Abstract
Despite evidence that nurses may play a crucial part in the wellbeing and recovery of cancer patients by facilitating their expression of feelings, research is lacking into the emotional content of nurse–patient talk and patients' use of language in emotion disclosure. In this study, 23 participating nurses in a variety of cancer care settings were asked to tape-record their conversations with patients during daily care. A data set of 60 nurse–patient conversations was collected. Individual expression of emotion by patients was identified through interpretive literary analysis within a framework of psychodynamic theory. Overall the picture of emotion disclosure was intense. In particular, patients' use of metaphor and figurative language to express their distress was powerful and pervasive. Participating nurses demonstrated responsive skills but their responses to figurative expression were often problematic.The study provides evidence of unconscious processes in nurses' work and advocates career-long psychoanalytically informed supervision for nurses to better support them in challenging dialogue with cancer patients. Research is needed to evaluate the impact of supervision on communications with cancer patients to ensure patients have access to appropriate emotional supportive and care.
Highlights
Cancer can change most aspects of a person’s life
Evidence that emotional and psychological support provides a sense of wellbeing and helps individuals cope with the trauma of cancer is a rationale for this study (Goodwin et al, 2001; LeMay & Wilson, 2008)
We identify the opportunities patients take in conversation to express their feelings, how they articulate them to the nurses, and the nature of their disclosures, elucidating the links between personal meaning and emotional expression
Summary
Cancer can change most aspects of a person’s life. Analysing how patients talk about, and make sense of, their own and others’ experience of cancer illness has gained currency over the last 30 years, reflecting increased recognition of the affective relationship between health-care professional and cancer patient as the foundation of sensitive, appropriate care and communication (Kennifer et al, 2009; National Cancer Action Team, 2010; National Institute for Clinical Excellence, 2004). Evidence that emotional and psychological support provides a sense of wellbeing and helps individuals cope with the trauma of cancer is a rationale for this study (Goodwin et al, 2001; LeMay & Wilson, 2008). Doris had attended a specialist hospital for a rare skin condition for two years before her lung cancer was suspected after a routine chest X-ray, a month before the recorded conversation. She was immediately referred to a cancer centre where a bronchoscopy with biopsy revealed an adenocarcinoma of her lung with mediastinal secondaries.
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