The effects of journaling for women with newly diagnosed breast cancer

Life is precious: Sarcoma/giant-cell tumors survivors' perspectives on their psychological journey

OBJECTIVES

Although surviving bone resection/limb salvage surgery treatment is the beginning of the journey towards recovery, the importance of providing patients with post-operative psychological support is often overlooked by health professionals. Hence, patients typically are left to their own devices in terms of ensuring their mental health and well-being. Methodological Approach and Participants: This qualitative analysis of seven long-term sarcoma survivors' reflective journal entries provides insights into the different phases of distress, resilience building, resilient growth and advice-giving that they moved through during their survivorship journey.

INTERPRETATION

Our findings identify the fragility of patient resilience and highlight areas for future research.

Optimizing the Benefits of Self-Monitoring Among Patients With Cancer

PURPOSE/OBJECTIVES

To investigate oncology professionals' perspectives about, experience with, and envisioned feasibility of incorporating patient self-monitoring as a patient-centered practice. 
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RESEARCH APPROACH

An interpretive, descriptive study.
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SETTING

Four health systems and five cancer centers in three states. 
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PARTICIPANTS

38 nurses, nurse practitioners, oncologists, physician assistants, and radiation therapists.
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METHODOLOGIC APPROACH

Individual and focus group interviews.
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FINDINGS

Three themes were revealed.

CONCLUSIONS

This study uncovers the potential contribution of patient self-monitoring as a means of providing patient-generated data that informs clinical decision making, going beyond self-monitoring for self-management only. Because the term self-monitoring is not used by clinicians, adoption of an agreed-upon term is recommended as the first step toward developing and implementing a self-monitoring strategy. Findings support the need to reenvision patient education to ensure self-monitoring is clinically useful while preventing an excessive focus on the negative, which may contribute to patient anxiety.
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INTERPRETATION

The full potential for self-monitoring by patients is not entirely reached. Because nurses are charged with providing patient education, they are strategically positioned to adopt the term self-monitoring and integrate a self-monitoring strategy into patient-centered practice.

Physiological reactivity during autobiographical narratives in older adults: the roles of depression and anxiety

OBJECTIVES

Physiological reactivity (PR) describes the change in physiological functioning (e.g., heart rate, blood pressure, pulse pressure) that occurs after the induction of a stressful task. This study aims to understand the influence of mental health symptoms on patterns of PR during autobiographical narratives in an older adult sample.

METHOD

Eighty older adults completed self-report measures regarding their symptoms of depression and anxiety. Next, their blood pressure was recorded while they completed two verbal autobiographical narratives.

RESULTS

During the positive narrative, anxiety was positively associated with increased PR while depression was negatively associated with PR. During the negative narrative, a significant interaction occurred whereby anxiety was significantly positively associated with PR for those participants low in depression.

DISCUSSION

The above results are explained in the context of the Tripartite Model of Depression and Anxiety, which predicts different patterns of PR as a function of mental health symptoms. Limitations and future directions are also discussed.

Sowing the seeds or failing to blossom? A feasibility study of a simple ecotherapy-based intervention in women affected by breast cancer

Engaging in nature-based activities is recognised as providing the basis for easily accessible, cost-effective interventions which can have other important physical and psychological health outcomes. The aim of the reported feasibility study was to explore the acceptability and potential psychological benefits of a simple ecotherapy-based intervention for individuals affected by cancer. A total of seven women from an existing breast cancer support group agreed to take part in the study by cultivating and customising a garden bowl for three months, maintaining a diary, and participating in a focus group at the end of the project. The analysis of the focus group data revealed four main themes that suggested that the women found engaging with the intervention to be therapeutic on a number of different levels: reflecting their cancer journey, a source of positivity, making meaning through memories, and a sense of control provided by engagement with the intervention. Engagement with the diary-writing element of the intervention, however, was not as widely endorsed by the group, as participants were even reluctant to make use of an online forum to share experiences of engaging with the intervention. Overall, the study suggests that the flexibility of level of engagement with an intervention is an important factor in developing acceptable interventions, and that the value of targeted recruitment to improve engagement with novel interventions is paramount.

