Metaphor and meaning in an online creative expression exercise to promote dyadic coping in young couples affected by breast cancer

Abstract

Background: Establishing a sense of shared meaning is related to optimal adjustment for couples faced with cancer. The present study examined couple response to a creative expression exercise designed to facilitate shared meaning construction in young couples affected by breast cancer.

Method: Thirteen women diagnosed with breast cancer and their male partners were guided through an original online exercise designed to help facilitate the creative processing of the couple's experience with cancer. All couples’ creative expressions were later subjected to a qualitative content analysis.

Results: This analysis yielded two main themes, Existential Hardship and Mutual Resilience. The majority of participants indicated that they found the exercise to be beneficial and/or enjoyable.

Conclusions: Creating a shared meaning of cancer through an online artistic expression exercise is feasible, and offers a novel approach to supporting the dyadic coping processes of young couples affected by breast cancer.

Keywords:

• Meaning-making
• breast cancer
• couple adjustment
• online intervention
• young adults
• resilience

Notes

1. As this was a novel intervention, the effectiveness of which had not yet been determined, decision was made to restrict the design of the programme to heterosexual couples. The primary rationale for this decision was that we wanted to ensure the programme was effective before applying it to working with specialized populations. Related to this point was that it was considered an empirical question, in and of itself, whether lesbian couples would prefer a platform that specifically catered to same-sex couples’ experiences with breast cancer and their unique concerns, or a website with integrated content (across couples with differing sexual orientations). Expanding the programme to include lesbian couples is an identified future direction, and on this point, we would first survey same-sex couples to see whether a specialized or integrated site would be preferred.

2. Like a “core category” used in the grounded theory method, we offer this meta-metaphor as a condensed expression of how young couples make meaning of their experience with breast cancer. One intention of the qualitative content analysis is to identify commonalities across couples’ experiences (expressed, in the current context, metaphorically, symbolically and/or artistically). Thus, we thought it fitting to tie these common themes together through the development of a “core” metaphor – in this case, a Seismic Detour. This choice, however, is not intended to subjugate the idiographic representations provided by individual couples, which are preserved in the Results section and provide the evidentiary scaffolding for the main themes and subthemes.