Categories
Academic Care and Recovery Patient Experiences

Emotion Work During Colorectal Cancer Treatments

  • Silence -> seen as ‘not getting upset in front of each other’ -> preserves relationships in CRC oncology clinic
    • Silence as relational form of moral work that preserves others’ well-being
  • Studies show a lot of emotional distress among patients with and beyond CRC
    • 1/5 people affected by CRC has a post-cancer diagnosis of depression
  • Emotion work in surface acting vs. deep acting
    • Embodied emotional experiences and the performative role of emotions
  • The study follows participants through treatment pathway until there was no evidence of disease in their bodies or referred to hospices
    • Some focus on pragmatism/practicality rather than emotions
    • Many manage expressions of emotions continuously in front of others
  • Nurses are cognizant of emotional texture of cancer treatments

“We just try to open it up and give them an opportunity to talk about [what they are feeling]. It is often letting them be cross, or to be angry, or to be frustrated, because all are logical and normal emotions to have during cancer treatments”

A Filipina senior chemotherapy nurse.
  • Staff and health professionals also have to do some emotional labor -> keeping boundaries and maintaining balance between distance and closeness to patients while keeping their emotional peace
    • Nurses are expected to connect with patients to do emotional labor in contrast to physicians, many of whom decided to pursue a ‘happier’ field
  • Many patients in the CRC support group disclosed the need to do emotion work as to not ‘burden others’ in fear of damaging relationships with others
    • The relatives also experience this fear of being a burden
  • Existing norms surrounding emotional management of relatives -> to not be upset because expressing it would impact their loved ones

Silence: reconsidered as relational practice of moral work, not maladaptive coping behavior

  • Reflections/questions:
    • Silence as moral relational work connects to
Categories
Academic Care and Recovery Personhood Treatment

“I Didn’t Feel Like I Was a Person Anymore”: Realigning Full Adult Personhood after Ostomy Surgery

  • Long term CRC survivors need temporary or permanent ostomies -> requiring the use of ostomy equipments and stoma bags
    • Parts of their intestines are removed and the remaining part is attached to an opening in abdoment where feces are discharged
    • More documented treatment-related challenges among survivors
  • Ostomies result in complex emotional, social and physical concerns
    • Adjustment to managing uncontrollable bowel movements is compared to second period of toilet training -> compromises adulthood
    • Erosion of adulthood due to physical disability
    • Relationships and sexual concerns
  • Surviving CRC with ostomy disrupts identity and adulthood -> loss of embodied self control
    • ostomy interferes with social roles and ideals
    • Western culture involves self responsibility
  • Narratives enables survivors to create continuity that reconnects them to social and cultural worlds
    • Hence why literature and art produced by cancer patients and survivors are so important
    • Cancer is very isolating and creating narrative is a way to reconnect

I didn’t feel like I was a person any more. I felt more like a non-person, you know, because you’ve got these things on you and then you’ve got this attachment, and not knowing how to care for this. We’d go places and we’d have to come home because I’d like overflow. … I guess that’s all in not knowing how to care for it.

A 62 year old divorced, ethnically mixed Filipina woman, discussing her difficulties and how they relate to personhood degradation.
An example ostomy bag
  • The women interviewed had common themes of technical difficulties, trial and error and the steep learning curve required to get used to living with an ostomy bag
  • Different techniques for regulating bodily functions and gaining control to realign with the ‘normal’ world to fit in and feel ‘normal’
    • Irrigation
    • Regulating timing of foods and dietary modifications
  • Reflections
    • Incorporate research similar to this study into nursing and other spheres of care -> rehabilitation efforts and follow-up efforts with health professionals to support these individuals
    • More interventions could help survivors living with impairments
    • Representations and discussions of ostomy procedures and bag can help make the process visible and negate stigma, such as this photoshoot

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