I-Poems: A Window Into the Personal Experiences of Family Caregivers of People Living With Advanced Cancer

Abstract

Background:

To date, there is little understanding of how caring during advanced cancer can be a transformational experience for personal becoming for family caregivers (FCGs). FCGs experience personal becoming as they create their own meaning of health and illness and choose patterns relating to the self-identity of the past while reaching forward into the unknowns. Gaining greater insight into a potentially positive aspect of cancer caregiving can contribute to family caregiver well-being and quality of life.

Objective:

This paper identifies I-Poems within cancer caregiver narratives and explores them for themes of personal becoming. The narrative environment created space for FCGs to construct and share their voices; at the same time, the analytic method of poetic inquiry provided the voice of the FCGs to be seen, heard, and contextually explored.

Methods:

As a secondary analysis, we used five cancer caregiver narrative texts obtained from the primary study to create individual I-Poems. Each of the I-statements within the cancer caregiver narrative texts was lifted and repositioned into a poem format while retaining the chronological order and voice of the participant. We then explored the I-Poems for converging themes of personal becoming as emerged from the primary narrative—thematic analysis.

Results:

I-Poems were created from each of the five participants caregivers’ narratives and then explored for themes of personal becoming. Each of the participant stories is briefly introduced, followed by their I-Poem. We found that the I-Poems converged with emergent themes and provided a first-person representation of their caring journey and transformation of being.

Discussion:

I-Poems are a postmodern form of poetic inquiry that can be used alongside thematic analysis to explore personal meaning of caring for someone with advanced cancer and how FCGs experience personal transformation of self. While we found I-Poems to be a meaningful and useful form of analysis for some narrative data, we propose an evolved genre of poetic inquiry—We-Poems—to be used in dyadic nursing research and with FCGs who are in partnered relationships.

Those affected by chronic or serious illness frequently experience a “crumbling away” of their former identity of self as part of the nature of suffering and loss (Charmaz, 1983, p. 167). The loss of sense of self is introduced by the pattern disruption of illness, which creates a restricted and marginalized relational existence (Charmaz, 1983; Eifert et al., 2015; Fringer et al., 2018; van Roij et al., 2019). The illness of cancer structures the world of family caregivers (FCGs) and reconstructs their social and personal lives to that which focuses on the care recipient and their medicalized world. FCGs can struggle to maintain a sense of self as they can become enmeshed in the lifeworld of their sick loved one (Eifert et al., 2015; Ugalde et al., 2012; van Roij et al., 2019). Tensions emerge during the transitional life experience of serious illness, often contributing to the deconstruction and reconstruction of the self-identity of patients and their caregivers (Dean et al., 2020). The identity of self becomes a dynamic construct influenced by role transitions during illness, shaped by social and domestic expectations. The introduction of illness contributes to a suspension of identities as the FCG navigates the lonely position of existing between two identities: the one they knew before illness and the one developed within and after illness (Cody & Lawlor, 2011).

When a person’s life is biographically disrupted by cancer, and they transition into a new role of caring, their transformational experience of personal becoming can be threatened by the loss of their sense of self and self-identity. FCGs can carry considerable burdens and report disregarding their own needs for self and self-care while assuming the position of caring for their sick loved ones (Tranberg et al., 2021). By taking on the deemed obligatory responsibilities of caring, their lifeworlds become narrow, and FCGs can lose or modify their sense of self and sense of identity (Fringer et al., 2018; van Roij et al., 2019). FCGs set aside their own needs and desires to prioritize the needs of their loved ones with cancer (Tranberg et al., 2021). The setting aside of self contributes to the view that FCGs are an extension of the sick person, which fosters the perception that FCGs often have of being invisible in their relationships with others, including their relationship to and with self (Adelman et al., 2014; Applebaum, 2015; Harding & Higginson, 2001; Tranberg et al., 2021; van Roij et al., 2019). FCGs of those with cancer relate to not being seen or heard by health care providers, again contributing to the perception of being invisible and not unique in their personhood (Tranberg et al., 2021). The sense of invisibility, marginalization, loneliness, and being all consumed with their loved one’s life and their care during the illness transition can contribute to the FCGs’ loss of identities and lost sense of personhood (Dean et al., 2020; Harding & Higginson, 2001; Tranberg et al., 2021; van Roij et al., 2019).

