Modes of relating to contingency: An exploration of experiences in advanced cancer patients

Kruizinga, Renske; Hartog, Iris D.; Scherer-Rath, Michael; Schilderman, Hans; Laarhoven, Hanneke W. M. van

doi:10.1017/s1478951516000936

Cited by 20 publications

(36 citation statements)

References 40 publications

(39 reference statements)

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“…The diagnosis of advanced, incurable cancer is likely to have a profound impact on people. [1][2][3][4][5] The limited lifetime left may directly conflict with the goals people have in life, and, as such, may entail an experience of contingency. 3,4 Contingency refers to the randomness of life, that everything could have been different.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5] The limited lifetime left may directly conflict with the goals people have in life, and, as such, may entail an experience of contingency. 3,4 Contingency refers to the randomness of life, that everything could have been different. [3][4][5][6] When life goals are jeopardized, questions like "why me" and "why now" may arise.…”

Section: Introductionmentioning

confidence: 99%

“…3,4 Contingency refers to the randomness of life, that everything could have been different. [3][4][5][6] When life goals are jeopardized, questions like "why me" and "why now" may arise. 1,4,5,7 Patients need to make meaning of their life with cancer and incorporate diagnosis and prognosis in their life story.…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5][6] When life goals are jeopardized, questions like "why me" and "why now" may arise. 1,4,5,7 Patients need to make meaning of their life with cancer and incorporate diagnosis and prognosis in their life story. 5 Integrating advanced cancer in one's narrative of life, however, is challenging, and feelings of hopelessness, depression, and even the desire for a hastened death were found to be common among patients with advanced cancer.…”

Section: Introductionmentioning

confidence: 99%

“…[10][11][12] The experience of contingency can be conceptualized as an interpretation crisis, and people may not be able to find words to express what is happening to them, that is, words may be insufficient in capturing intense experiences. [4][5][6] Thus, the use of questionnaires or in-depth interviews can only uncover part of patients' experiences. 10,13 A different approach invites patients to tell their story through visuals, in addition to spoken language.…”

Section: Introductionmentioning

confidence: 99%

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Living with advanced cancer: Rich Pictures as a means for health care providers to explore the experiences of advanced cancer patients

et al. 2019

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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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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Living with advanced cancer: Rich Pictures as a means for health care providers to explore the experiences of advanced cancer patients

et al. 2019

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Exploring resonance theory and uncontrollability during co‐creative art making: A qualitative study among cancer patients

Weeseman,

Scherer‐Rath,

Christophe

et al. 2024

Cancer Medicine

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PurposeCo‐creation, characterised by artists and patients creating a joint work of art, may support patients with the integration of life events, such as living with cancer, into their life story. In the process of co‐creation, resonance relationships between patients, artists and material may evolve that support such integration. Using the framework of resonance theory, we aim to investigate if and how patients move through the three phases of resonance during a process of co‐creation and explore the role of uncontrollability in this process.MethodsTen patients who received cancer treatment with palliative intent completed co‐creation processes, which were audio recorded. These recordings were imported in Atlas‐Ti and analysed by applying content analysis. We searched for the three phases of resonance, Being affected, touched and moved; Self‐efficacy and responding; Adaptive transformation. We additionally searched for signs of uncontrollability.ResultsPatients used 4–8 sessions (median 5 sessions) with a duration 90–240 min per session (median duration 120 min). We found that patients move through the three phases of resonance during co‐creation processes. Uncontrollability both presents a challenge and an invitation to integrate experiences of contingency into one's life narrative. Patients express self‐recognition and the experience of contingency in their work of art.ConclusionsIntegration of experiences of contingency into a life narrative can be supported by the process of co‐creation of art, which invites patients to relate to their illness, their environment and themselves. The phases of resonance in combination with uncontrollability as a continuously present factor, provide a means to both study and support the integration of experiences of contingency into the life narrative.

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Repeated use of rich pictures to explore changes in subjective experiences over time of patients with advanced cancer

et al. 2021

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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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Modes of relating to contingency: An exploration of experiences in advanced cancer patients

Abstract: Our study is the first to investigate the different ways of relating to contingency in clinical practice. The defined modes will improve our understanding of the various ways in which cancer patients relate to their disease, allowing caregivers to better target and shape individual care.

Cited by 20 publications

References 40 publications

Living with advanced cancer: Rich Pictures as a means for health care providers to explore the experiences of advanced cancer patients

Living with advanced cancer: Rich Pictures as a means for health care providers to explore the experiences of advanced cancer patients

Exploring resonance theory and uncontrollability during co‐creative art making: A qualitative study among cancer patients

Repeated use of rich pictures to explore changes in subjective experiences over time of patients with advanced cancer

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