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Fryze M, Wisniewska P, Wiertlewska-Bielarz J, Moskalewicz M. Past Happiness and Broken Future Horizon of Oncological Patients during Chemotherapy-A Quantitative Exploration of a Phenomenological Hypothesis. Cancers (Basel) 2024; 16:2124. [PMID: 38893243 PMCID: PMC11171201 DOI: 10.3390/cancers16112124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/22/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024] Open
Abstract
Understanding the impact of cancer on the experience of time is crucial in the context of hope and recovery. This study, a follow-up to a previous qualitative study of ovarian cancer patients - explored two types of such experiences-the memory of past happiness and the limited future planning. A sociodemographic questionnaire with nine questions about the experience of time was used on a convenience sample of 202 patients with various cancers, predominantly women with breast, ovarian, and cervical cancer. It was found that the respondents experienced increased focus on the present, decreased focus on the future, and a sense of unpredictability, with a relatively short temporal horizon measured in weeks and months, not years. Almost half of the respondents (46%) measured time during treatment by the rhythm of chemotherapy and check-ups, which thus appeared as the most meaningful events. The increase in the frequency with which patients underwent chemotherapy mildly affected their focus on the present (R = 0.25, p < 0.05), likely because of the discomfort of the side effects. The correlations between age and time in treatment, on the one hand, and the experience of time, on the other, were negligible. Changed temporal experience during chemotherapy is a factor that can have an impact on patients' well-being and ability to cope with the disease. It thus should be taken into account when planning oncology care.
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Affiliation(s)
- Magdalena Fryze
- Department of Psychology, Medical University of Lublin, 20-059 Lublin, Poland
| | - Patrycja Wisniewska
- Philosophy of Mental Health Unit, Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Jadwiga Wiertlewska-Bielarz
- Philosophy of Mental Health Unit, Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Marcin Moskalewicz
- Philosophy of Mental Health Unit, Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 61-701 Poznań, Poland
- Phenomenological Psychopathology and Psychotherapy, Psychiatric Clinic, University of Heidelberg, 69115 Heidelberg, Germany
- Institute of Philosophy, Maria Curie-Sklodowska University, 20-400 Lublin, Poland
- IDEAS NCBR, Chmielna 69, 00-801 Warsaw, Poland
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Dewar J, Cook C, Smythe E, Spence D. An analysis of time conceptualisations and good care in an acute hospital setting. Nurs Inq 2024; 31:e12613. [PMID: 37927168 DOI: 10.1111/nin.12613] [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: 09/16/2023] [Revised: 10/16/2023] [Accepted: 10/21/2023] [Indexed: 11/07/2023]
Abstract
This study articulates the relationship between conceptualisations of time and the accounts of good care in an acute setting. Neoliberal healthcare services, with their focus on efficiencies, predominantly calculate quality care based on time-on-the-clock workforce management planning systems. However, the ways staff conceptualise and then relate to diverse meanings of time have implications for good care and for staff morale. This phenomenological study was undertaken in acute medical-surgical wards, investigating the contextual, temporal nature of care embedded in human relations. The study interviews involved 17 participants: 11 staff, 3 previous patients and 3 family members. Data were analysed iteratively to surface the phenomenality of temporality and good care. The following constituents of the data set are explored that together illustrate the relationship between the conceptualisations of time and the accounts of good care in an acute setting: patient time as a relational journey; patient time, sovereign time and time ethics and time, teamwork and flow. The findings are clinically significant because they offer a contrasting narrative about the relationship between time and care quality. The experiences of giving and receiving good care are indivisible from how temporality is experienced and the social relations within which care is embedded. Healthcare staff experience temporality differently from patients and families, a point that healthcare participants in this study appeared to comprehend and accommodate. For all parties involved in providing care or being the recipient of care, however, the capacity to be present was valued as a humanising ethic of care. Our study reinforces the importance of not creating presumptive binaries about which temporal structures are more or less humanising-there is a place for a fast-paced tempo, which can be experienced as being in the flow of human relations with one's team and on behalf of patients.
