Reflexivity on an Empirical Study about Cancer Patients' Perception of Good Caring in Light of Goffman's Theory

Kvåle, Kirsti; Synnes, Oddgeir; Jacobsen, Frode F.

doi:10.1177/160940691501400103

Cited by 4 publications

(5 citation statements)

References 15 publications

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“…The study's limitations are that the findings from qualitative studies cannot be generalised, and that illness narratives are not objective truths but represent the truth of the telling (there and then). The narrators choose what they want to tell, whom they trust and how they prefer to present themselves (Goffman, ; Kvåle, Synnes, & Jacobsen, ), and therefore we cannot exclude the possibility that some wanted to present themselves as strong persons who were in control of the situation even if they had a hard time. A possibility of selection bias cannot be excluded, given that the sampling was purposive and not randomised.…”

Section: Discussionmentioning

confidence: 99%

Living with life-prolonging chemotherapy-control and meaning-making in the tension between life and death

Kvåle

Synnes

2017

Eur J Cancer Care

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Chemotherapy, radiotherapy, hormone therapy and immune therapy have made many cancers chronic, potential curable diseases rather than inevitably fatal, but the treatments are often both mentally and physically stressful even if the side effects varies.The right use of palliative chemotherapy is a complex issue and there are many aspects to take into consideration. The aim of the study was to gain insight into the illness narratives of cancer patients, from the day they suspected that something was wrong up to the present day where they are living with incurable cancer, undergoing lifeprolonging chemotherapy. Thirteen narrators were included. They were all cancer patients on chemotherapy with the intention of prolonging life (informed by their oncologist) in an outpatient's clinic in Norway. Narrative analyse of their illness stories was applied. The main findings showed that the narrators considered their lives worth living in spite of the treatment. They seemed to take control and build a new life on "what was left after the storm," and described how they found meaning living in the tension between life and death. K E Y W O R D Scancer patients, life-prolonging treatment, narratives | INTRODUCTIONTreatments such as chemotherapy, radiotherapy, hormone therapy and immune therapy have made many cancers chronic, potentially curable diseases rather than inevitably fatal, but the treatments are often both mentally and physically stressful, despite their varying side effects.The right use of palliative chemotherapy, where the intention is lifeprolonging or symptom relief or both, is a complex issue, with many aspects to consider (Harrington & Smith, 2008). The literature often focuses on how to communicate with patients about the dilemma, when to stop chemotherapy and how to deal with the end-of-life issue (Bensing, Rimondini, & Visser, 2013). Guidelines are also provided (Back et al., 2008). Some questions discussed are whether the physician avoids addressing these questions, offers patients a real alternative to treatment, and knows how to balance between giving hope and stating the reality (Harrington & Smith, 2008;Innes & Payne, 2009;Pavlish, Brown-Saltzman, Fine, & Jakel, 2015). However, patients' own stories about how they live within the frame of life-prolonging chemotherapy have seldom received attention. In this article, we want to let the patients' voices be heard through their illness stories. | This study's aimThis study's aim was to gain insight into the illness narratives of cancer patients, from the day they suspected that something was wrong up to the present day where they are living with incurable cancer, undergoing life-prolonging chemotherapy. | METHODS | DesignListening to patients' stories is often part of clinical practice, but Bingly, Thomas, Brown, Reeve, and Payne (2008) emphasised the difference between the value of using stories to improve communication with patients under clinical palliative care and research that systematically analyses these stories by using narrative methods or narrati...

