (HRQoL), controlled for response shift, yield more valid estimates of changes in HRQoL, as indicated by stronger associations with criterion measures of change, than without controlling for response shift, and (3) if occurrences of response shift are related to patient characteristics. METHODS Patients with CAD completed the SF-36 and the Seattle Angina Questionnaire (SAQ7) at baseline and 3 months after coronary revascularization. Sociodemographic, clinical and psychosocial variables were measured with the patient version of the New York Heart Association-class, Subjective Significance Questionnaire, Reconstruction of Life Events Questionnaire (RE-LIFE), and HEXACO personality inventory. Oort's Structural Equation Modeling (SEM) approach was used to investigate response shift. RESULTS 191 patient completed questionnaires at baseline and at 3 months after treatment. The SF-36 showed recalibration and reprioritization response shift and the SAQ7 reconceptualization response shift. Controlling for these response shift effects did not result in more valid estimates of change. One significant association was found between reprioritization response shift and complete integration of having CAD into their life story, as indicated by the RE-LIFE. CONCLUSION Results indicate response shift in HRQoL following coronary revascularization. While we did not find an impact of response shift on the estimates of change, the SEM approach provides a more comprehensive insight into the different types of change in HRQoL following coronary revascularization.
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Affiliation(s)
- Tom H Oreel
- Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Pythia T Nieuwkerk
- Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Iris D Hartog
- Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands.,Faculty of Philosophy, Theology and Religious Studies, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Justine E Netjes
- Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Alexander B A Vonk
- Department of Cardio-Thoracic Surgery, Amsterdam University Medical Centers, VU University Amsterdam, Amsterdam, Netherlands
| | - Jorrit Lemkes
- Department of Cardiology, Amsterdam University Medical Centers, VU University Amsterdam, Amsterdam, Netherlands
| | - Hanneke W M van Laarhoven
- Department of Medical Oncology, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, Netherlands
| | - Michael Scherer-Rath
- Faculty of Philosophy, Theology and Religious Studies, Radboud University Nijmegen, Nijmegen, Netherlands
| | - José P S Henriques
- Department of Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Frans J Oort
- Research Institute of Child Development and Education, University of Amsterdam, 15776, 1001 NG, Amsterdam, Netherlands
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Mathilde G E Verdam
- Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands. .,Department of Methodology and Statistics, Institute of Psychology, Leiden University, Leiden, Netherlands.
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20
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Kamp A, Bood Z, Scherer-Rath M, Weeseman Y, Christophe N, Dörr H, Sanders J, Sprangers M, Helmich E, Timmermans L, van Wolde E, van Laarhoven HWM. Narrative recognition and identification: a qualitative pilot study into reading literary texts with advanced cancer patients. J Cancer Surviv 2021; 16:531-541. [PMID: 34129212 PMCID: PMC9142438 DOI: 10.1007/s11764-021-01048-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/19/2021] [Indexed: 11/28/2022]
Abstract
Purpose Patients with advanced cancer can experience their disease as a contingent life event. The sudden interruption of their life stories can obscure life goals and disrupt meaning making. In the context of the research project “In search of stories,” we aim to investigate the reading and discussion of selected stories which present ways of dealing with a contingent life event. In addition, we examine the use of a newly developed guide for reading these exemplary texts together with advanced cancer patients. Methods This qualitative study describes the experiences of five patients with advanced cancer who participated in a guided reading and discussion about selected literary texts. The intervention consisted of reading a selected story, after which each patient was interviewed, using the reading guide as a conversation template. The interviews were then thematically analyzed for their conceptual content using a template analysis. Results All five conversations showed some form of recognition in reaction to the chosen text, which led to personal identification of experiences of contingency, such as loss of life goals, impending death, or feelings of uncertainty. Besides the important role of identification, revealed by the responses to the questions in the reading guide, the discussion of the text helped them articulate their own experience and sources of meaning. Diverse worldviews came to the fore and concepts of meaning such as fate, life goals, quality of life, and death. Conclusions First experiences with our newly developed reading guide designed to support a structured reading of stories containing experiences of contingency suggest that it may help patients to express their own experiences of contingency and to reflect on these experiences. Implications for Cancer Survivors The intervention tested in this study may contribute to supportive care for survivors with advanced cancer, but further research is needed to evaluate its effect on quality of life.
