The use of metaphors in non-Hodgkin's lymphoma patients undergoing chemotherapy.

AIM: The aim of this study was to explore the use of metaphors by non-Hodgkin's lymphoma (NHL) patients undergoing chemotherapy in a haematology ward setting. BACKGROUND: There is a dearth of literature exploring the use of metaphors in people with cancer undergoing aggressive treatment. Hence, this study aims to explore the use of metaphors in NHL patients undergoing chemotherapy and additionally, examining whether the use of such metaphors has an empowering/disempowering effect. DESIGN: A qualitative design was used. METHODS: The participants were six adult patients diagnosed with NHL and undergoing chemotherapy. Data collection was undertaken between July 2016-December 2016. Each participant was interviewed twice using semi-structured interviews. The data were analysed using Pragglejaz method for finding metaphors. FINDINGS: The participants used metaphors 17 times per 1,000 words to describe their experience of undergoing chemotherapy for NHL. The metaphors cited focused on aspects relating to "war", "prison" and a "journey". CONCLUSIONS: The findings demonstrate that certain metaphors used by the study participants, such as those pertaining to "war" or a "journey", concur with those described in narratives of people with cancer in general. However, the use of the "prison" metaphor by NHL patients undergoing chemotherapy relates particularly to their context of being isolated while undergoing treatment for fear of infection. Consequently, there is the need to interpret metaphors in relation to the specific type of illness and context. Furthermore, the findings of this study suggest that the impact of metaphors in empowering/disempowering people with cancer depends on the unique interpretation of the individual patient.

Coping with non-Hodgkin's lymphoma: a qualitative study of patient perceptions and supportive care needs whilst undergoing chemotherapy.

PURPOSE: Research to date on patients with non-Hodgkin's lymphoma has focused on the physical and psychological impact of undergoing chemotherapy. However, there is a dearth of studies targeting the coping strategies in this patient group. This article addresses the dearth in literature by exploring the coping strategies and supportive care needs of patients with non-Hodgkin's lymphoma whilst undergoing chemotherapy. METHODS: An exploratory qualitative phenomenological design was used. Six adult patients with non-Hodgkin's lymphoma and who were receiving chemotherapy were each interviewed twice using semi-structured interviews, which were audio-recorded. The data was transcribed verbatim and analysed using interpretative phenomenological analysis. RESULTS: Four themes emerged which outline how patients with non-Hodgkin's lymphoma cope with the challenges of undergoing chemotherapy. These are as follows: 'Interpreting life through a different lens', 'Wearing a mask', 'Suppressing thoughts about chemotherapy' and 'Support along the journey'. CONCLUSIONS: This article provides insight into the coping strategies and supportive care needs of patients with non-Hodgkin's lymphoma and who are undergoing chemotherapy. Some participants described attributing a new meaning to life, while others tried suppressing thoughts about cancer and chemotherapy. Additionally, some participants described hiding their true feelings by 'wearing a mask' in an effort to avoid distressing their families and consequently themselves. Nevertheless, all the participants emphasised the importance of support from health care providers, family and friends. These results provide insight which may guide future support services and interventional research aimed at assisting patients with non-Hodgkin's lymphoma to cope with the challenges of undergoing chemotherapy.

Being diagnosed with cancer: The experiences of patients with non-Hodgkin's lymphoma.

