Pain Clinical Trial
Official title:
Phenomenological Study of Psycho-Socio-Spiritual Healing in the Context of Chronic or Life-Threatening Illness
Background:
- A person s mental state, personal relationships, or spiritual well-being often change in
many ways during or after cancer. Some of these changes can have a life-changing
positive side, called psycho-socio-spiritual or PSS Healing. For example, a person may
feel mentally stronger or more whole than before their cancer.
- Because researchers are interested in enhancing such experiences in other cancer
patients, there is interest in developing a way to measure PSS Healing that would be
helpful in understanding this phenomenon.
Objective:
- To determine and categorize the characteristics of PSS Healing, which could lead to
development of a psychometric instrument to measure it.
Eligibility:
- Adults who have cancer or have had cancer that was diagnosed after the age of 18 and who
have had at least one strong positive emotional or mental change in relation to the cancer
(e.g., relationships with others, spiritual well-being or faith, thoughts about the meaning
of life, reactions to stress).
Design:
- The study design does not involve any treatment or counseling.
- Participants will be interviewed by a research team member. The one-time interview will
last up to 2.25 hours and will be audiotaped and transcribed.
- Interviews will consist of an in-depth portion to assess the positive changes in
relation to the illness. Participants will then be asked to identify from a list of
short descriptions the ones that best reflect their personal experience of PSS Healing.
- Transcribed information will be coded and categorized according to standard research
techniques.
We identify healing in the context of chronic or life-threatening illness as a
patient-reported outcome consisting of growth or benefit in psychological, social and/or
spiritual dimensions representing improvement well above the patient s pre-morbidity
baseline. This positive outcome often occurs despite substantial suffering during the
illness, even in terminal cases (Kearney 2000).
In previous phenomenological studies, qualitative descriptions of healing and the processes
by which it develops have not been structured in categories suitable for the development of a
fully validated and standardized psychometric instrument. Also, the relationship of healing
to psychometrically measurable constructs such as posttraumatic growth, resilience, coping,
and acceptance is not clear.
Objective: This program is to provide (1) a qualitative model of healing-related processes,
(2) phenomenological categories of healing suitable for a psychometric instrument
development, (3) the relationship of healing to other relevant constructs such as trauma,
coping, and adult development, and (4) questionnaire items for healing assessment and (5)
software tools that greatly increase the qualitative analysis speed and rigor of
phenomenological category building.
Study populations: Two populations of subjects who have experienced a life-threatening
disease or serious chronic illness (cancer or cardiac disease) will be recruited from three
sites. The first population (50 subjects) are individuals with exemplary healing experiences
(life-transforming positive outcomes connected to illness along psychological, social and/or
spiritual dimensions) or in the early stages of healing-related processes. In-depth interview
data from these subjects will empirically help identify endpoint markers and process pathways
of profound healing. The second population (400 subjects) consists of current or past
participants in structured healing or medical rehabilitation programs. In a written
interview, these participants will qualitatively evaluate questionnaire items for identifying
readiness for and progress toward healing using their first-hand, illness-related experience.
Design: This protocol has a qualitative, phenomenological, natural history design similar to
identifying features of a medical syndrome or psychological disorder. It has two formats of
data collection: in-depth individual interviews of the exemplary healing population, and
self-administered written interviews for current participants in formal healing or
rehabilitation programs. In-depth interview sessions have 2 1/4-hour duration with three
components: a 50-minute, in depth phenomenological interview, a 30-minute short-statement
interview (how subjects view healing-related short questionnaire statements), and a 25-minute
related-constructs interview (how their positive outcomes, may be related to personality).
Interview and short-statement analyses consist of standard qualitative methodologies
including transcription, memo-writing, coding, categorization, and modeling.
Outcome measures: None (non-interventional)
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