Article

Storytelling Intervention for Patients With Cancer: Part 2—Pilot Testing

Neva L. Crogan

Bronwynne C. Evans

Robert Bendel

complementary and alternative therapies, social support
ONF 2008, 35(2), 265-272. DOI: 10.1188/08.ONF.265-272

Purpose/Objectives: To evaluate symptom reports and the impact of a nurse-led storytelling intervention in a supportive group setting on mood, stress level, coping with stress, pain, self-efficacy, and satisfaction with life in patients with cancer.

Design: Descriptive pilot project using a pretest/post-test control group.

Setting: Local regional medical center in the Pacific Northwest region of the United States.

Sample: Convenience sample of 10 patients with various cancer diagnoses; 7 completed the intervention.

Methods: Participants were randomly assigned to a storytelling or control group. Using a tool kit generated for this project, a nurse facilitator guided storytelling group participants in 12 1.5-hour sessions. Six instruments, symptom assessments, and a retrospective physician chart review were completed for each group. Data were analyzed using repeated measures analysis of variance.

Main Research Variables: Mood, stress, coping, pain, self-efficacy, and satisfaction with life.

Findings: Comparison of changes in group mean scores revealed a significant decrease in anxiety in the storytelling group despite disease progression. Documentation of psychosocial symptomatology by physicians is limited; however, nursing assessments were useful in determining psychosocial status before and after the intervention.

Conclusions: Results can be viewed only in context of a feasibility study and are not generalizable because of a limited sample size. A trained oncology nurse was able to use the storytelling intervention. Initial results are promising and warrant further study.

Implications for Nursing: After additional testing, the intervention could be used to enhance storytelling groups for patients with cancer or for individuals who are uncomfortable in or do not have access to storytelling groups.