While there has been a significant amount of research done on caregiver burden (Bevans & Sternberg, 2012; Chou, 2000; Liu et al., 2020; Mishra et al., 2021; Morgan et al., 2022; Tanco et al., 2021) and the negative aspects of caregiving to include loss of self and self-identity, these studies also indicate the need to explore the positive aspects of FCG in cancer care. One way to do this is to explore and understand caring for serious illness as a transformational embodied experience that can contribute to personal becoming. To date, we do not know how FCGs’ identity of self is reconstructed through the awakening and transformative process of personal becoming.

This paper aims to identify I-Poems within the primary cancer caregiver narrative data set and explore them for themes of personal becoming. We were interested in seeing how the secondary poetic analysis converged with the themes emerging from the primary narrative thematic analysis, and how the narrative themes of personal becoming could be further illuminated through the first-person voice of FCGs located within I-Poems. Additionally, this paper is a response to Tarbi and Morgan’s (2022) invitation to nurse researchers to incorporate poetic inquiry into research design and disseminate new knowledge in an emerging human-centered paradigm.

Definition and Theoretical Framework of Personal Becoming

Becoming is an ontological phenomenon that considers the wholeness, complexities, and connectedness of transformation and evolving consciousness. Cancer FCGs can engage and activate the process of personal becoming as they create their own meaning of health and illness and choose patterns relating to the self-identity of the past while reaching forward into the unknowns. To know self through personal becoming is a process of pattern unfolding personal preferences by which one knows oneself and desires to be known by others. The process of knowing the self is awakening to becoming (Bunkers, 2015).

Two nursing theories in the unitary-transformative nursing paradigm, The Theory of Transpersonal Caring (Watson, 2008) and The Theory of Human Becoming (Parse, 1992), theoretically ground and guided the parent study. The Theory of Transpersonal Caring (Watson, 2008) described becoming as an evolutionary, transformative, and dynamic means to become more human and more whole as caring, spiritual beings. Becoming invites new ways of knowing, new truths, and new stories as a way to awaken wholeness and healing in oneself (Watson & Horton-Deutsch, 2019). The Theory of Human Becoming (Parse, 1992) further explicates becoming as an intersubjective, transforming, and transcending process in which human wholeness is patterned in the mutual and unique process of unfolding with the universe. Becoming is transformative as a person shifts understandings of what is and was known through a different and new light introduced through new experiences and changes in one’s patterns, such as introduced by serious illness landscapes. New meanings of life and being can be illuminated through health-illness transitions as an ongoing human-universe process, transcending the previously known relationship to self and others (Cody, 1995).

Methods

Design

The parent study utilized Riessman’s (1993, 2008) narrative inquiry methods as a qualitative research framework used to study stories, work with narrative materials, and tell stories about stories. We recognize that storytelling can be an act of self-invention wherein participants—as narrators—claim a position of self and identity of how they want to be known through the story and by the telling of it. Storytelling and story construction facilitate “I” knowledge and knowing, remembering, and returning to oneself (Watson, 2008, p. 204). Cancer caregiver narratives were co-constructed through a relational dialogue, and the narrative text was interpreted through narrative, thematic analysis (Riessman, 2008). To complete the secondary analysis of the primary study narrative dataset (Long-Sutehall et al., 2011), we turned toward the postmodern and feminist-informed framework of the Listening Guide (Gilligan et al., 2006) to create first-person voice I-Poems as an arts-based research data analysis approach.

Recruitment, Sample, Setting

The primary study used a strategy of purposeful sampling of FCG participants (Creswell & Poth, 2018). The inclusion criteria included a person who was over the age of 18, actively providing care for an adult loved one with advanced cancer (noncurable) for a minimum of 3 months before study enrollment, with the ability to understand and speak the English language, and able to participate in an hour-long interview either in person or virtually. Participants were recruited through a flyer that was displayed: (a) in a regional cancer center in North Carolina, (b) in public and digital spaces such as libraries, churches, and social media outlets, and (c) on Research Match (2023). Five of the 26 potential participants were eligible, enrolled, and completed the primary study. Reasons for exclusion included less than 3 months in the caregiver role, the person being cared for was deceased, limited stage cancer or pediatric status of the care recipient, and failure to enroll in or complete the primary study.