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Affiliation(s)
- Albert Kamp
- Faculty of Philosophy, Theology and Religious Studies, Radboud University, Nijmegen, The Netherlands
| | - Zarah Bood
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Michael Scherer-Rath
- Faculty of Philosophy, Theology and Religious Studies, Radboud University, Nijmegen, The Netherlands
| | - Yvonne Weeseman
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | | | - Henny Dörr
- HKU University of the Arts Utrecht, Utrecht, The Netherlands
| | - José Sanders
- Centre for Language Studies, Radboud University, Nijmegen, The Netherlands
| | - Mirjam Sprangers
- Department of Medical Psychology, Amsterdam Public Health, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Esther Helmich
- Amsta Healthcare Organisation, Amsterdam, The Netherlands
| | - Liesbeth Timmermans
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ellen van Wolde
- Faculty of Philosophy, Theology and Religious Studies, Radboud University, Nijmegen, The Netherlands
| | - Hanneke W M van Laarhoven
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
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21
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Solvang PK, Heiaas I, Romsland G, Søberg HL. The unexpected other: Challenges and strategies after acquired impairment. Health (London) 2021; 27:345-361. [PMID: 34075795 DOI: 10.1177/13634593211021482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
People experiencing traumatic brain injury or multitrauma will often live with problems in functioning for a profound period in life. A situation of great complexity emerges involving both the experience of an impaired body and the experience of a changed social position. This article addresses the intricate relations between the altered body, personal ambitions, and social surroundings in the first 2-3 years after an injury. The conceptual framework centers around the process of change, applying concepts such as the unexpected other and biographical reconstruction. Twenty-one people of working age were interviewed two times. All interviewees had experienced traumatic brain injury or multitrauma. A thematic narrative analysis was applied. Consequences of the injury took place at a carnal level where fatigue is something completely different from becoming exhausted and where elimination of body waste takes place through practices novel to the injured person. Living with impairment also took place at the level of social interaction. Here, family relations, shame, and establishing a new identity seemed profoundly important. This article makes two novel contributions. First, it emphasizes more than previous studies do that the daily management of altered body functions is more important for independence and wellbeing. Second, the article identifies the narrative about the accident as an important issue for injured people to settle.
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Affiliation(s)
| | - Ida Heiaas
- Oslo Metropolitan University, Norway.,Norwegian Women's Public Health Association, Norway
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22
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Ebenau A, Groot M, Visser A, van Laarhoven HWM, van Leeuwen R, Garssen B. Spiritual care by nurses in curative oncology: a mixed-method study on patients' perspectives and experiences. Scand J Caring Sci 2020; 34:96-107. [PMID: 31095760 PMCID: PMC7074061 DOI: 10.1111/scs.12710] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/12/2019] [Indexed: 11/26/2022]
Abstract
AIMS Spirituality can be important in adjusting to the experience of cancer and its medical treatment. Since nurses have frequent contact with patients, they seem to have a unique role in providing spiritual care. Nurses consider spiritual care important; however, little is known about how patients in a curative setting experience and value spiritual care. Therefore, this study aimed to give insight into patients' experiences with and opinions about spiritual care as provided by nurses in curative cancer care. METHODS This is a national, multicentre mixed-methods study, combining a quantitative approach using questionnaires (n = 62) and a qualitative analysis of semi-structured interviews (n = 61). Nonparametric tests were used for quantitative data, and qualitative data were analysed inductively. FINDINGS Most patients rarely received spiritual care by nurses. If spiritual care was provided, it mainly consisted of noticing problems and referring to other professionals. This appeared to be dependent on certain 'triggers', such as age. Structural discussions on spirituality with a nurse were experienced rarely. This was explained by, among other factors, the hospital setting. Yet, the majority (79%) of patients found the attention to spirituality sufficient or very good. Furthermore, a majority (58%) viewed spiritual care as a nursing task: nurses should notice spiritual problems and refer to other professionals, though extensively discussing patients' spirituality was neither considered nurses' task nor capability. CONCLUSIONS Attention to spiritual care in a curative setting, though not so much desired by most patients, should be pursued, because of its importance in performing person-centred nursing care and its positive impact on patients' health. By training nurses in offering spiritual care in proactive and 'nonactive' (accepting) ways, spiritual care could be structurally offered in clinical practice in personalised forms. Since younger and less spiritual patients are not much satisfied with spiritual care by nurses, they need special attention.
