Cover not available
Article published In:
Narrative Inquiry
Vol. 31:2 (2021) ► pp.358–380

Metacommunication process during a 3-day digital storytelling workshop for patients recovering from hematopoietic cell transplantation

A qualitative approach

| Arizona State University, Phoenix
| Arizona State University, Tempe
| Arizona State University, Phoenix
| Arizona State University, Phoenix
| Arizona State University, Phoenix
| Arizona State University, Phoenix
| Mount Saint Mary’s University
| Mayo Clinic College of Medicine

Purpose: The purpose of this study was to qualitatively analyze metacommunication during the digital storytelling (DST) workshop process for patients undergoing hematopoietic cell transplantation (HCT).

Methods: HCT survivors who had undergone transplant within the past 2 years were recruited at a cancer center in the Phoenix Metropolitan area. Participants (M age = 51.5 years) attended a 3-day DST workshop telling and creating digital stories around their HCT experiences. Using a constructivist grounded theory approach, line by line coding and content analysis were conducted with four research team members.

Results: Four themes emerged from the data: (1) communal connection; (2) expressing and processing emotions; (3) self-empowerment; and (4) multi-dimensional coping. Participants described telling and sharing their story with other HCT patients as therapeutic.

Conclusion: DST shows promise as a potential coping tool and offers multiple dimensions of the role of narrative as a coping technique, in community building, and in patient-centered contexts within HCT.

