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. 2017 Oct;26(10):2739-2754.
doi: 10.1007/s11136-017-1611-8. Epub 2017 Jun 12.

Recovering from chronic myeloid leukemia: the patients' perspective seen through the lens of narrative medicine

G Graffigna  1 , I Cecchini  2 , M Breccia  3 , E Capochiani  4 , R Della Seta  5 , S Galimberti  6 , A Melosi  7 , F Simonetti  8 , M Pizzuti  9 , S F Capalbo  10 , F Falzetti  11 , P Mazza  12 , N Di Renzo  13 , L Mastrullo  14 , D Rapezzi  15 , E Orlandi  16 , T Intermesoli  17 , A Iurlo  18 , E Pungolino  19 , M Pacilli  20
Affiliations

Recovering from chronic myeloid leukemia: the patients' perspective seen through the lens of narrative medicine

G Graffigna et al. Qual Life Res. 2017 Oct.

Abstract

Purpose: The main objective of this study is to gain a deeper understanding of how patients suffering from chronic myeloid leukemia (CML) cope with their illness. The study aims to reconstruct the subjective meaning-making process related to CML in order to gain insights into the impact the disease has on patients' emotions and everyday lives, as well as to explore the psychological impact of their being presented with the chance to suspend their therapy and recover from the disease.

Methods: Data were gathered from a qualitative study conducted in Italy on 158 Italian CML patients. Basing the study on the narrative inquiry approach, the patients were required to describe their patient journey in a qualitative narrative diary. These contained prompts to elicit the free expression of their needs, expectations, and priorities. A lexicographic analysis was carried out with T-LAB software and in particular a thematic analysis of elementary contexts (TAECs) and a word association analysis (WAA).

Results: The TAEC detected four thematic clusters related to two factors (temporal frame and contextual setting) that explained the variance among the narratives. The WAA evidenced a wide variety of emotions, both positive and negative, as patients reacted to the possibility of interrupting their therapy.

Conclusions: A better understanding of patients' experiences can offer insights into promoting the development of more sustainable healthcare services and into therapeutic innovation aimed at improving patients' quality of life and at engaging them more in their treatment. The findings of this study can also help make medical professionals more aware of the patient's burden and help them identify potential interactions and emotional levers to improve clinical relationships.

Keywords: Chronic myeloid leukemia; Illness experience; Narrative inquiry approach; Patient engagement; Patients’ psychological representations.

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