Marlene Greenberg

The use of research‐based theatre in a project related to metastatic breast cancer

Research‐based theatre represents an innovative approach to disseminating the results of qualitative studies. In this paper, we provide a rationale for the importance of research‐based theatre and also review previous work that has been done in the area. We then describe our experience in transforming research data into a dramatic production, Handle with Care? This production was based on two studies – one with women with metastatic breast cancer, and the other with medical oncologists treating breast cancer patients. Results from ongoing assessment of the project are reported. We discuss some of the factors related to the success of Handle with Care? and reflect on what has been learned about the process of developing dramatic pieces related to serious illness.

A comparison of physician and patient perspectives on unconventional cancer therapies.

In two related studies about unconventional cancer therapies, patients and physicians were interviewed about their experiences and opinions. In this paper comparisons are made and implications discussed. There was general agreement among physicians and patients about the importance of providing access to information about unconventional approaches for interested patients. However, there were substantial differences in perspective on other issues, including: what constitutes ‘unconventional’, the helpfulness of typical physician responses to patients interested in or using unconventional therapies, the proper interface between practitioners of conventional and unconventional therapies, the reasons for communication problems (related to unconventional therapies) between physicians and patients, and the proper criteria for making decisions about unconventional therapies. Cancer specialists, family physicians and other health professionals need to look for ways to better understand and meet the needs of their patients with interests in unconventional approaches if they hope to preserve or improve relations.

EXPLORING THE BARRIERS TO CERVICAL SCREENING IN AN URBAN CANADIAN SETTING

Cervical cancer is potentially one of the most preventable cancers. The benefits of cervical screening come to those who are actually screened. Despite the known value of cervical screening, a significant number of women do not avail themselves of the procedure. This study examined the barriers to cervical screening in an urban Canadian setting. Focus group methodology was used to explore the perspectives of socioeconomically disadvantaged women regarding their access to health care. The sessions were tape-recorded, and subsequent content analysis revealed four broad themes: being able to talk with doctors is important; being treated as a person is important; finding answers to many questions about cancer is important; and having a Pap test is uncomfortable. Implications for practice and program design were highlighted.

Utilization of professional supportive care services by women with breast cancer

This paper reports on the results of a survey of utilization of professional supportive care services by women with breast cancer, and on patterns of differential service utilization by sub-groups of patients. Study participants were women with invasive breast cancer diagnosed 23–36 months prior to contact about the study, and randomly selected from the Ontario Cancer Registry. From among 1,119 eligible women sent survey questionnaires, 731 returned completed questionnaires (65%). A total of 31% of respondents reported accessing one or more of the following professionals: social worker, psychologist, psychiatrist, dietitian, physiotherapist. Among those who responded to a question about whether they would have liked specific services, 34% reported that there was at least one professional supportive care service they would have liked to use, but were unable to access. Factors shown to be related to greater utilization of services included: younger age, higher household income, employed or student status, private health insurance coverage, and having received chemotherapy. Overall, there was a surprisingly low utilization of professional specialized supportive care services among women with breast cancer. Policy implications include finding strategies to better inform cancer patients about existing services, and ensuring that a core set of services are available to all patients.

Staging Breast Cancer, Rehearsing Metastatic Disease

Social science researchers have fruitfully used a range of conceptualizations of “performance”: as a metaphor for social life, a way of vivifying research findings, and a form of scholarly representation. In this article, the researchers consider performance in its hermeneutic sense, as a way of generating meaning. The drama Handle With Care? Living With Metastatic Breast Cancer was created by a research team, a theater troupe, and women with breast cancer. The researchers employ an interpretive phenomenological framework to explore interviews with women with breast cancer involved in creating Handle With Care? The performative context in which the drama developed allowed certain illness meanings to emerge, intensify, and shift. The article also considers ethical dilemmas surfaced by this project.

ONCOLOGY NURSES' PERSPECTIVES ON UNCONVENTIONAL THERAPIES

Unconventional therapies have become increasingly popular with health care consumers in recent years. As patients seek information and attempt to make decisions about unconventional therapies, they often turn to nurses, asking their opinion about certain therapies. The nurses attitudes and beliefs about unconventional therapies very likely will influence the response to the patients inquiries. This work represents the findings of interviews with 48 nurses regarding their perspectives on unconventional therapies. Without exception, all nurses interviewed emphasized the need for information regarding unconventional therapies to be readily available for patients and health care professionals. The other themes identified in the interviews included the following: various people use unconventional therapies; people seek unconventional therapies for a variety of reasons; communication about unconventional therapies needs to be open; and conventional and unconventional practitioners ought to work collaboratively. The participants interviewed saw a clearly defined role for nurses regarding unconventional therapies.