Keywords: digital storytelling, narrative, metacommunication, distress coping, stem cell transplantation, bone marrow transplantation, qualitative
Article outline
  • Introduction
    • Digital storytelling: Validating experience and potential therapeutic value
    • Narrative theory and social cognitive theory as a conceptual framework
      • Listening to story as therapy
      • Telling one’s story as therapy
  • Methods
    • Participant recruitment and samples
    • The digital storytelling workshop process
    • Data collection
    • Data analysis
  • Results
    • Sample description and participation
    • DST experience: Emergent themes
      • Communal connection
      • Expressing and processing emotions
      • Self-empowerment
      • Multi-dimensional coping
  • Discussion
  • Limitations
  • Implications and conclusion
  • Conflicts of interest
  • Acknowledgements
  • References
Published online: 20 April 2020
DOI logo
https://doi.org/10.1075/ni.19036.kim
References
Andersen, B. L., Thornton, L. M., Shapiro, C. L., Farrar, W. B., Mundy, B. L., Yang, H. C., & Carson, W. E.
(2010) Biobehavioral, immune, and health benefits following recurrence for psychological intervention participants. Clinical Cancer Research, 16(12), 3270–3278. DOI logoGoogle Scholar
Anderson, J. O., & Martin, P. G.
(2003) Narratives and healing: exploring one family’s stories of cancer survivorship. Health Communication, 15(2), 133–143. DOI logo [doi]Google Scholar
Andrykowski, M. A.
(1994a) Psychiatric and psychosocial aspects of bone marrow transplantation. Psychosomatics, 35(1), 13–24. DOI logo [pii]Google Scholar
(1994b) Psychosocial factors in bone marrow transplantation: a review and recommendations for research. Bone Marrow Transplant, 13(4), 357–375.Google Scholar
Atkinson, S., & Rubinelli, S.
(2012) Narrative in cancer research and policy: voice, knowledge and context. Critical Reviews in Oncology/Hematology, 84 (Suppl 2), S11–16. DOI logo [doi]Google Scholar
Bandura, A.
(1986) Social foundations of thought and action. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
Cameron, L. D., Leventhal, H., & Love, R. R.
(1998) Trait anxiety, symptom perceptions, and illness-related responses among women with breast cancer in remission during a tamoxifen clinical trial. Health Psychology, 17(5), 459–469. DOI logoGoogle Scholar
Campbell, J. L., Quincy, C., Osserman, J., & Pedersen, O. K.
(2013) Coding In-depth Semistructured Interviews:Problems of Unitization and Intercoder Reliability and Agreement. Sociological Methods & Research, 42(3), 294–320. DOI logoGoogle Scholar
Carlick, A., & Biley, F. C.
(2004a) Thoughts on the therapeutic use of narrative in the promotion of coping in cancer care. European Journal of Cancer Care, 13(4), 308–317. DOI logoGoogle Scholar
(2004b) Thoughts on the therapeutic use of narrative in the promotion of coping in cancer care. European Journal of Cancer Care, 13(4), 308–317. DOI logoGoogle Scholar
Charmaz, K.
(2006) Constructing grounded theory: A practical guide through qualitative analysis. London: Sage Publications.Google Scholar
Cooke, L., Gemmill, R., Kravits, K., & Grant, M.
(2009) Psychological issues of stem cell transplant. Seminars in Oncology Nursing, 25(2), 139–150. DOI logoGoogle Scholar
Copelan, E. A.
(2006) Hematopoietic stem-cell transplantation. New England Journal of Medicine, 354(17), 1813–1826. DOI logoGoogle Scholar
Creswell, J. W.
(2009) Research Design: Qualitative, Quantitative, and Mixed Methods Approaches (3rd ed.). Thousand Oaks, Calif.: Sage Publications.Google Scholar
Crogan, N. L., Evans, B. C., & Bendel, R.
(2008) Storytelling intervention for patients with cancer: part 2-pilot testing. Oncology Nursing Forum, 35(2), 265–272. DOI logoGoogle Scholar
DiFulvio, G. T., Gubrium, A. C., Fiddian-Green, A., Lowe, S. E., & Del Toro-Mejias, L. M.
(2016) Digital storytelling as a narrative health promotion process: Evaluation of a pilot study. International Quarterly of Community Health Education, 36(3), 157–164. DOI logoGoogle Scholar
Dwight-Johnson, M., Ell, K., & Lee, P. J.
(2005) Can collaborative care address the needs of low-income Latinas with comorbid depression and cancer? Results from a randomized pilot study. Psychosomatics, 46(3), 224–232. DOI logoGoogle Scholar
Ell, K., Sanchez, K., Vourlekis, B., Lee, P. J., Dwight-Johnson, M., Lagomasino, I., Russell, C.
(2005) Depression, correlates of depression, and receipt of depression care among low-income women with breast or gynecologic cancer. Journal of Clinical Oncology, 23(13), 3052–3060. DOI logoGoogle Scholar
Fiddian-Green, A., Kim, S., Gubrium, A. C., Larkey, L. K., & Peterson, J. C.
(2019) Restor (y) ing Health: A Conceptual Model of the Effects of Digital Storytelling. Health Promotion Practice, 20(4), 1–11. DOI logoGoogle Scholar
Gooley, T. A., Chien, J. W., Pergam, S. A., Hingorani, S., Sorror, M. L., Boeckh, M., Appelbaum, F. R.
(2010) Reduced mortality after allogeneic hematopoietic-cell transplantation. New England Journal of Medicine, 363(22), 2091–2101. DOI logoGoogle Scholar
Green, M. C., & Brock, T. C.