An examination of the information disclosure behavior of infertility bloggers

Purpose

– The study aimed to investigate the information disclosure behavior of women bloggers who suffer from infertility by examining their self-disclosure as it relates to the anonymity patterns they adopted.

Design/methodology/approach

– A survey was distributed to approximately 300 authors of infertility blogs, 135 bloggers answered the request to take part in the study. The survey gathered basic demographic and blogging practice data, and measured different elements of the bloggers' discursive and visual anonymity as well as their patters of self-disclosure.

Findings

– Findings reveal that the majority of respondents identify themselves on their blogs and only a small percentage decided to be totally anonymous, and about half of the bloggers post actual photos of themselves and their lives. The participants reported a high rate of self-disclosure, revealing sensitive information, letting their defenses down, disclosing highly intimate details about their lives, writing openly about their infertility treatments on their blog. No significant correlation was observed between visual and discursive anonymity and the perceived self-disclosure of participants. Results show that the more anonymous the bloggers are, the more afraid they become that their blog may be read by people they know offline. On the other hand, the more identifiable the bloggers are, the more willingness they show to share the content of their journal with people they know offline. The majority of participants expressed concerns that blogging could negatively impact their lives.

Originality/value

– This study explores an alternate explanation through the examination of the bloggers' self-disclosure patterns as they relate to the degree of anonymity adopted.

Experiences from having breast cancer and being part of a support group. Notes written in diaries by women during radiotherapy

Objective:

The purpose of this study was to examine the experiences of breast cancer patients participating in a support group.

Method:

This study explores 28 stories of women with breast cancer as expressed through written diaries. Diaries were written during a 5-week period in parallel with radiotherapy and participation in a support group in a hospital. Answers to six open-ended evaluative questions concerning the support group were included in the majority of the written diaries. A qualitative content analysis was used to identify themes.

Results:

Three themes were constructed during the analysis: “positive group development.” “Inhibited group development.” and “the individual living with the disease.” Hopes and fears for the future in regards to illness and getting better, the value of family and friends, and feelings related to daily life with breast cancer such as fatigue and changes in body image were also expressed in the diaries.

Significance of results:

The findings suggest that the women with breast cancer found it valuable to be able to share experiences with other women in a similar situation in the context of a support group. Being part of such a group provided a space and an opportunity for reflection.

Implementing an expressive writing study in a cancer clinic

Patients at a comprehensive cancer center have participated in a weekly writing program for 7 years. Anecdotal evidence following writing in this clinical setting appeared congruent with the results of expressive writing studies conducted in laboratory settings. To move expressive writing research beyond the laboratory, we evaluated the feasibility of engaging a clinical population in a structured expressive writing task while they waited for an appointment in a cancer clinic. Adult leukemia and lymphoma patients (n = 71) completed a baseline assessment, 20-minute writing task, postwriting assessment, and 3-week follow-up; 88% completed the writing task and 56% completed the follow-up. Participants reported positive responses to the writing, and immediately postwriting about half (49.1%) reported that writing resulted in changes in their thoughts about their illness, while 53.8% reported changes in their thoughts at the 3-week follow-up. Reports of changes in thoughts about illness immediately postwriting were significantly associated with better physical quality of life at follow-up, controlling for baseline quality of life. Initial qualitative analyses of the texts identified themes related to experiences of positive change/transformation following a cancer diagnosis. Findings support the feasibility of conducting expressive writing with a clinical population in a nonlaboratory setting. Cancer patients were receptive to expressive writing and reported changes in the way they thought about their illness following writing. These preliminary findings indicate that a single, brief writing exercise is related to cancer patients' reports of improved quality of life.