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Affiliation(s)
- Anne Ebenau
- Helen Dowling Institute for Psycho‐oncological CareBilthovenThe Netherlands
- Department of Anesthesiology, Pain and Palliative CareRadboud University Medical CenterNijmegenThe Netherlands
| | - Marieke Groot
- Helen Dowling Institute for Psycho‐oncological CareBilthovenThe Netherlands
- Department of Anesthesiology, Pain and Palliative CareRadboud University Medical CenterNijmegenThe Netherlands
| | - Anja Visser
- Helen Dowling Institute for Psycho‐oncological CareBilthovenThe Netherlands
- Faculty of Theology and Religious Studies, Comparative Study of ReligionUniversity of GroningenGroningenThe Netherlands
| | | | - René van Leeuwen
- Faculty of Health CareChristian University of Applied Sciences ViaaZwolleThe Netherlands
| | - Bert Garssen
- Helen Dowling Institute for Psycho‐oncological CareBilthovenThe Netherlands
- Department Health PsychologyRijksuniversiteit GroningenGroningenThe Netherlands
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23
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Kerr DJ, Deane FP, Crowe TP. Pilot study of a serious board game intervention to facilitate narrative identity reconstruction in mental health recovery. Health Psychol Open 2020; 7:2055102920905628. [PMID: 32095256 PMCID: PMC7008560 DOI: 10.1177/2055102920905628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
This quasi-experimental study explores the effects of a narrative coaching board game intervention aimed at enhancing participants’ sense of self-mastery as part of facilitating narrative identity reconstruction. Three mixed analyses of variance compared differences between clinical (n = 31) and non-clinical (n = 31) groups over time on a measure of mastery. There were no significant group-by-time interaction effects, but both groups demonstrated a statistically significant improvement in mastery over time. From a complex adaptive system perspective, changes may indicate adaptive growth in recovery. A serious board game may be a useful way of facilitating narrative identity reconstruction in recovery.
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24
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Bood ZM, Scherer-Rath M, Sprangers MAG, Timmermans L, van Wolde E, Cristancho SM, Heyning F, Russel S, van Laarhoven HWM, Helmich E. Living with advanced cancer: Rich Pictures as a means for health care providers to explore the experiences of advanced cancer patients. Cancer Med 2019; 8:4957-4966. [PMID: 31278862 PMCID: PMC6718737 DOI: 10.1002/cam4.2342] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/28/2019] [Accepted: 05/30/2019] [Indexed: 11/09/2022] Open
Abstract
Background To provide holistic care to patients with advanced cancer, health care professionals need to gain insight in patients’ experiences across the different domains of health. However, describing such complex experiences verbally may be difficult for patients. The use of a visual tool, such as Rich Pictures (RPs) could be helpful. We explore the use of RPs to gain insight in the experiences of patients with advanced cancer. Methods Eighteen patients with advanced cancer were asked to draw a RP expressing how they experienced living with cancer, followed by a semi‐structured interview. Qualitative content analysis, including the examination of all elements in the drawings and their interrelationships, was used to analyze the RPs, which was further informed by the interviews. Results The RPs clearly showed what was most important to an individual patient and made relations between elements visible at a glance. Themes identified included: medical aspects, the experience of loss, feelings related to loss, support from others and meaningful activities, and integration of cancer in one's life. The added value of RPs lies in the ability to represent these themes in one single snapshot. Conclusions RPs allow for a complementary view on the experiences of advanced cancer patients, as they show and relate different aspects of patients’ lives. A RP can provide health care professionals a visual summary of the experiences of a patient. For patients, telling their story to health care professionals might be facilitated when using RPs.
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Affiliation(s)
- Zarah M Bood
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Michael Scherer-Rath
- Faculty of Philosophy, Theology, and Religious Studies, Radboud University-Nijmegen, Nijmegen, The Netherlands
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Liesbeth Timmermans
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ellen van Wolde
- Faculty of Philosophy, Theology, and Religious Studies, Radboud University-Nijmegen, Nijmegen, The Netherlands
| | - Sayra M Cristancho
- Centre for Education Research & Innovation and Department of Surgery, Health Sciences Addition, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - Fenna Heyning
- Association of Topclinical Hospitals STZ, Utrecht, the Netherlands
| | - Silvia Russel
- Independent Artist, Researcher, Amsterdam, the Netherlands
| | - Hanneke W M van Laarhoven
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Esther Helmich
- Center for Education Development and Research in Health Professions, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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