Art therapy and self-image: A 5-year follow-up art therapy RCT study of women diagnosed with breast cancer.

OBJECTIVE: This follow-up study on perceived self-image and psychophysical distress/psychic symptoms was based on a ranomized contolled study of art therapy on women with breast cancer. METHOD: The aim was to examine the long-term effects of time-limited art therapy using the instruments of Structural Analysis of Social Behavior (SASB) and Symptom Check List-90 (SCL-90). RESULTS: Three attachment clusters of the SASB showed significant changes post therapy: Autonomous self (cluster 1), Accepting self (cluster 2), and Loving self (cluster 3). Clusters 2 and 3 continued to change in favor of the intervention group at the 5-year follow-up. There were no significant differences in the SCL-90 results between the intervention group and the control group in the follow-up study. SIGNIFICANCE OF RESULTS: The art therapy intervention was both therapeutic and psycho-educative. The conclusion of this study is that approaching emotions through time-limited art therapy seems to have a long-lasting effect on the attachment behavioral system shown in the SASB model post intervention, and this effect remained 5 years later.

The meaning of occupation for patients in palliative care when in hospital.

OBJECTIVE: The aim of this study was to describe how patients in palliative care relate to occupation during hospitalization and to define the meaning it has for them. METHOD: Eight inpatients in palliative care with various cancer diagnoses were interviewed one time. These interviews were transcribed and analyzed using qualitative content analysis. RESULTS: Patients experience occupations as meaningful when in hospital during the last period of their lives. They would like to be able to handle their own needs as much as possible. Staff behavior, the design of the environment, the lack of accessible occupations, and the degree to which patients can decide whether to receive or decline visits affect the possibility to make their wishes a reality. Our results also revealed that patients experience a sense of loss of their role, as well as a lack of control and participation. SIGNIFICANCE OF RESULTS: Our results confirm the importance of occupation and of patients having the option to and being given opportunities to take care of themselves when in palliative care. Further studies are needed to enable us to understand how organized occupations might influence patients' experience of being in a hospital during the final period of life.

Breast cancer survivorship--intersecting gendered discourses in a 5-year follow-up study.

In this article the authors present a follow-up study of women's interview narratives about life 5 to 7 years after a breast cancer operation. The women had taken part in a study during the 6-month postoperation period. Art therapy contributed to well-being, including strengthening personal boundaries. In the new study, interview analysis informed by critical discursive psychology indicated three problematic discourses that the women still struggled with several years after the operation: the female survivor, the "good woman," and individual responsibility. We concluded that many women with a history of breast cancer need support several years after their medical treatment is finished.

Sharing experiences in a support group: men's talk during the radiotherapy period for prostate cancer.

OBJECTIVE: Prostate cancer, one of the most common cancers in men, is often treated with radiotherapy, which strains both physical and mental health. This study aimed to describe the experiences of men living with prostate cancer shared within conversational support groups during a course of radiotherapy. METHOD: Nine men participated in one of two groups that met six or seven times, led by a professional nurse. Qualitative content analysis was used to identify themes and subthemes in the recorded group conversations. RESULTS: The analysis resulted in six themes: living with a changing body, being in the hands of others, learning to live with the disease, the importance of knowledge, everyday life support, and meeting in the support group. The men discussed a wide variety of bodily experiences and described support from healthcare professionals, relatives, friends, and the support group as crucial to their recovery. SIGNIFICANCE OF RESULTS: Meeting men in a similar situation, sharing experiences of living with the disease, and feeling allied to each other were important to the men in our study. The conversational support group provided the patient with prostate cancer a forum where sharing was made possible.

Talking via the child: discursively created interaction between parents and health care professionals in a pediatric oncology ward.

The aim of this study was to describe discursively constructed interactions between parents and health care professionals (HCPs) in a pediatric oncology ward. Field notes from 70 focused participant observations and 16 informal interviews with 25 HCPs interacting with 25 parents of children with cancer were analyzed using discursive psychology. Six dominant interpretative repertoires (flexible parts of discourses used in everyday interaction) were found. Repertoires used by the HCPs were child, parent, or family oriented, mirroring the primary focus of the interaction. Parents used a spokesperson repertoire to use their own expertise to talk on behalf of the child; an observer repertoire, in which they kept in the background and interfered only when needed; or a family member repertoire to position themselves on a level equal to the ill child. The results are discussed in relation to philosophies influencing pediatric nursing, such as family-centered nursing and child-centered nursing.

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.

'They don't understand you cut yourself in order to live.' Interpretative repertoires jointly constructing interactions between adult women who self-harm and professional caregivers.