(2000) The role of transportation in the persuasiveness of public narratives. Journal of Personality and Social Psychology, 79(5), 701–721. DOI logoGoogle Scholar
Gubrium, A., Fiddian-Green, A., Lowe, S., DiFulvio, G., & Del Toro-Mejias, L.
(2016) Measuring Down: Evaluating Digital Storytelling as a Process for Narrative Health Promotion. Qualitative Health Research, 26(13), 1–15. DOI logoGoogle Scholar
Gubrium, A.
(2009) Digital storytelling: An emergent method for health promotion research and practice. Health Promotion Practice, 10(2), 186–191. DOI logoGoogle Scholar
Gubrium, A., Fiddian-Green, A., Lowe, S., DiFulvio, G., & Peterson, J.
(2019) Digital storytelling as critical narrative intervention with adolescent women of Puerto Rican descent. Critical Public Health, 29(3), 290–301. DOI logoGoogle Scholar
Han, W. T., Collie, K., Koopman, C., Azarow, J., Classen, C., Morrow, G. R., Spiegel, D.
(2005) Breast cancer and problems with medical interactions: relationships with traumatic stress, emotional self-efficacy, and social support. Psychooncology, 14(4), 318–330. DOI logoGoogle Scholar
Hatzimichael, E., & Tuthill, M.
(2010) Hematopoietic stem cell transplantation. Stem Cells and Cloning: Advances and Applications, 3(1), 105–117. DOI logoGoogle Scholar
Hinyard, L. J., & Kreuter, M. W.
(2007) Using Narrative Communication as a Tool for Health Behavior Change: A Conceptual, Theoretical, and Empirical Overview. Health Education & Behavior, 34(5), 777–792. DOI logoGoogle Scholar
Houston, T. K.
(2011) The Art and Science of Patient Storytelling – Harnessing Narrative Communication for Behavioral Interventions: The ACCE Project. Journal of Health Communication, 16(7), 686–697. DOI logoGoogle Scholar
Houston, T. K., Cherrington, A., Coley, H. L., Robinson, K. M., Trobaugh, J. A., Williams, J. H., Allison, J. J.
(2011) The art and science of patient storytelling-harnessing narrative communication for behavioral interventions: the ACCE project. Journal of Health Communication, 16(7), 686–697. DOI logoGoogle Scholar
Hoybye, M. T., Johansen, C., & Tjornhoj-Thomsen, T.
(2005) Online interaction. Effects of storytelling in an internet breast cancer support group. Psychooncology, 14(3), 211–220. DOI logoGoogle Scholar
Kazi, A.
(2008) Psychological and physical adjustment to breast cancer over 12 months following a cognitive behavioral stress management intervention: identifying different trajectories of change. (Doctor of Philosophy), University of Miami, Coral Gables, FL.Google Scholar
Kressler, J.
(2014) Women’s stories of breast cancer: sharing information through YouTube video blogs. University of Western Ontario, London, Canada.Google Scholar
Kreuter, M. W., Green, M. C., Cappella, J. N., Slater, M. D., Wise, M. E., Storey, D., Holmes, K.
(2007) Narrative communication in cancer prevention and control: a framework to guide research and application. Annals of Behavioral Medicine, 33(3), 221–235. DOI logoGoogle Scholar
Lambert, J.
(2012) Digital storytelling: Capturing lives, creating community. Abingdon-on-Thames: Routledge.Google Scholar
Langer Kelly, T. H., Storer, B. E., Hall, S. P., Lucas, H. G., & Syrjala, K. L.
(2012) Expressive talking among caregivers of hematopoietic stem cell transplant survivors: acceptability and concurrent subjective, objective, and physiologic indicators of emotion. Journal of Psychosocial Oncology, 30(3), 294–315. DOI logoGoogle Scholar
Larkey, & Hill, A.
(2012) Using narratives to promote health: a culture-centric approach. In H. Cho (Ed.), Health Communication Message Design: Theory and Practice (pp. 95–112). Los Angeles, CA: Sage Publications.Google Scholar
Larkey, L., Del Toro-Mejías, L., DiFulvio, G., & Gubrium, A.
(2018) Narrative influences on “desire to act in my community” in digital storytelling workshops for Latina teens. International Quarterly of Community Health Education, 38(3), 163–167. DOI logoGoogle Scholar
Larkey, L. K., & Hecht, M.
(2010) A model of effects of narrative as culture-centric health promotion. Journal of Health Communication, 15(2), 114–135. DOI logoGoogle Scholar
Lemieux, J., Beaton, D. E., Hogg-Johnson, S., Bordeleau, L. J., Hunter, J., & Goodwin, P. J.
(2007) Responsiveness to change to change due to supportive-expressive group therapy, improvement in mood and disease progression in women with metastatic breast cancer. Quality of Life Research, 16(6), 1007–1017. DOI logoGoogle Scholar
Lloyd-Williams, M., Cobb, M., O’Connor, C., Dunn, L., & Shiels, C.
(2013) A pilot randomised controlled trial to reduce suffering and emotional distress in patients with advanced cancer. Journal of Affective Disorders, 148(1), 141–145. DOI logoGoogle Scholar
Manne, S., Ostroff, J., Winkel, G., Goldstein, L., Fox, K., & Grana, G.
(2004) Posttraumatic growth after breast cancer: patient, partner, and couple perspectives. Psychosomatic Medicine, 66(3), 442–454.Google Scholar
Martin, S. L., McLean, J., Brooks, C., & Wood, K.
(2019) “I’ve Been Silenced for so Long”: Relational Engagement and Empowerment in a Digital Storytelling Project With Young Women Exposed to Dating Violence. International Journal of Qualitative Methods, 181, 1–12. DOI logoGoogle Scholar
