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Martino ML, Lemmo D, Moylan J, Stevenson C, Bonalume L, Freda MF, Singer JA. The Role and Function of Autobiographical Memory Narratives during the Emotional Processing of Breast Cancer Treatment: An Empirically-Derived Memory Coding System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1492. [PMID: 36674247 PMCID: PMC9859229 DOI: 10.3390/ijerph20021492] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/28/2022] [Accepted: 12/31/2022] [Indexed: 06/17/2023]
Abstract
Breast cancer (BC) in younger age is a critical and potentially traumatic experience that can interrupt the continuity of self-narrative during a crucial phase. In the Narrative Identity framework the translation of memories into autobiographical narratives is an internal and external process that plays a key role in meaning-making, social relationships and self-coherence. The aim of this study is to examine the role and function that autobiographical memory narratives (AMN) play in the process of adaptation to BC medical treatment. Seventeen BC women below 50 years received prompts to provide autobiographical memory narratives at four phases during their treatment (pre-hospitalization-T1-post-surgery-T2-chemo-radio therapy-T3-follow-up-T4). The Emotional Processing Scale (EPS) was also administered. In all, 68 AMN were collected. A three step procedure of data analysis was conducted. The first one, an empirically-derived memory coding manual to analyze key dimensions of AMN was developed: Agency; Emotional Regulation and Interpersonal Relations. Findings show a particular vulnerability in narrative identity faced by BC women during the shift from T1-T3. In the second one, an emotional coping profile for each woman focusing on the shift from T1-T3 was created. For the third step, these profiles were compared with the EPS scores. The final results suggest the capacity of the AMNs to differentiate the women's emotional adaptation over the course of the BC treatment. Despite the study's limitations, it supports the use of AMN as clinical device to construct a deeper knowledge and profiling trajectory of how women have internalized and elaborated past encounters with illness and help providers, as well as their prior experience of bodily/psychological health and integrity. This information adds to an understanding of their current efforts at recovery and adaptation. In this way we believe that the recollection of narrative memories, not only at the end of the cancer treatment but also during its process, could help the women to mend the broken continuity of their narrative self, as they seek to maintain a healthy balance of internal resources across their past, present, and projected future.
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Affiliation(s)
| | - Daniela Lemmo
- Department of Humanities, Federico II University, 80133 Naples, Italy
| | - Joshua Moylan
- Department of Psychology, Connecticut College, New London, CT 06107, USA
| | - Caroline Stevenson
- Department of Psychology, Connecticut College, New London, CT 06107, USA
| | - Laura Bonalume
- Department of Clinical Psychology (U.O.S.D), Territorial Healthcare Company, 20873 Brianza, Italy
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Lemmo D, Martino ML, Donizzetti AR, Freda MF, Caso D. The Relationship between Healthcare Providers and Preventive Practices: Narratives on Access to Cancer Screening. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710942. [PMID: 36078658 PMCID: PMC9517751 DOI: 10.3390/ijerph191710942] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/26/2022] [Accepted: 08/27/2022] [Indexed: 05/06/2023]
Abstract
Cancer screening programs are public health interventions beneficial to early diagnoses and timely treatments. Despite the investment of health policies in this area, many people in the recommended age groups do not participate. While the literature is mainly focused on obstacles and factors enabling access to health services, a gap from the point of view of the target population concerns healthcare providers. Within the "Miriade" research-action project, this study aims to explore the dimensions that mediate the relationship between healthcare providers and preventive practices through the narrations of 52 referents and healthcare providers involved in breast, cervical and colorectal cancer screening. We conducted ad hoc narrative interviews and used theory-driven analysis based on Penchansky and Thomas' conceptualization and Saurman's integration of six dimensions of healthcare access: affordability, availability, accessibility, accommodation, acceptability and awareness. The results show that 21 thematic categories were representative of the access dimensions, and 5 thematic categories were not; thus, we have classified the latter as the dimension of affection. The results suggest trajectories through which psychological clinical intervention might be constructed concerning health, shared health decisions and access to cancer screening.
