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.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Orthorexia nervosa (ON) is a condition that is characterized by a pathological obsession with eating foods one considers healthy and has recently been suggested as a new possible diagnosis. However, ...there is limited published research on health professionals' recognition, ideas and opinions regarding the diagnosis and classification of ON.
The aim of this mixed-methods study was to gain insight into the perspectives of clinically active health professionals on ON, and into their opinions on if and how the disorder should be classified.
Psychologists, psychiatrists, dietitians and physiotherapists in the Netherlands (
= 160) participated by responding to a self-administered questionnaire. Most health professionals (78%) reported that they thought that ON should have its own diagnosis. This opinion was more common in physical health professionals than in mental health professionals. A majority (74%) agreed that ON fits within the Diagnostic and Statistical Manual of Mental Disorders (DSM) category Eating and Feeding Disorders. Interviews with 15 mental health professionals were analyzed using code frequencies and continuous comparisons. Mental health professionals reported believing that ON is prevalent in the general population and that a separate diagnosis would have both advantages and disadvantages for health professionals and patients. Interview participants described the typical ON patient as being young, female, and highly educated; characteristics that overlap with typical anorexia nervosa and obsessive compulsive disorder cases.
The results suggest that some health professionals from a heterogenous sample in the Netherlands think ON should have a separate diagnosis in the DSM, however, the study needs to be replicated to allow for further generalization. Methodological design of this study may be utilized in future research with similar aims. The findings can serve as a foundation for investigation of individuals' experiences of distress caused by ON, and further refinement of the diagnostic criteria.
Orthorexia Nervosa (ON) is a newly coined eating pattern which disproportionately affects Western countries. Research on the matter is scarce. This study aimed to investigate how the Dutch (mental) ...health professionals evaluate the influence of "Western culture" on the development of ON. This mixed methods study included interviews (
= 15) and a questionnaire (
= 157). The extent of influence of the "Western culture" was suggested to be quite high, with a score of 74 out of 100. The factors believed to affect Orthorexia included societal transitions (epidemiological and welfare) and cultural ideas (body ideal and control over life) which, in turn, are influenced by the internet and media. In addition, it was noted that ON is unique among the eating disorders since it does not carry the negative connotations of anorexia or obesity associated with "losing control." The findings suggest that "Western culture" contributes to the establishment of a high-risk environment for the development of behaviors associated with ON.
A diagnosis of advanced cancer can be described as an unexpected disruption of someone’s life story, an experience of contingency.1 To address an experience of contingency, a new sense of direction ...and coherence in life needs to be found. One’s story of life needs to be rewritten, which requires creative thinking. This process may be supported by a specific art-perception method: Art-Based Learning. Art-Based Learning is a step-wise process of observing an artwork, creating a new narrative related to this artwork, and connecting this narrative to the personal situation.2 Art-Based Learning is designed to stimulate creative thinking through four steps: 1. Formulation of a personal question. 2. Observation of details of an artwork. 3. Imagination of a story based on the artwork. 4. Sharing the art-perception experience and reflection on the link with the personal question with a fellow participant. We aimed to explore how persons with advanced cancer could benefit from Art-Based Learning to deal with contingency experiences and stimulate meaning-making.
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.
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.
Describing the experience of having advanced cancer verbally may be difficult for patients. The use of a visual tool, such as Rich Pictures (RPs) could be helpful. RPs allow for a complementary view on the experiences of advanced cancer patients, and can provide health care professionals a visual summary of the experiences of a patient.
Background
The combination of verbal and visual tools may help unravel the experiences of advanced cancer patients. However, most previous studies have focused on a specific symptom, at only one ...moment in time. We recently found that a specific visual tool, originating from systems thinking, that is, rich pictures (RPs), could provide a more comprehensive view of the experiences of patients with advanced cancer.
Aims
To examine whether the repeated use of RPs can make changes in subjective experiences of patients living with advanced cancer visible over time.
Methods and results
We performed a prospective study with a generic qualitative approach that was mostly informed by the process of grounded theory. We invited patients to make an RP twice, at the start of the study, and again after 2 months. Both RP drawing sessions were directly followed by a semi‐structured interview. Patients with all types of solid tumors, above the age of 18, and with a diagnosis of advanced, incurable cancer, were eligible. Eighteen patients participated and 15 patients were able to draw an RP twice. In eight RP‐sets, considerable differences between the first and second RP were noticeable. Two patterns were distinguished: (1) a change (decline or improvement) in physical health (five patients), and/or (2) a change in the way patients related to cancer (three patients).
Conclusion
RPs are a valuable qualitative research method that can be used to explore the experiences of patients with advanced cancer, not only at a single point in time but also over time.
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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