McQueen, A., Kreuter, M. W., Kalesan, B., & Alcaraz, K. I.
(2011) Understanding narrative effects: the impact of breast cancer survivor stories on message processing, attitudes, and beliefs among African American women. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 30(6), 674–682. DOI logoGoogle Scholar
Mosher, C. E., DuHamel, K. N., Rini, C., Corner, G., Lam, J., & Redd, W. H.
(2011) Quality of life concerns and depression among hematopoietic stem cell transplant survivors. Support Care Cancer, 19(9), 1357–1365. DOI logoGoogle Scholar
Mosher, C. E., Redd, W. H., Rini, C. M., Burkhalter, J. E., & DuHamel, K. N.
(2009) Physical, psychological, and social sequelae following hematopoietic stem cell transplantation: a review of the literature. Psychooncology, 18(2), 113–127. DOI logoGoogle Scholar
Niederwieser, D., Baldomero, H., Szer, J., Gratwohl, M., Aljurf, M., Atsuta, Y., Gratwohl, A.
(2016) Hematopoietic stem cell transplantation activity worldwide in 2012 and a SWOT analysis of the Worldwide Network for Blood and Marrow Transplantation Group including the global survey. Bone Marrow Transplant, 51(6), 778–785. DOI logoGoogle Scholar
Park-Fuller, L. M.
(2000) Performing absence: The staged personal narrative as testimony. Text and Performance Quarterly, 20(1), 20–42. DOI logoGoogle Scholar
Pasquini, M. C., Wang, Z., Horowitz, M. M., & Gale, R. P.
(2010) 2010 report from the Center for International Blood and Marrow Transplant Research (CIBMTR): current uses and outcomes of hematopoietic cell transplants for blood and bone marrow disorders. Clinical transplants, 87–105.Google Scholar
Paterno, M. T., Fiddian-Green, A., & Gubrium, A.
(2018) Moms Supporting Moms: Digital Storytelling With Peer Mentors in Recovery From Substance Use. Health Promotion Practice, 19(9), 545–556. DOI logoGoogle Scholar
Pennebaker, J. W., & Chung, C. K.
(2011) Expressive writing: Connections to physical and mental health. In H. S. Friedman (Ed.), Oxford Handbook of Health Psychology (pp. 417–437). Oxford: Oxford University Press.Google Scholar
Pennebaker, J. W., & Evans, J. F.
(2014) Expressive writing: Words that heal. Washington: Idyll Arbor, Incorporated.Google Scholar
Pidala, J., Anasetti, C., & Jim, H.
(2010) Health-related quality of life following haematopoietic cell transplantation: patient education, evaluation and intervention. British Journal of Haematology, 148(3), 373–385. DOI logoGoogle Scholar
Riessman, C. K.
(2008) Narrative methods for the human sciences. Los Angeles, CA: Sage Publications.Google Scholar
Rini, C., Austin, J., Wu, L. M., Winkel, G., Valdimarsdottir, H., Stanton, A. L., Redd, W. H.
(2014) Harnessing benefits of helping others: A randomized controlled trial testing expressive helping to address survivorship problems after hematopoietic stem cell transplant. Health Psychology, 33(12), 1541–1551. DOI logoGoogle Scholar
Shaffer, V. V. A.
(2013) The Effect of Narrative Information in a Publicly Available Patient Decision Aid for Early-Stage Breast Cancer. Health Communication, 29(1), 64–73. DOI logo pmid:Google Scholar
Sharf, B. F., & Vanderford, M. L.
(2003) Illness narratives and the social construction of health. In T. L. Thompson, A. Dorsey, R. Parrott & K. Miller (Eds.), The Routledge Handbook of Health Communication (pp. 9–34). Abingdon-on-Thames: Routledge.Google Scholar
Stanton, A. L., Danoff-Burg, S., Cameron, C. L., Bishop, M., Collins, C. A., Kirk, S. B., Twillman, R.
(2000) Emotionally expressive coping predicts psychological and physical adjustment to breast cancer. Journal of Consulting and Clinical Psychology, 68(5), 875. DOI logoGoogle Scholar
Stanton, A. L.
(2011) Regulating emotions during stressful experiences: The adaptive utility of coping through emotional approach. In S. Folkman (Ed.), The Oxford Handbook of Stress, Health, and Coping (pp. 369–386). Oxford: Oxford University Press.Google Scholar
Sun, C. L., Francisco, L., Baker, K. S., Weisdorf, D. J., Forman, S. J., & Bhatia, S.
(2011) Adverse psychological outcomes in long-term survivors of hematopoietic cell transplantation: a report from the Bone Marrow Transplant Survivor Study (BMTSS). Blood, 118(17), 4723–4731. DOI logoGoogle Scholar
Valsiner, J., & Branco, A. U.
(2006) Communication and metacommunication in human development. Charlotte, North Carolina: IAP.Google Scholar
Visser, M. R., & Smets, E. M.
(1998) Fatigue, depression and quality of life in cancer patients: how are they related? Support Care Cancer, 6(2), 101–108. DOI logoGoogle Scholar
Wexler, L., Gubrium, A., Griffin, M., & DiFulvio, G.
(2013) Promoting positive youth development and highlighting reasons for living in Northwest Alaska through digital storytelling. Health Promotion Practice, 14(4), 617–623. DOI logo; DOI logoGoogle Scholar
Wingard, J. R., Majhail, N. S., Brazauskas, R., Wang, Z., Sobocinski, K. A., Jacobsohn, D., Rizzo, J. D.
(2011) Long-term survival and late deaths after allogeneic hematopoietic cell transplantation. Journal of Clinical Oncology, 29(16), 2230–2239. DOI logoGoogle Scholar
Cited by