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Martino ML, Gargiulo A, Lemmo D, Dolce P, Barberio D, Abate V, Avino F, Tortoriello R. Longitudinal effect of emotional processing on psychological symptoms in women under 50 with breast cancer. Health Psychol Open 2019; 6:2055102919844501. [PMID: 31037219 PMCID: PMC6475855 DOI: 10.1177/2055102919844501] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Breast cancer is a potential traumatic event associated with psychological symptoms, but few studies have analysed its impact in under-50 women. Emotional processing is a successful function in integrating traumatic experiences. This work analysed the relationship between emotional processing and psychological symptoms during three phases of treatment (before hospitalization, counselling after surgery and adjuvant therapy) in 50 women under the age of 50 with breast cancer. Mixed-effects models tested statistical differences among phases. There were significant differences in symptoms during the treatments: the levels of anxiety decrease from T1 to T3 (0.046), while those of hostility increase (<0.001). Emotional processing is a strong predictor of all symptoms. Clinical implications are discussed.
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Affiliation(s)
| | | | | | | | | | | | - Franca Avino
- National Cancer Institute 'G. Pascale Fondazione', Italy
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Wallace R, Kaliambou M, Qayyum Z. Fairy Tales and Psychiatry: a Psychiatry Residency's Experience Using Fairy Tales and Related Literary Forms to Highlight Theoretical and Clinical Concepts in Childhood Development. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2019; 43:114-118. [PMID: 30155601 DOI: 10.1007/s40596-018-0968-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 08/07/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Ryan Wallace
- Yale University School of Medicine, New Haven, CT, USA.
| | | | - Zheala Qayyum
- Yale University School of Medicine, New Haven, CT, USA
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De Luca Picione R, Luisa Martino M, Freda MF. Understanding Cancer Patients’ Narratives: Meaning-Making Process, Temporality, and Modal Articulation. JOURNAL OF CONSTRUCTIVIST PSYCHOLOGY 2016. [DOI: 10.1080/10720537.2016.1227738] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Raffaele De Luca Picione
- SInAPSi (Center for Active and Integrated Inclusion of Students), Federico II University, Naples, Italy
| | - Maria Luisa Martino
- SInAPSi (Center for Active and Integrated Inclusion of Students), Federico II University, Naples, Italy
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Martino ML, Onorato R, Freda MF. Linguistic Markers of Processing Trauma Experience in Women's Written Narratives During Different Breast Cancer Phases: Implications for Clinical Interventions. EUROPES JOURNAL OF PSYCHOLOGY 2015; 11:651-63. [PMID: 27247683 PMCID: PMC4873081 DOI: 10.5964/ejop.v11i4.991] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 09/25/2015] [Indexed: 11/20/2022]
Abstract
Research into the change processes underlying the benefits of expressive writing is still incomplete. To fill this gap, we investigated the linguistic markers of change in cognitive and emotional processing among women with breast cancer, highlighting the differences and peculiarities during different treatment phases. A total of 60 writings were collected from 20 women: 10 receiving chemotherapy and 10 receiving biological therapy. We performed a series of repeated measures ANOVA for the most meaningful LIWC linguistic categories, including positive/negative emotions and cognitive processes, to assess change over three sessions. Results demonstrated a significant increase in the positive emotions category for the entire group of women, with particular relevance for the biological therapy group of women, and a marginally significant (p = .07) greater use of words indicating cognitive processes for women receiving biological therapy. For the negative emotions category time was significant for the whole group of women, showing a peak of use in the second session of writing. Peculiar differences in the linguistic markers of processing trauma were observed between the two groups. Although the writing intervention is a support for both groups of women, it seems to be beneficial when there is a large time gap since the administration of chemotherapy and, thus, when the patient can revisit the experience. The relationship of the illness with life can be rearticulated, and the writing becomes a space for resignifying the traumatic cancer experience.
