Repeated use of rich pictures to explore changes in subjective experiences over time of patients with advanced cancer

Cancer Rep (Hoboken). 2022 Jan;5(1):e1428. doi: 10.1002/cnr2.1428. Epub 2021 Jul 26.

Abstract

Background: The combination of verbal and visual tools may help unravel the experiences of advanced cancer patients. However, most previous studies have focused on a specific symptom, at only one moment in time. We recently found that a specific visual tool, originating from systems thinking, that is, rich pictures (RPs), could provide a more comprehensive view of the experiences of patients with advanced cancer.

Aims: To examine whether the repeated use of RPs can make changes in subjective experiences of patients living with advanced cancer visible over time.

Methods and results: We performed a prospective study with a generic qualitative approach that was mostly informed by the process of grounded theory. We invited patients to make an RP twice, at the start of the study, and again after 2 months. Both RP drawing sessions were directly followed by a semi-structured interview. Patients with all types of solid tumors, above the age of 18, and with a diagnosis of advanced, incurable cancer, were eligible. Eighteen patients participated and 15 patients were able to draw an RP twice. In eight RP-sets, considerable differences between the first and second RP were noticeable. Two patterns were distinguished: (1) a change (decline or improvement) in physical health (five patients), and/or (2) a change in the way patients related to cancer (three patients).

Conclusion: RPs are a valuable qualitative research method that can be used to explore the experiences of patients with advanced cancer, not only at a single point in time but also over time.

Keywords: cancer; metastasis; methods; patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Art Therapy / methods*
  • Female
  • Grounded Theory
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / psychology*
  • Prospective Studies
  • Qualitative Research
  • Quality of Life*