Ethical Considerations

As directed and overseen by the Colorado Multiple Institutional Review Board (#22–0756), the verbal informed consent addressed the data collection completed in the two modality options: the use of notes and audio recordings. All participants were provided electronic, written versions of the consent prior to giving verbal consent before study enrollment. Participants consented to using their data in future research and disseminating the future study findings. Reusing the parent study data set for purposes related to the primary research aims to honor the ethical contract between the participants and the researcher team. The primary narrative data set was de-identified of names, places, institutions, identifiable body parts, and cancer-type and pseudonyms were assigned. No patient-protected information was obtained to complete this study. While traditional member-checking was not employed (Riessman, 2008), all participants were given the opportunity to see the final transcripts from their interviews as well as the interpretive findings. No participants opted to see the final transcripts.

Data Collection

In the primary study, we used open-ended interviews completed between the primary researcher and the individual participants (Weiss et al., 2023). Three interviews were completed in person at a location of the participant’s choice (coffee shop, participant’s home, and an alcove in a cancer clinic waiting room) and two through Zoom—a virtual communication platform. The interviews averaged 60 min (range 45–90 min). Interviews were digitally recorded and manually transcribed. All data were stored on a VPN double-password-protected hard drive. The narrative text was cleaned up of grammatical dysfluencies and de-identified. All five of the primary data set interview transcripts were assessed for quality and deemed to offer rich narrative data relevant to the aim of the secondary analysis.

Poetic Analysis

The methodological underpinning of the secondary analysis of the complete narrative data set was guided by Gilligan et al. (2006) Listening Guide. The Listening Guide (Gilligan et al., 2006) incorporates a series of four “listenings” or readings of the narrative text, each guiding a different path of understanding of and through the narrative. This study’s primary interest was in the first and second listenings. The first listening aimed to stay close to the narrative by paying attention to the overall story and identifying the content or plot through words, metaphors, and dominant themes (Edwards & Weller, 2012; Gilligan & Eddy, 2017), much akin to a thematic narrative analysis (Riessman, 2008) as completed in the primary study. The second listening traced how the participant represents or speaks of self in the narrative, from where the I-Poem analysis arises (Edwards & Weller, 2012; Koelsch, 2015). We listened for themes of personal becoming as identified in the primary study and then shaped the production of I-Poems by discovering how the participants represented themselves in the narrative and “concerns the stream of consciousness that is carried by the first person references” (Edwards & Weller, 2012, p. 205).

The primary researcher (CW) and the qualitative methodological expert (RK) analyzed the participants’ narrative texts using the I-Poem method. At the same time, we worked inductively alongside the primary, narrative thematic analysis. Creating an I-Poem involves two essential steps (Gilligan & Eddy, 2017). First, the interview transcripts were read, and every first-person use of the word “I” and the associated verb or important following text were highlighted. This process was intuitive and subjective, as we reflectively negotiated as a researcher team while respecting the “reflexive relationship” that the primary researcher developed with the participants (Long-Sutehall et al., 2011) to determine which words were meaningful to understand the participant’s sense of self and transformational process (Gilligan & Eddy, 2017). The second step involved lifting the highlighted words or phrases from the primary narrative text and placing them on separate lines in a new document. This process requires the researcher to keep the words and phrases in the order from which they originally occurred in the interview. The lines of the text then appeared as lines of a poem that could be constructed into stanzas to note changes in themes, topics, or voice. In this way, the “ebbs and flows or change and continuity” created within one narrative occasion could be followed (Edwards & Weller, 2012, p. 205). By separating the “I voice,” the participants’ sense of agency and self is located and repositioned to the forefront of the story (Koelsch, 2015, p. 98). The process of poetic analysis constructs an authentic analytical mode of being-in-relation of “being-with” or “standing alongside” (Edwards & Weller, 2012, p. 215). This mode of being-with invites the reader to slow down and enter the text at an emotional and empathetic level, thus increasing the understanding of the participants’ lived experiences (Koelsch, 2015).

Results

The five FCG participants recruited in the primary study self-identified as their care recipient’s primary informal caregivers, including two male spouses, one female spouse, one female cousin, and one daughter. Of these, four identified as White non-Hispanic and one as African American. Religious affiliation was included as part of the demographic inquiry, wherein three identified with none, one with Christianity, and one with Buddhism. They were between 54 and 63 years of age; length of relationship with their care recipient averaged 39 years (20–50 years); and time of known cancer diagnosis averaged 14 months (4–24 months). The care recipients’ cancer diagnoses were diverse (lymphoma, breast, colon, and renal) and described by the participants as serious and noncurable.