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Affiliation(s)
| | - Raffaella Onorato
- Department of Humanistic Studies, Federico II University, Naples, Italy
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Rahimzadeh V, Bartlett G, Longo C, Crimi L, Macdonald ME, Jabado N, Ells C. Promoting an ethic of engagement in pediatric palliative care research. BMC Palliat Care 2015; 14:50. [PMID: 26474573 PMCID: PMC4608148 DOI: 10.1186/s12904-015-0048-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 10/08/2015] [Indexed: 11/12/2022] Open
Abstract
Background This paper defends the ethical and empirical significance of direct engagement with terminally ill children and adolescents in PPC research on health-related quality of life. Clinical trials and other forms of health research have resulted in tremendous progress for improving clinical outcomes among children and adolescents diagnosed with a life-threatening illness. Less attention has been paid, however, to engaging this patient population directly in studies aimed at optimizing health-related quality of life in PPC. Though not restricted to care at the end of life, PPC—and by extension PPC research—is in part dependent on recognizing the social complexities of death and dying and where health-related quality of life is a fundamental element. To explore these complexities in depth requires partnership with terminally ill children and adolescents, and acknowledgement of their active social and moral agency in research. Discussion Principles of pediatric research ethics, theoretical tenets of the “new sociology of the child(hood),” and human rights codified in the United Nations Convention on the Rights of the Child (UNCRC) underpin the position that a more engagement-centered approach is needed in PPC research. The ethics, sociologies and human rights of engagement will each be discussed as they relate to research with terminally ill children and adolescents in PPC. Qualitative method(ologies) presented in this paper, such as deliberative stakeholder consultations and phenomenology of practice can serve as meaningful vehicles for achieving i) participation among terminally ill children and adolescents; ii) evidence-bases for PPC best practices; and iii) fulfillment of research ethics principles. Conclusion PPC research based on direct engagement with PPC patients better reflects their unique expertise and social epistemologies of terminal illness. Such an approach to research would strengthen both the ethical and methodological soundness of HRQoL inquiry in PPC.
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Affiliation(s)
- Vasiliki Rahimzadeh
- Department of Family Medicine, Centre of Genomics and Policy, McGill University, 5858 Côte-des-Neiges, Suite 300, Montréal, QC, H3S 1Z1, Canada.
| | - Gillian Bartlett
- Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, Suite 300, Montréal, QC, H3S 1Z1, Canada
| | - Cristina Longo
- Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, Suite 300, Montréal, QC, H3S 1Z1, Canada
| | - Laura Crimi
- Department of Family Medicine, McGill University, 5858 Côte-des-Neiges, Suite 300, Montréal, QC, H3S 1Z1, Canada
| | - Mary Ellen Macdonald
- Division of Oral Health and Society, Pediatric Palliative Care Research, Montreal Children's Hospital, McGill University, #530-2001 McGill College Avenue, Montreal, QC, H3A 1G1, Canada
| | - Nada Jabado
- Department of Pediatrics, Montreal Children's Hospital Research Institute, McGill University Health Center, 1001 Décarie Boulevard, Montreal, H4A 3J1, QC, Canada
| | - Carolyn Ells
- Biomedical Ethics Unit, McGill University, 3647 Peel St, Montreal, QC, H3A 1X1, Canada
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Borders and Modal Articulations. Semiotic Constructs of Sensemaking Processes Enabling a Fecund Dialogue Between Cultural Psychology and Clinical Psychology. Integr Psychol Behav Sci 2015; 50:29-43. [DOI: 10.1007/s12124-015-9318-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Freda MF, Martino ML. Health and writing: meaning-making processes in the narratives of parents of children with leukemia. QUALITATIVE HEALTH RESEARCH 2015; 25:348-359. [PMID: 25246328 DOI: 10.1177/1049732314551059] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
There is literary evidence stating that expressive writing affects health outcomes. Nevertheless, the processes underlying its benefits remain unclear. In our previous article, we described the benefits of writing; in this article, we investigate the meaning-making processes underlying the traumatic experiences of parents of children with leukemia in off-therapy. We collected the writings of 23 parents and grouped them according to the parents' psychological outcome (low/good/high) with respect to anxiety, as assessed during a follow-up. We qualitatively analyzed the texts written by parents with good psychological outcomes to highlight their main meaning-making processes, that is, how they put into words the shattering experience, reordered the events, connected their emotions and the events, reevaluated the event, and reconstructed the time process. We found that parents with low/high outcomes articulated these processes differently. Furthermore, we discussed the uses and functions of written narration for each group.
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