The aim of the study was to illuminate interpretative repertoires that jointly construct the interaction between adult women who self-harm and professional caregivers in psychiatric inpatient care. Participant observations and informal interviews were conducted among six women who self-harm and their professional caregivers in two psychiatric inpatient wards, and analysed using the concept of interpretative repertoires from the discipline of discursive psychology. The analysis revealed four interpretative repertoires that jointly constructed the interaction. The professional caregivers used a "fostering repertoire" and a "supportive repertoire" and the women who self-harmed used a "victim repertoire" and an "expert repertoire." The women and the caregivers were positioned and positioned themselves and people around them within and among these interpretative repertoires to make sense of their experiences of the interaction. It was necessary to consider each woman's own life chances and knowledge about herself and her needs. The participants made it clear that it was essential for them to be met with respect as individuals. Professional caregivers need to work in partnership with individuals who self-harm-experts by profession collaborating with experts by experience. Caregivers need to look beyond behavioural symptoms and recognise each individual's possibilities for agency.

Caring for traffic accident victims: the stories of nine male police officers.

Psychological strain due to the work environment is common, especially in those occupations which involve working in critical situations. Working as a police officer seems to increase the risk of psychological problems such as symptoms of stress and post traumatic stress disorders. The aim of this study was to describe male police officers' experiences of traumatic situations when caring for victims of traffic accidents, and to reflect the results through the perspective of gender theories. Nine police officers were asked to narrate and reflect upon their experiences in taking care of people who had been severely injured in traffic accidents. The interviews were analysed with qualitative content analysis. The findings are presented in three themes: "being secure with the support system", "being confident about prior successful actions, and "being burdened with uncertainty". The officers' descriptions showed that most of them had strategies that they used when they were first responders, developed on the basis of their own knowledge and actions and the support systems in their organization which enabled them to act in traumatic situations. When support systems, knowledge, and actions were insufficient, they sometimes felt insecure and "burdened with uncertainty". In this male-dominated context, there was a risk that the officers may not talk enough about traumatic situations, thus influencing their ability to cope successfully.

Individual brief art therapy can be helpful for women with breast cancer: a randomized controlled clinical study.

OBJECTIVE: Recent research shows that almost every second woman with breast cancer is depressed or has anxiety; the risk for younger women is even higher. Moreover, research shows that women are at risk for developing depression, also a threat for women with breast cancer. The aim of this randomized controlled clinical trial was to study the outcome of five sessions of art therapy given at a 5-week period of postoperative radiotherapy. METHODS: The participants were between 37 and 69 years old; six participants in each group were below 50 years of age. Half of the participants (n = 20) received art therapy and the other half (n = 21) were assigned to a control group. At the first measurement, at least 17% (n = 7) of the participants medicated with antidepressants. Data were collected before and after art therapy and at a 4-month follow-up using self-rating scales that measure self-image (the Structural Analysis of Social Behaviour) and psychiatric symptoms (the Symptom Check List-90). RESULTS: At follow-up, significant lower ratings of depression, anxiety, and somatic symptoms and less general symptoms were reported for the art therapy group compared to the control group. The regression analysis showed that art therapy relates to lower ratings of depression, anxiety, and general symptoms; chemotherapeutic treatment predicts lower depressive symptoms; in contrast to axillary surgery and hormonal treatment as well as being a parent predicts higher ratings of anxiety and general symptoms. SIGNIFICANCE OF RESULTS: The conclusion suggests that art therapy has a long-term effect on the crisis following the breast cancer and its consequences.

Art therapy improves coping resources: a randomized, controlled study among women with breast cancer.

OBJECTIVE: Women with breast cancer suffer from considerable stress related to the diagnosis, surgery, and medical treatment. It is important to develop strategies to strengthen coping resources among these women. Research in art therapy has shown outcomes such as an increase in self-esteem and cohesion, significant improvement in global health, and a decrease in anxiety and depression. The aim of the present article was to describe the effects of an art therapy intervention program on coping resources in women with primary breast cancer. METHOD: In this article, we report some of the results from a study including 41 women, aged 37-69 years old, with nonmetastatic primary breast cancer, referred to the Department of Oncology at Umeå University Hospital in Sweden for postoperative radiotherapy. The women represented various socioeconomic backgrounds. They were randomized to a study group (n = 20) with individual art therapy for 1 h/week during postoperative radiotherapy or to a control group (n = 21). The article focuses on changes in coping resources, as measured by the Coping Resources Inventory (CRI) before and 2 and 6 months after the start of radiotherapy. The study protocol was approved by the Umeå University Ethical Committee at the Medical Faculty (archive number 99-386). RESULTS: There was an overall increase in coping resources among women with breast cancer after taking part in the art therapy intervention. Significant differences were seen between the study and control groups in the social domain on the second and third occasions. Significant differences were also observed in the total score on the second occasion. SIGNIFICANCE OF RESULTS: This study shows that individual art therapy provided by a trained art therapist in a clinical setting can give beneficial support to women with primary breast cancer undergoing radiotherapy, as it can improve their coping resources.