AIMS AND OBJECTIVES: To explore the lived experiences of patients on receiving a diagnosis of non-Hodgkin's lymphoma. BACKGROUND: Persons with non-Hodgkin's lymphoma are often diagnosed with cancer when at an advanced stage. This may arise due to a lack of screening programmes and delays in help seeking as the symptoms experienced are fairly nonspecific in nature. Consequently, receiving an unexpected diagnosis of non-Hodgkin's lymphoma may pose a psychosocial challenge to the individual. DESIGN: An exploratory qualitative phenomenological design was used. METHODS: Six adult patients diagnosed with non-Hodgkin's lymphoma were recruited and participated in two semi-structured interviews at different timepoints. Transcribed texts were analysed using interpretative phenomenological analysis. RESULTS: Three main themes emerged: "Emotional reaction to the diagnosis," "Struggling with a lack of understanding" and "Searching through past experiences." Most of the participants expressed shock, disbelief and fear at the news of being diagnosed with non-Hodgkin's lymphoma. A sense of relief was expressed by one participant, who could now provide a label to the pain experienced. CONCLUSIONS: This study highlights the responses of patients with non-Hodgkin's lymphoma on receiving a diagnosis. These responses are influenced by their knowledge about the illness, type of symptoms experienced, their own personal circumstances and the manner in which the diagnosis was given. RELEVANCE TO CLINICAL PRACTICE: Nursing care relates to an understanding of the patients' experiences. By reflecting on these findings, nurses are empowered to communicate with persons who have received a diagnosis of non-Hodgkin's lymphoma in a patient-sensitive manner, which establishes a relationship of trust and respect.

Patient and public involvement in research: Reflections and experiences of doctoral cancer nurse researchers in Europe.

PURPOSE: Early career researchers lack guidance about patient and public involvement (PPI). The overall aim of the study was to explore the knowledge and experiences of using PPI in research among doctoral students who are registered nurses. METHODS: This qualitative study included findings generated from reflective essays and focus groups involving ten registered cancer nurses who are undertaking doctoral research. The study has two stages of data collection. Participants initially wrote a reflective essay using a set of guiding questions to structure a response which was subsequently analysed. Two focus groups were then conducted to provide further insight into the themes identified in the reflective essays. Reflective thematic analysis was used to identify, name, and define the final themes. RESULTS: There were ten participants from seven countries and were at various stages of their doctoral study. Analysis of data from reflective essays (n = 10) and focus groups (n = 2) identified four themes namely, (a) evolving recognition and appreciation of PPI, (b) embracing PPI and impact on doctoral studies, (c) the influence of the research environment, and (d) the need to empower doctoral students to integrate PPI in their research journey. CONCLUSION: Participants reported differing experiences of PPI awareness showing disparity in guidance about PPI for junior researchers across Europe. We recommend provision of early PPI training for doctoral students to support and encourage involvement of patients and the public in their research. Opportunities for sharing PPI experiences to help improve PPI culture in research environments that support doctoral students should be explored.

The lived experience of patients with non-Hodgkin's lymphoma undergoing chemotherapy.

PURPOSE: Patients with non-Hodgkin's lymphoma face many challenges when undergoing chemotherapy. However, there is a dearth of literature targeting the experiences of this patient group. Hence, the aim of this study was to explore the lived experience of patients with non-Hodgkin's lymphoma during the initial stages of chemotherapy (i.e. from commencement to mid-treatment). METHOD: This study adopted a qualitative research design. Semi-structured interviews were conducted with six adult patients having non-Hodgkin's lymphoma and undergoing chemotherapy. Data collection was undertaken between July 2016 and December 2016. The interviews were audio-recorded and transcribed verbatim. The data was analysed using Interpretative Phenomenological Analysis. RESULTS: Three themes emerged: 'Living an emotional rollercoaster', 'Becoming dependent on others' and 'Facing an uncertain future'. This study highlights that, whilst undergoing chemotherapy, the participants experienced a rollercoaster of emotions, such as fear, relief, acceptance and depression, in addition to physical dysfunction. Moreover, two participants described feeling so overwhelmed emotionally that they even considered committing suicide. Nevertheless, all the participants stated that they hoped that their life would revert back to normal on completion of their treatment. CONCLUSIONS: The findings of this study may help guide the formulation of interventions that target the needs of patients undergoing chemotherapy for non-Hodgkin's lymphoma. Such interventions may include the introduction of community services where health care providers can provide domestic support to these patients. Additionally, the information generated can also inform hospital policies, such as the introduction of screening programs to monitor for psychological distress in this patient group during treatment.