Nurses' perspectives on unconventional therapies

Unconventional therapies have become increasingly popular with health care consumers in recent years. As patients seek information and attempt to make decisions about unconventional therapies, they often turn to nurses, asking the nurses opinion about certain therapies. The nurses attitudes and beliefs about unconventional therapies quite likely will influence the response to the patients inquiries. This article represents the findings of interviews with 20 nurses regarding their perspectives on unconventional therapies. Without exception, all nurses who were interviewed emphasized that information regarding unconventional therapies needs to be available readily for both patients and health care professionals. Other themes identified in the interviews included the following: Various people use unconventional therapies; people seek unconventional therapies for a variety of reasons; communication about unconventional therapies needs to be open, and a place should be found for unconventional therapies. The interviewees saw a clearly defined role for nurses regarding unconventional therapies.

Cultural relevance of a fruit and vegetable food frequency questionnaire.

PURPOSE Canadas multicultural population poses challenges for culturally competent nutrition research and practice. In this qualitative study, the cultural relevance of a widely used semi-quantitative fruit and vegetable food frequency questionnaire (FFQ) was examined among convenience samples of adults from Torontos Cantonese-, Mandarin-, Portuguese-, and Vietnamese-speaking communities. METHODS Eighty-nine participants were recruited through community-based organizations, programs, and advertisements to participate in semi-structured interviews moderated in their native language. Data from the interviews were translated into English and transcribed for analysis using the constant comparative approach. RESULTS Four main themes emerged from the analysis: the cultural relevance of the foods listed on the FFQ, words with multiple meanings, the need for culturally appropriate portion-size prompts, and the telephone survey as a Western concept. CONCLUSIONS This research highlights the importance of investing resources to develop culturally relevant dietary assessment tools that ensure dietary assessment accuracy and, more important, reduce ethnocentric biases in food and nutrition research and practice. The transferability of findings must be established through further research.Purpose: Canada’s multicultural population poses challenges for culturally competent nutrition research and practice. In this qualitative study, the cultural relevance of a widely used semiquantitative fruit and vegetable food frequency questionnaire (FFQ) was examined among convenience samples of adults from Toronto’s Cantonese-, Mandarin-, Portuguese-, and Vietnamesespeaking communities. Methods: Eighty-nine participants were recruited through community-based organizations, programs, and advertisements to participate in semi-structured interviews moderated in their native language. Data from the interviews were translated into English and transcribed for analysis using the constant comparative approach. Results: Four main themes emerged from the analysis: the cultural relevance of the foods listed on the FFQ, words with multiple meanings, the need for culturally appropriate portionsize prompts, and the telephone survey as a Western concept. Conclusions: This research highlights the importance of investi...

Partnerships between Self-Help Networks and Health Care Facilities: The Case of the Bayview Support Network

This article discusses the role of patients and their families as peer support providers to other patients, and as decision makers within organizations. We use as a model the Bayview Support Network, a self-help network at the Toronto-Sunnybrook Regional Cancer Centre. We review the benefits of partnership, costs, limitations and risks. A list of features that contribute to effective partnerships is also provided.

Knowledge of Antioxidants and Breast Cancer Risk Among Women Attending Breast Cancer Risk Assessment Clinics

This qualitative study used semistructured interviews to examine the accuracy of knowledge concerning antioxidants and health among a convenience sample of 79 women attending a breast cancer risk assessment clinic. Despite a high level of familiarity (98%) with the word antioxidant, few participants could name more than one of these compounds and most relied on print media (41.6%) and radio/TV (22.2%) for antioxidant information. Thematic content analysis revealed participants’ beliefs that antioxidants were strongly linked to reduced breast cancer risk and improved health. They described antioxidant functions that take place before (e.g., “Prevention . . . a best defense mechanism” and “To boost strength and good health”) or after (e.g., “Fights diseases, free radicals, and cancer,” “Acts as a cleanser or purifier,” and “Undoes the harm that I am consciously or unconsciously doing to my body”) a health threat. Participants’ understandings of the links between antioxidant intake and breast cancer risk did not accurately reflect the scientific evidence. This large priority population group needs tailored, evidence-based nutrition communications to address inaccurate understandings about antioxidant intake and breast cancer risk.