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Section: Discussionmentioning

confidence: 99%

Living with life-prolonging chemotherapy-control and meaning-making in the tension between life and death

Kvåle

Synnes

2017

Eur J Cancer Care

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“…In qualitative research, reflections are mostly based on interactional setting in which interviewer and respondent conduct the interview from different perspectives, with different expectations and objectives, having different social roles, theoretical backgrounds, and positions [ 26 ]. These differences certainly influence the interaction in the interview situation making researcher’s positionality pivotal in qualitative research.…”

Section: Methodsmentioning

confidence: 99%

Fears and barriers: problems in breast cancer diagnosis and treatment in Pakistan

2021

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Background Women in Pakistan lack appropriate awareness about diagnosis and treatment for breast cancer due to a range of multifaceted barriers. There is a dearth of literature examining the socio-cultural factors that inhibit women from breast cancer screening, diagnosis and treatment in Punjab, Pakistan. Addressing this gap, this qualitative study sought to identify and explore the barriers that hinder women from seeking timely screening and treatment. Methods In this process 45 women (age = 18–50 years) with breast cancer were purposively sampled and interviewed from the Punjab Institute of Nuclear Medicine (PINUM) hospital, Faisalabad, Pakistan. Results An inductive approach was used to analyze the data which resulted in the emergence of eight subthemes under the umbrella of three major themes that delineate individual, socio-cultural and structural barriers to seek screening and treatment of breast cancer in Punjab. Individual barriers included lack of awareness, hesitance in accepting social support, and spiritual healing. The identified socio-cultural factors included feminine sensitivity, stigmatization, and aversion to male doctors. Lack of financial resources and apathetic medical services were structural barriers that hinder screening and treatment. Conclusions These barriers can be addressed through raising awareness and community mobilization about breast-self exam and treatment. The healthcare system should also pay attention to socio-psychological and cultural factors impeding women's access to available health facilities.

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“…Limitations of the method are based on illness narratives not always being the objective truths but representing the truth of the telling (there and then) . Also, a possibility of selection bias cannot be excluded, given that the sampling was purposive.…”

Section: Discussionmentioning

confidence: 98%

Patients' illness narratives—From being healthy to living with incurable cancer: Encounters with doctors through the disease trajectory

2019

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Background: Narrative medicine emphasizes how stories can increase the understanding of patients' experiences and give important insights into how patients interpret and strive to make meaning in the situation they find themselves in.Aim: The aim of this study was to gain insight into the illness narratives of cancer patients, from the day they suspected that something was wrong until living with incurable cancer. Methods and results: Six men and seven women, aged 47 to 79 years, diagnosed with metastatic cancer and undergoing chemotherapy with life-prolonging intent in an oncology outpatient clinic, were asked to tell their illness stories as freely as possible, without guiding questions. Stories were tape recorded, transcribed, and analyzed by a thematic narrative analysis. Encounters with doctors through the disease trajectory were highlighted by all narrators. Several informants described poor communication and consequences in the form of "doctors delay" and substandard psychosocial care. Continuity in follow-up and the physician's ability or inability to break bad news and adapt information to the patient's wishes and preferences were particularly emphasized. Conclusion: A key finding was the importance of the doctor's role throughout the whole trajectory. A good doctor-patient relationship was characterized by continuity of care in follow-up, and trust acquired over time, based on the physician's thorough medical knowledge combined with sensitive communication and empathy. K E Y W O R D S cancer patients, communication, continuity of care, doctor-patient relationship, doctor's delay, illness narratives 1 | INTRODUCTION The last decades have seen an increasing research interest in patients' experiences of living with a cancer disease. 1-3 Doctor-patient communication has also been a central research topic for many years, and many different communication models are recommended, such as the SPIKES model 4,5 and the Four Habits model. 6 Another model is the Turner Social Drama Model. 7 This model emphasizes people's perspectives, values, needs, and experiences contextualized in an illness process. The model pays close attention to people's journeys and how these may dynamically change over time. By taking both biographical and clinical aspects of people's journeys into account, this model could be an alternative to clinical pathway models, with a sharper focus on humanizing care. 7,8 Good doctor-patient communication is

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Reflexivity on an Empirical Study about Cancer Patients' Perception of Good Caring in Light of Goffman's Theory

Cited by 4 publications

References 15 publications

Living with life-prolonging chemotherapy-control and meaning-making in the tension between life and death

Living with life-prolonging chemotherapy-control and meaning-making in the tension between life and death

Fears and barriers: problems in breast cancer diagnosis and treatment in Pakistan

Patients' illness narratives—From being healthy to living with incurable cancer: Encounters with doctors through the disease trajectory

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