‘I am not the same’ has been conceived by Norwegian researchers, for breast cancer patients in Norway. However, we were fortunate to have been given an opportunity to initiate the study abroad, with seven US breast cancer patients. Researchers from Stavanger University Hospital are collaborating with colleagues at MD Anderson Cancer Center in Houston, Texas. This is the first international nursing/health science research project between two sister institutions within the Global Academic Programs (GAP) network.
‘I am not the same’ has an exploratory and descriptive design, consisting of three qualitative branches. Part I is an implementation trial on expressive writing for breast cancer patients. Part II is a about the patient’s journey from diagnosis to end of oncological treatment: experiences of breast cancer, breast loss and reconstruction in a psychosocial and cultural context. Part III is a comparative study of breast cancer, loss of breast and reconstruction from a cross-cultural perspective, with collection of data from American and Norwegian breast cancer women, who also contribute to Part I and II of the project.
The Norwegian study has enrolled 14 breast cancer patients through the course of 2013-2014, utilizing two complementary methods for data collection: expressive writing texts/breast biographies and semi-structured interviews. 7 of these participants have removed and reconstruct the breast during the primary operation (new surgical method in Norway), and 7 have removed the breast without reconstruction (traditional surgical method). The figure below provides an overview of the study design.
The US component of ‘I am not the same’ is identical to the original Norwegian study design. Seven breast cancer patients were enrolled in the course of 2012, with one year follow up in 2013. The women were informed about the study and instructed individually through conversation with a researcher. They were then asked to write at home following specific instructions, within one month after surgery, and invited to attend an interview after the end of their writing. This was repeated again one year after, when the women had completed additional treatments, such as chemo or radiation. The accumulated material from both the interviews and the texts produced through expressive writing and breast biographies, provides data for further content analysis.
There are considerable differences in the types and timing of surgery and treatments offered in the US and Norway, hence we are not able to reproduce identical samples. But the US study will allow us to add another level of inquiry: exploring cultural differences and similarities between American and Norwegian breast cancer patients.