Talking cancer - cancer talking: a linguistic and thematic analysis of patient narratives

Abstract

Purpose The narratives of patients with cancer in various diagnostic categories and clinical stages are explored, using thematic analysis and LIWC-methodology. Exploring the psychological response - “the lived experience” - to cancer has humanistic, scientific, and clinical importance, informing researchers, clinicians, and patients about focus and methods of improving quality of life and quality of care. Methods Narratives of 20 patients were listened to in the patients’ homes - “at the kitchen table” - in order to optimally capture the lived experience of cancer. Audiotaped narratives were transcribed and analyzed with the Linguistic Inquiry and Word Count (LIWC) methodology. Thematic Analysis was used to explore themes in the narratives. Results Scores on relevant LIWC-dimensions of the 20 patients were compared with norm data for respondents without cancer. Compared to LIWC-scores of healthy respondents, the patients with cancer scored higher on ‘anger’ and ‘sadness’ (psychologic processes dimension), lower on ‘insight’, ‘causes’ and ‘tentatives’ (cognitive processes dimension), and lower on ‘religion’. The Thematic Analysis data of the narratives disclosed as major themes resilience, fatigue, social relationships, turning inward psychologically, preferences for shared-decision making, and psychological support. LIWC-scores and Thematic Analysis scores paint a picture of patients doing their utmost to make sense of their illness experience, potentially informing psychological support for people with cancer. Conclusion LIWC analysis and Thematic Analysis of the patients’ illness narratives demonstrate the clinical relevance of studying the lived experience of cancer. Narratives of patients with cancer are detectable with LIWC-methodology and Thematic Analysis; they offer pathways to clinical interventions. Incorporating illness narratives into clinical cancer care contributes to care that focuses on “outcomes that matter”.