Cited by 7 other publications

di Furia, Marco, Nicholas Nicoli, Özgür Yasar Akyar & Martina Rossi
2022. Storytelling Practice in Sectors of Education, Psychology, Communication, Marketing: A Narrative Review. In Psychology, Learning, Technology [Communications in Computer and Information Science, 1606], ► pp. 41 ff. DOI logo
Fiddian-Green, Alice, Aline Gubrium & Amy Hill
2023. Digital Storytelling. In Handbook of Social Sciences and Global Public Health, ► pp. 877 ff. DOI logo
Fiddian-Green, Alice, Aline Gubrium & Amy Hill
2023. Digital Storytelling. In Handbook of Social Sciences and Global Public Health, ► pp. 1 ff. DOI logo
Jagelaviciute, Gabriele, Elena Kum, Edward W. Li, Aaron Rosenfeld, Kenneth Williams, Rana Kandel, Natalie DeGurse, Brady Park, Sylvia Okonofua, Lauren Sano, Moriah Gerofsky, Alexander Sharp, Rupal Hatkar, Santhosh Thyagu & Warren B. Fingrut
2022. Why We Swab: A library of stories in stem cell donation. Transfusion 62:10 ► pp. 2095 ff. DOI logo
Kim, Wonsun, Shelby Langer, Michael Todd, Linda Larkey, Soojung Jo, Lauren R. Bangerter & Nandita Khera
2022. Feasibility of a Digital Storytelling Intervention for Hematopoietic Cell Transplant Patients. Journal of Cancer Education 37:5 ► pp. 1275 ff. DOI logo
Lohr, Abby M., Graciela Porraz Capetillo, Luz Molina, Miriam Goodson, Kaitlyn Smith, Joan M. Griffin, Mark L. Wieland & Irene G. Sia
2024. Development of a Digital Storytelling Intervention to Increase Breast, Cervical, and Colorectal Cancer Screening in the Hispanic/Latino Community: a Qualitative Evaluation. Journal of Cancer Education 39:2 ► pp. 160 ff. DOI logo
Lohr, Abby M., Jhenitza P. Raygoza Tapia, Elizabeth Salerno Valdez, Leslie C. Hassett, Aline C. Gubrium, Alice Fiddian-Green, Linda Larkey, Irene G. Sia & Mark L. Wieland
2022. The use of digital stories as a health promotion intervention: a scoping review. BMC Public Health 22:1 DOI logo

This list is based on CrossRef data as of 29 may 2024. Please note that it may not be complete. Sources presented here have been supplied by the respective publishers. Any errors therein should be reported to them.