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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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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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Assessing Effects of Mandala Painting on Anxiety of 9–14-Year-Old Children with Cancer. ADVANCES IN INTEGRATIVE MEDICINE 2023. [DOI: 10.1016/j.aimed.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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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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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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Bood ZM, Scherer-Rath M, Sprangers MAG, Timmermans L, van Wolde E, Cristancho SM, Heyning F, Russel S, van Laarhoven HWM, Helmich E. Repeated use of rich pictures to explore changes in subjective experiences over time of patients with advanced cancer. Cancer Rep (Hoboken) 2021; 5:e1428. [PMID: 34313027 PMCID: PMC8789615 DOI: 10.1002/cnr2.1428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 04/09/2021] [Accepted: 05/05/2021] [Indexed: 11/11/2022] Open
Abstract
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.
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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, London, Ontario, Canada
| | - Fenna Heyning
- Association of Topclinical hospitals STZ, Utrecht, 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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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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