Jump to a section

    References

    Abell, N. (1991). The Index of Clinical Stress: A brief measure of subjective stress for practice and research. Social Work Research and Abstracts, 27(2), 12-15.
    Andrews, C.A., Ironside, P.M., Nosek, C., Sims, S.L., Swenson, M.M., Yeomans, C., et al (2001). Enacting narrative pedagogy: The lived experiences of students and teachers. Nursing and Health Care Perspectives, 22(5), 252-259.
    Archibald, G. (2003). Patients' experiences of hip fracture. Journal of Advanced Nursing, 44(4), 385-392.
    Banks-Wallace, J. (1998). Emancipatory potential of storytelling in a group. Image, 30(1), 17-21.
    Beckman, J.C., Burker, E.J., Lytle, B.L., Feldman, M.E., & Costakis, M.J. (1997). Self-efficacy and adjustment in cancer patients: A preliminary report. Behavioral Medicine, 23(3), 138-142.
    Benner, P., & Wrubel, J. (1989). The primacy of caring. Menlo Park, CA: Addison-Wesley.
    Boykin, A., & Schoenhofer, S. (1991). Story as link between nursing practice, ontology, epistemology. Image, 23(4), 245-248.
    Branch, M., Min, D., & Anderson, M. (1999). Storytelling as a teaching-learning tool with RN students. Association of Black Nursing Faculty Journal, 10(6), 131-135.
    Burish, T.G. (2000). The role of behavioral and psychosocial science in reducing cancer morbidity and mortality. Oncologist, 5(3), 263-266.
    Carson, A.M., & Fairbairn, G.J. (2002). The whole story: Toward an ethical research methodology. Nurse Researcher, 10(1), 15-29.
    Caserta, M.S., & Lund, D.A. (1993). Intrapersonal resources and the effectiveness of self-help groups for bereaved older adults. Gerontologist, 33(5), 619-629.
    Clarke, A., Hanson, E.J., & Ross, H. (2003). Seeing the person behind the patient: Enhancing the care of older people using a biographical approach. Journal of Clinical Nursing, 12(5), 697-706.
    Cohen, M.Z., Kahn, D.L., & Steeves, R.H. (1998). Beyond body image: The experience of breast cancer. Oncology Nursing Forum, 25(5), 835-841.
    Cole-Kelly, K. (1992). Illness stories and patient care in the family practice context. Family Medicine, 24(1), 45-48.
    Cunningham, A.J. (2000). Adjuvant psychological therapy for cancer patients: Putting it on the same footing as adjunctive medical therapies. Psycho-Oncology, 9(5), 367-371.
    Diekelmann, N. (2001). Narrative pedagogy: Heideggerian hermeneutical analyses of lived experiences of students, teachers, and clinicians. Advances in Nursing Science, 23(3), 53-71.
    Diekelmann, N., Swenson, M.M., & Sims, S.L. (2003). Reforming the lecture: Avoiding what students already know. Journal of Nursing Education, 42(3), 103-105.
    Diener, E., Emmons, R.A., Larsen, R.J., & Griffin, S. (1985). The Satisfaction With Life Scale. Journal of Personality Assessment, 49(1), 71-75.
    Errante, A. (2000). But sometimes you're not part of the story: Oral histories and ways of remembering and telling. Educational Researcher, 29(2), 16-27.
    Frank, A. (1997). The wounded storyteller: Body, illness, and ethics. Chicago: University of Chicago Press.
    Greenhalgh, T., & Hurwitz, B. (1998). Narrative-based medicine: Dialogue and discourse in clinical practice. London: BMJ Books.
    Hensel, W.A., & Rasco, T. (1992). Storytelling as a method for teaching values and attitudes. Academic Medicine, 67(8), 500-504.
    Higson, R., & Winter, M. (2003). Epidemiology and consequences of drinking and driving. Alcohol Research and Health, 27(1), 63-78.
    Ironside, P.M. (2003). New pedagogies for teaching thinking: The lived experiences of students and teachers enacting narrative pedagogy. Journal of Nursing Education, 42(11), 509-516.
    Ironside, P.M. (2004). "Covering content" and teaching thinking: Deconstructing the additive curriculum. Journal of Nursing Education, 43(1), 5-12.
    Jolly, K., Weiss, J., & Liehr, P. (2007). Understanding adolescent voice as a guide for nursing practice and research. Issues in Comprehensive Pediatric Nursing, 30(1-2), 3-13.
    Kahn, D.L., & Steeves, R.H. (1995). The significance of suffering in cancer care. Seminars in Oncology Nursing, 11(1), 9-16.
    Kellner, R. (1986). The Brief Depression Rating Scale. In N. Sartorius & T. Ban (Eds.), Assessment of depression (pp. 179-183). New York: Springer-Verlag.
    Kilpatrick, F.P., & Cantril, H. (1960). Self-anchoring scaling: A measure of individual's unique reality worlds. Journal of Individual Psychology, 16(2), 158-173.