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Affiliation(s)
- Jan Dewar
- Department of Nursing, Faculty of Health and Environmental Sciences, School of Clinical Sciences, Auckland University of Technology North Campus, Auckland, New Zealand
| | - Catherine Cook
- Department of Nursing, Faculty of Health and Environmental Sciences, School of Clinical Sciences, Auckland University of Technology North Campus, Auckland, New Zealand
| | - Elizabeth Smythe
- Department of Nursing, Faculty of Health and Environmental Sciences, School of Clinical Sciences, Auckland University of Technology North Campus, Auckland, New Zealand
| | - Deborah Spence
- Department of Nursing, Faculty of Health and Environmental Sciences, School of Clinical Sciences, Auckland University of Technology North Campus, Auckland, New Zealand
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Moskalewicz M, Kordel P, Kokociński M, Wiertlewska-Bielarz J, Makowski P. The rhythm of chemotherapy and the felt experience of time: a front-loaded phenomenological retrospective cohort study. Sci Rep 2023; 13:9286. [PMID: 37286667 DOI: 10.1038/s41598-023-35856-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 05/24/2023] [Indexed: 06/09/2023] Open
Abstract
It is well-known that chemotherapy brings about various adverse physical effects such as fatigue, nausea, or vomiting, and that it lowers mental well-being. It is less known that it desynchronizes patients with social environment. This study explores the temporal aspects and challenges of chemotherapy. Three groups equal in size and distinguished according to weekly, biweekly, and triweekly treatment schemes, each independently representative in terms of sex and age of the cancer population (total N = 440) were compared. The study found that chemotherapy sessions, regardless of their frequency, patients' age, and the overall length of treatment, have a very large effect on changing the felt pace of time from flying to dragging (Cohen's d = 1.6655). Most patients pay more attention to the passing of time than before treatment (59.3%), which has to do with the disease (77.4%). They also experience the loss of control over time, which they subsequently attempt to regain. The patients' actual activities before and after chemotherapy, however, are mostly the same. All these aspects create a unique 'chemo-rhythm', in which the significance of the type of cancer and demographic variables is negligible, and the mere rhythmic nature of treatment plays a central role. In conclusion, patients find the 'chemo-rhythm' stressful, unpleasant and difficult to control. It is vital to prepare them for it and help to reduce its adverse effects.
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Affiliation(s)
- Marcin Moskalewicz
- Phenomenological Psychopathology and Psychotherapy, Psychiatric Clinic, University Hospital Heidelberg, Heidelberg, Germany.
- Philosophy of Mental Health Unit, Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Poznan, Poland.
- Institute of Philosophy, Marie Curie-Sklodowska University, Lublin, Poland.
- IDEAS NCBR, Warsaw, Poland.
| | - Piotr Kordel
- Philosophy of Mental Health Unit, Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Poznan, Poland
| | - Maciej Kokociński
- Faculty of Sociology, Adam Mickiewicz University in Poznan, Poznan, Poland
| | - Jadwiga Wiertlewska-Bielarz
- Philosophy of Mental Health Unit, Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Makowski
- Faculty of Management, University of Warsaw, Warsaw, Poland
- Queen's University, Belfast, UK
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Johnston B, Dowling M. Qualitative Research and Cancer Nursing: A Guide for Novice Researchers. Semin Oncol Nurs 2023; 39:151397. [PMID: 36813627 DOI: 10.1016/j.soncn.2023.151397] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 01/23/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVE To introduce the cancer nurse to qualitative research. DATA SOURCES A search of published literature including articles and books was conducted to inform the article using University libraries (University of Galway and University of Glasgow) and CINAHL, Medline, and Google Scholar databases using broad terms, including qualitative research, qualitative methods, paradigm, qualitative, and cancer nursing. CONCLUSION It is important for cancer nurses wishing to read, critically appraise, or undertake qualitative research to understand the origins and different methods employed in qualitative research. IMPLICATIONS FOR NURSING PRACTICE The article is of relevance for cancer nurses globally who wish to read, critique, or undertake qualitative research.