The thematic threads of personal becoming were identified within and across these caregiver narratives as caring invitations for personal transformation and awakenings; this paper adds contextual understanding of these themes through the creation and exploration of I-Poems. First, we provide a brief introduction of a single participant’s story (represented by pseudonyms) and describe how we interpreted the theme within their caregiver narrative. We then present that participants’ constructed I-Poem in a table format.

Theme 1: Past Caring Informs Present Caring

Susan is a 58-year-old female whose spouse of 40 years was recently diagnosed with high-grade blood cancer. While creating her caregiver narrative, Susan shared how she had previously cared for her 15-year-old daughter, who had childhood cancer. Her experience caring for her daughter influenced how she cares both for her husband and herself. While caring for her daughter, Susan denied her self-care needs, which resulted in a decline in her emotional and spiritual health. The experience of placing her needs on the “backburner” taught her the importance of caring for herself while now attending to the care of her husband, who has cancer. Susan’s story and the I-Poem (Table 1) reflect the theme of past caring informing present caring for self.

Table 1.

Susan’s I-Poem

Our daughter is a cancer survivor

I think that really probably set us up

Changed our life

I decided to go to school because of what she went through

That was the major life changing moment I think for our whole family

I was able to quit my job and care for [daughter]

I was very task oriented

I had a check list

I have to do this

I have to just go through the motions

Making sure everyone else is ok

I fell apart

I took some time to really re-evaluate

I worked part time job

Trying to figure out what I want

I was on some sleep aids and some antidepressants

I gained probably 50–75 pounds

I put myself completely on the backburner

The day [daughter] was diagnosed with cancer we went out to lunch

Cheeseburgers, French fries, and a milk shake

I had not ordered [that] in like 2 years

I stopped caring for myself

I just wasn’t focused on myself at all

I am older

I am definitely more cognizant of taking care of myself

I’m getting there

I am not great at it sometimes

I am trying

Going for more walks, crafting, some creative things

Theme 2: Transforming Meaning of Life and Purpose of Self

Ron is a 64-year-old male whose wife of over 30 years was recently diagnosed with stage IV breast cancer. While Ron was raised in a Christian home environment and made churchgoing a regular part of his life, he found that his primary values of faith and family became more apparent and meaningful to his purpose of self as he lived alongside family members who had cancer. While religious affiliation was not a part of the narrative thematic or poetic analyses, the situational context of Ron’s religious and spiritual background and beliefs was foundational to his story creation and informed the meaning of the theme. He shared stories of caring for his parents, his daughter, and now his wife, all of whom experienced the disease of cancer. Through caring for his family members—and especially in caring for his lifelong partner—he found a new purpose of self and renewed recognition of the value of family relationships. Caregiving has become a means for him to fulfill his marriage vows to his wife and reciprocate the care she provided him with when he was ill after a heart attack. Ron’s story and the I-Poem (Table 2) reflect the theme of transforming the meaning of life and the purpose of self through caregiving.

Table 2.

Ron’s I Poem

I think without God

It would’ve been devastating

Everything happens for a reason

It’s given me strength

***

It’s been hard

After you see both parents die with cancer

I felt so strongly about it

I actually sold cancer policies

To try to help people

***

I had 100% blockage

I’m lucky to be alive

When you say your vows

I think you should make them

For better, for richer, for sickness, and in health

If you care for somebody during the good times

You should also care for them during the rough times

***

My wife and I first got married

My aunt died with cancer

I can’t remember

We had like 3 or 4 funerals

In the first two years we were married

Still tough

When you lose family members

My father died

My mother died

Without family you don’t have anything

If you don’t have somebody to care for

Life is a whole lot tougher in my opinion

And for them to care about you also

***

We just take it one day at a time

Try to make the best of it

Pray, faith, God has a plan

Theme 3: Transforming Relationships with Others

These FCGs shared stories of how the introduction of cancer in their loved ones contributed to meaningful bonds and connections with others and opened doors for new and unexpected relationships to emerge. Jane (aged 50) had plans to marry her sweetheart, yet because of her mother’s decline of health due to metastatic breast cancer and the societal barriers related to COVID-19, she deferred her wedding until later. Surprisingly to her, Jane’s first cousin became a vital emotional support, a companion to her mother in a time of need, and facilitated her mother’s attendance at her wedding. Jane’s narrative story and the I-Poem (Table 3) reflect the theme of transforming relationships with others.

