Abstract
BackgroundTo 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.MethodsEighteen 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.ResultsThe 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.ConclusionsRPs 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.
Highlights
The most dominant themes shared through the Rich Pictures (RPs) and interviews were the experience and feelings around loss, and the importance of social relationships
Rather than providing new themes, the added value of RPs lies in the ability to represent the themes in one single snapshot
Creating an RP can be considered an introductory step in narrative meaning making itself, as drawing one's story might stimulate reflection and meaning making in the interpretation crisis resulting from an incurable cancer diagnosis.[5,10,16]
Summary
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.[3,4,5,6] When life goals are jeopardized, questions like “why me” and “why ” 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]. 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. Describing such complex experiences verbally may be difficult for patients. We explore the use of RPs to gain insight in the experiences of patients with advanced cancer. 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
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