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Affiliation(s)
- Bridget Johnston
- Clinical Professor of Nursing and Palliative Care, Director of Research School of Medicine, Dentistry & Nursing, University of Glasgow and Chief Nurse Research, NHS Greater Glasgow & Clyde, Glasgow, Scotland.
| | - Maura Dowling
- Associate Professor of Nursing, School of Nursing and Midwifery, University of Galway, Galway, Ireland
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Moskalewicz M, Kordel P, Wiertlewska-Bielarz J. Chemotherapy, clocks, and the awareness of death: A quantitative phenomenological study. Front Psychol 2023; 14:1097928. [PMID: 36998375 PMCID: PMC10043210 DOI: 10.3389/fpsyg.2023.1097928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/16/2023] [Indexed: 03/17/2023] Open
Abstract
Following a previous phenomenological study of lived time in ovarian cancer, this research aims to find how the frequency of chemotherapy affects orientation in time (the so-called “chemo-clock”) and the awareness of mortality of service users with various cancers. For this purpose, a variation of a front-loaded phenomenological method that combines scientific hypothesis testing with phenomenological insights of both conceptual and qualitative nature was developed. The study is based on a purposive quota sample of 440 participants representative of the Polish cancer population in terms of sex (m:f ratio 1:1) and age (m > 65 = 61%; f > 65 = 53%) and undergoing chemotherapy for at least a month. The exposure environmental factors of interest are temporal: the frequency of chemotherapy [weekly (N = 150), biweekly (N = 146), and triweekly (N = 144)] and time since the beginning of treatment. The study confirms the relevance of the “chemo-clock”—participants use the pace of hospital appointments for orientation in time, and significantly more often when in triweekly treatments (weekly 38%; biweekly 61%; triweekly 69.4%; V = 0.242, p < 0.001, while neither age nor time since the beginning of treatment differentiate the usage of calendar categories and the “chemo-clock”). Simultaneously, chemotherapy increases their awareness of finitude, which again correlates neither with age nor time since the beginning of treatment but is significantly stronger in those with lower chemotherapy frequencies. Lower treatment frequencies are thus associated with its increased significance in terms of its impact on how people with cancer measure time and whether they increasingly consider their mortality.
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Affiliation(s)
- Marcin Moskalewicz
- Phenomenological Psychopathology and Psychotherapy, Psychiatric Clinic, University of Heidelberg, Heidelberg, Germany
- Philosophy of Mental Health Unit, Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Poznań, Poland
- Institute of Philosophy, Marie Curie-Sklodowska University, Lublin, Poland
- *Correspondence: Marcin Moskalewicz,
| | - Piotr Kordel
- Philosophy of Mental Health Unit, Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Poznań, Poland
| | - Jadwiga Wiertlewska-Bielarz
- Philosophy of Mental Health Unit, Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Poznań, Poland
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Egilsdóttir H, Jónsdóttir H, Klinke ME. Living in Rural Areas and Receiving Cancer Treatment Away From Home: A Qualitative Study Foregrounding Temporality. Glob Qual Nurs Res 2022; 9:23333936221111802. [PMID: 35875361 PMCID: PMC9305796 DOI: 10.1177/23333936221111802] [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: 12/06/2021] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 11/26/2022] Open
Abstract
We used explorative interviews to gauge (inter)personal, physiological, and emotional challenges of seven rural cancer patients who traveled long distances to cancer treatment centers. After a thematic analysis, we foregrounded experiences of temporality by using a phenomenologically inspired approach. The analysis resulted in three themes: (a) An epiphany of “what really matters in life”—time gains new meaning, (b) Feeling out of sync with others and own body—striving for coherence and simultaneity, and (c) Being torn between benefits of home and treatments site—time and distance as a tangible aspect of traveling and being away. Under these themes, 13 meaning units were generated, which reflected changes in temporality. During treatment, life primarily revolved around repeating circles of travel arrangements, staying on top of treatment schedule, and synchronizing a home life with a life away from home. Nurses should provide comprehensive care to enhance stability in cancer patients’ temporal experiences.