Table 3.

Jane’s I-Poem

My relationship with my oldest cousin

I mean as almost as dramatically

With my mom

Changed this relationship with my cousin

I am one of the youngest cousins

I barely knew her

I always kind of had this weird impression of her

We were very, very different

I started talking to [cousin]

I had never been close

I just felt this bonding

Our relationship has just grown and grown

[cousin] came and stayed with me

I was like, “Well come sleep here”

We were having so much fun

We text all the time

We were just texting

I never would’ve had relationship without this cancer thing

Theme 4: Transforming Patterns of Relating to the Natural World

The participants shared stories of how caring for and living alongside a person with cancer opened new avenues of understanding self through being in relation to the earth and the natural world. Mitchell, a 58-year-old male, became the primary caregiver of his wife, who has two types of advanced cancer. His stories highlight how caring during serious illness can contribute to a new perspective of oneness and interconnection with one’s natural environment. Mitchell was intentional to spend time in nature, in solitude, as he sought to engage in the simplicity of life by being present in the moment as he attended to the unfolding of events occurring in the natural world. He shared photos he took while outdoors, prompting him to share how being engaged in nature helped create meaning in his caring experiences. Mitchell’s story and the I-Poem (Table 4) reflect the theme of transforming patterns relating to the natural world.

Table 4.

Mitchell’s I-Poem

What I experience

What I’m experiencing

I keep it pure and not interpret it

I don’t know

I left the hospital

Came over here to XX lake

Sitting at a picnic table

I saw an otter go in the lake

I didn’t know otters went into the lake

I found out, sometimes they do

This incredible experience of this creature

Out there living his life I mean

Circumstance allowed me to see it

Take comfort from it

***

We shaved her head for when the chemo started

I offered to shave mine too

I wrote

I’ve been focused on is: everybody has pain

I draped the hair

I cut from her head

Over a magnolia branch, as an offering

We said, “Maybe some creature could use your hair for a nest.”

Theme 5: Transforming Patterns of Spiritual Knowing

Kanika, a 48-year-old female, supports and cares for her male cousin, who has advanced colorectal cancer. Kanika has been the primary caregiver for various family members with serious illnesses over the last 20 years, and she views the role of caring as a primary joy of her adult life. She has adopted patterns of spiritual knowing and understanding, which support her during her caregiving experiences. Caring has become her way of honoring another’s life and is her gift of herself to others. While she has experienced and witnessed much change and loss in her extended family, Kanika’s faith in a higher purpose of goodness has not shifted. Kanika’s story and the I-Poem (Table 5) reflect the theme of transforming patterns of spiritual knowing.

Table 5.

Kanika’s I-Poem

I get joy in caring

I feel you know

I get

I put out a lot of good energy

Good things will continue to happen for me

I limit myself

I don’t’ allow myself to go too far into the future

I’m kinda on the fence

I guess

I just go ahead and stay in the moment, appreciate the day

Something that I’m planning

Something that I know that’s coming

I’ll address it

I don’t even know

How I manage

But I do

My faith continues to be strong…in spite of

Losing my grandparents

I just didn’t imagine

I will say it was gift, an honor, a privilege

I was able to be there with her

***

What brings me comfort

I am able to be there

What brings me comfort

What brings me comfort

I am able to help him

I just shake my head

We just laugh

I just shake my head

Theme 6: Transforming Patterns of Aesthetic Knowing

Jane, a 50-year-old female, is the primary caregiver for her older mother with metastatic breast cancer. She primarily cares for her mother from a geographic distance, as they reside approximately 1,200 miles apart. Jane shared stories of how the arts and participating in aesthetic endeavors opened avenues for her to slow down, be mindful of the present moment, create meaning in her caring experiences, and relate to her mother in new ways. Aesthetics have helped Jane live with the ambiguity of not knowing, by accepting that non-knowing is a part of her journey of living alongside someone with advanced cancer. Arts have assisted her in appreciating her life’s path as a natural unfolding. Jane’s co-constructed story and the I-Poem (Table 6) reflect the theme of transforming patterns of aesthetic knowing.

Table 6.