    Kirkpatrick, M.K., Ford, S., & Castelloe, B.P. (1997). Storytelling: An approach to client-centered care. Nurse Educator, 22(2), 38-40.
    Koithan, M. (1994). The seeing self: Photography and storytelling as a health promotion methodology. In P. Chinn & J. Watson (Eds.), Art and aesthetics in nursing (pp. 247-261). New York: National League for Nursing.
    Leight, S.B. (2002). Starry night: Using story to inform aesthetic knowing in women's health nursing. Journal of Advanced Nursing, 37(1), 108-114.
    Liehr, P.R., Meininger, J., Vogler, R., Chan, W., Frazier, L., Smallings, S., et al (2006). Adding story-centered care to standard lifestyle intervention for people with stage I hypertension. Applied Nursing Research, 19(1), 16-21.
    Liehr, P.R., & Smith, M.J. (1999). Middle-range theory: Spinning research and practice to create knowledge for the new millennium. Advances in Nursing Science, 21(4), 81-91.
    Liehr, P.R., & Smith, M.J. (2000). Using story theory to guide nursing practice. International Journal for Human Caring, 4(2), 13-18.
    Liehr, P.R., & Smith, M.J. (2007). Story inquiry: A method for research. Archives of Psychiatric Nursing, 21(2), 120-121.
    Melzack, R. (1975). The McGill Pain Questionnaire: Major properties and scoring methods. Pain, 1(3), 277-299.
    Moules, N., & Streitberger, S. (1997). Stories of suffering, stories of strength: Narrative influences in family nursing. Journal of Family Nursing, 3(4), 365-377.
    Nicholas, B., & Gillett, G. (1997). Doctors' stories, patients' stories: A narrative approach to teaching medical ethics. Journal of Medical Ethics, 23(5), 295-299.
    Paterson, B.L., Crawford, M., Saydak, M., Venkatesh, P., Tschikota, S., & Aronowitz, T. (1995). How male nursing students learn to care. Journal of Advanced Nursing, 22(3), 600-609.
    Platt, F.W., Gaspar, D.L., Coulehan, J.L., Fox, L., Adler, A.J., Weston, W.W., et al (2001). "Tell me about yourself": The patient-centered interview. Annals of Internal Medicine, 134(11), 1079-1085.
    Ramsey, C.A. (2000). Storytelling can be a valuable teaching aid. AORN Journal, 72(3), 497-499.
    Ryckman, R., Robbins, M., Thornton, B., & Cantrell, P. (1982). Development and validation of a physical self-efficacy scale. Journal of Personality and Social Psychology, 42(5), 891-900.
    Sandelowski, M. (1994). We are the stories we tell: Narrative knowing in nursing practice. Journal of Holistic Nursing, 12(1), 23-33.
    Seifert, P.C. (1999). Leading and articulating expertise through stories. AORN Journal, 70(3), 368-372.
    Severtsen, B.M., & Evans, B.C. (2000). Education for caring practice. Nursing and Health Care Perspectives, 21(4), 172-177.
    Smith, M., Kennison, M., Gamble, S., & Loudin, B. (2004). Intervening as a passenger in drinking/driving situations. Applied Nursing Research, 17(3), 142-149.
    Smith, M.J., & Liehr, P. (1999). Attentively Embracing Story: A middle-range theory with practice and research implications. Scholarly Inquiry for Nursing Practice, 13(3), 187-210.
    Smyth, J.M., Stone, A.A., Hurewitz, A., & Kaell, A. (1999). Effects of writing about stressful experiences of symptom reduction in patients with asthma or rheumatoid arthritis. JAMA, 281(14), 1304-1309.
    Spiegel, D., Stroud, P., & Fyfe, A. (1998). Complementary medicine. Western Journal of Medicine, 168(4), 241-247.
    Steeves, R.H. (1992). Patients who have undergone bone marrow transplantation: Their quest for meaning. Oncology Nursing Forum, 19(6), 899-905.
    Steeves, R.H. (1996). Loss, grief, and the search for meaning. Oncology Nursing Forum, 23(6), 897-903.
    Sutherland, J.A. (2001). Teaching abstract concepts by metaphor. Journal of Nursing Education, 40(9), 417-419.
    Taylor, J., Banks-Wallace, J., & Tripp-Reimer, T. (2001). Storytelling and violence against women. Association of Black Nursing Faculty Journal, 12(2), 28-31.
    Ten Kroode, H. (1998). Active listening to cancer patients' stories. Netherlands Journal of Medicine, 53(2), 47-52.
    Utley, R. (1999). The evolving meaning of cancer for long-term survivors of breast cancer. Oncology Nursing Forum, 26(9), 1519-1523.
    Watson, J. (1985). Nursing: The philosophy and science of caring. Niwot, CO: University of Colorado Press.
    Watson, J. (2002). Intentionality and caring-healing consciousness: A practice of transpersonal nursing. Holistic Nursing Practice, 16(4), 12-19.