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Affiliation(s)
| | | | - Marianne Elisabeth Klinke
- University of Iceland, Reykjavik, Iceland.,Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
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Moskalewicz M, Kordel P, Sterna A. The rhythm of chemotherapy and cancer patients' time perspectives. PeerJ 2022; 10:e14486. [PMID: 36536628 PMCID: PMC9758969 DOI: 10.7717/peerj.14486] [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: 07/14/2022] [Accepted: 11/08/2022] [Indexed: 12/15/2022] Open
Abstract
Background While it is well known that illnesses such as cancer modify the experience of time, the impact of the rhythm and length of treatment on patients' time perspectives remains unknown. Methods A short version of Zimbardo Time Perspective Inventory and Transcendental Future Perspective Questionnaire as well as a demographic questionnaire on a convenience sample of 259 patients (66.8% female, mean age 52.36) with various cancers and undergoing chemotherapy with different frequencies (1, 2, 3 weeks) and mean time in treatment 23.4 months. Results The temporal perspectives mean scores of cancer patients are: positive past 3.69, negative past 3.13, present hedonism 3.08, future 3.77, transcendental future 3.40. Patients tend only slightly to lose faith alongside the course of oncological treatment regardless of their age (ρ = - 0.210, p < 0.01). The frequency of chemotherapy mildly differentiates temporal perspectives of patients regarding present hedonism and transcendental future: a weekly treatment is more disturbing than the triweekly one and no treatment in terms of hedonism, while patients not in chemo score significantly higher in transcendental future than patients in biweekly and triweekly chemo. Conclusions The variations of treatment rhythm are less significant than predicted, although still relevant. Since most sociodemographic variables are of no relevance, cancer experience likely unifies temporal perspectives among people of different backgrounds.
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Affiliation(s)
- Marcin Moskalewicz
- Philosophy and Mental Health Unit, Department of Social Sciences and the Humanities, Poznań University of Medical Sciences, Poznań, Wielkopolskie, Poland.,Institute of Philosophy, Maria Curie-Sklodowska University Lublin, Lublin, Lubelskie, Poland
| | - Piotr Kordel
- Philosophy and Mental Health Unit, Department of Social Sciences and the Humanities, Poznań University of Medical Sciences, Poznań, Wielkopolskie, Poland
| | - Anna Sterna
- Philosophy and Mental Health Unit, Department of Social Sciences and the Humanities, Poznań University of Medical Sciences, Poznań, Wielkopolskie, Poland
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Moskalewicz M, Popova Y, Wiertlewska-Bielarz J. Lived time in ovarian cancer - A qualitative phenomenological exploration. Eur J Oncol Nurs 2021; 56:102083. [PMID: 34998214 DOI: 10.1016/j.ejon.2021.102083] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 11/12/2021] [Accepted: 11/29/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE To explore lived time of women with ovarian cancer during chemotherapy. METHODS Consensual qualitative research combined with descriptive phenomenology on a purposive sample of 9 middle-aged women (aged between 33 and 52 years, mean age 41.7) with ovarian cancer undergoing chemotherapy in an outpatient chemo center in a clinical hospital. Patients partnered in the design of the study by reviewing the research questions. RESULTS Four essential temporal structures were uncovered, namely: 1) Explicit finitude - the vivid presence of the thoughts of one's limited lifespan and of time passing towards death. 2) Broken horizon - a sense of an overwhelming unpredictability of life that makes one living in the narrow present. 3) The paradoxes of the chemo-clock - treatment rhythm becoming a basis for the conceptualization of time while lived experience both decelerates and accelerates. 4) Happiness closed-off by regret - the past being distantiated yet present in the form of thoughts about actions that have not been accomplished and no longer can. CONCLUSION The research shows unsecure lived time of participants, particularly anxiety concerning premature death and fear of the future due to harsh prognosis. The proposed hybrid method of collecting and analyzing data is an example of combining phenomenological and scientific-objectifying procedures. It can lead to wider replications in different populations with respect to type and stage of the cancer and treatment.
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Affiliation(s)
- Marcin Moskalewicz
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Rokietnicka 7, 60-806, Poznan, Poland.
| | - Yanna Popova
- Oxford Brookes University, UK; Polish Institute of Advanced Studies, Poland
| | - Jadwiga Wiertlewska-Bielarz
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Rokietnicka 7, 60-806, Poznan, Poland
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