Jane’s I-Poem

The interpretation

Most meaningful and important to me

To me, it’s been very important to accept

Let it unfold

Wu Wei has been my guiding mantra

I try to apply it

Every aspect of my life

My relationships

My relationship with my work

I’m transitioning

I’m doing

Just letting it unfold

I adopted it during this period

I did

When I have time

I do enjoy

I’m trying to learn Sumi-E

I have a number of pictures

I’ve done

I did more art

I would send her art pieces

I did some cute little foxes

I’m trying

I’m trying to get good

I’m painting a fox

I’m going to be this fox

Discussion

The findings from this poetic analysis of a primary collection of caregiver narratives contribute to new knowledge theoretically grounded by two unitary-transformative nursing theories; it suggests that FCGs can develop an evolving and transformative awareness of self and knowing oneself through being close to and caring for their loved ones with advanced cancer. Caring can provide FCGs opportunities to demonstrate their love and personal values to their sick family members, which facilitates the transformation of self (Bouchal et al., 2015; Li & Loke, 2013; Moreno-González et al., 2019; Ugalde et al., 2012) as coming-to-be, or personal becoming. The themes of personal becoming that emerged from the I-Poem analysis were convergent with the themes identified through the thematic narrative analysis in the parent study and further illuminate to nurses who care for persons with cancer how cancer FCGs adopt new ways of knowing self and knowing others through living alongside someone with serious illness by adopting aesthetic and spiritual patterns of knowing while also learning from the natural world.

We found that the analytical process of listening and reflection facilitated through the I-Poem analysis offered us—as researchers and clinicians—a unique landscape to walk beside the FCGs as they coproduced narratives of personal discovery. This type of postmodern analysis can create a landscape for nursing researchers and clinicians to engage and reflect upon a less traditional, reflective, and relational stance as we attend to how we are socially and culturally located and then how we see and hear people in their storytelling. We were open to multiple meanings, imaginations, and truths of the data; we recognized that each poem could be interpreted differently based on the researcher’s positionality of the researcher study’s aims. The I-Poem prompted us to reflect upon the different voices of the FCGs as they co-constructed stories with back and forth, ebbs and flows of meaning creation.

Similar to Lyndon and Edwards’s (2021) experience using I-Poem, the more we listened to the first-person voices of the narrative, the more our empathy and understanding expanded of what it means to live alongside a loved one with advanced cancer. We hope the clinical audience will also experience the empathic knowing that I-Poems can facilitate. One of the strengths of the I-Poem is how it remains grounded in the data while creating a contextual space for the listener to “imagine [themselves] within the experience” (Koelsch, 2015, p. 96). Furthermore, we postulate that poetic inquiry is a methodology that is congruent with unitary-transformative theories as it creates space for the infinity of the human soul to be mirrored back upon itself to us and connects us to “the face,” “the glance,” of our shared humanity and the complex mystery of being and living (Levinas, 1996; Watson, 2003).

To our knowledge, this is the first nursing-led study that used I-Poem to locate cancer FCGs’ sense of self within co-constructed narratives. With a few exceptions, the Listening Guide has been used to analyze data gathered from the stories of women and girls (Koelsch, 2015). However, we found it to be a flexible framework to analyze the voice of our male participants as they, too, shared stories reflective of their struggles with cultural stigma, marginalization, and being unheard by others. This may reflect the marginalization of caregiving as a role as it is often ascribed to be a female role. This suggests that future research could benefit by examining male caregivers and their experiences using the Listening Guide and other more empowerment-based methods.

Creating the I-Poems became an emancipatory opportunity to shift power back to the caregivers and a means of resisting the tendency of biomedically situated research to reduce human phenomena (Watson, 2008) into single linear narratives. Furthermore, we attest that engaging with poetic inquiry as a data source of knowledge contributes to nursing essential freedom by liberating our science from the narrow confines of biomedical infrastructures in research and facilitating humanization social justice action whereby research participants, as unique human beings, are valued, respected, and regarded with moral worth (Perry et al., 2017; Willis et al., 2014).

Limitations

Our study has several limitations. First, an analytic ontological shift of “standing alongside” (Gilligan & Eddy, 2017), the participants were required of the researchers to analyze and synthesize the narrative data from a voices and linguistical approach, essential to complete an I-Poem rendition. Secondly, we found that the participants who were engaged in a partnered relationship with their care recipients often spoke through a relational voice, using the language of “we” instead of “I.” Even after introducing interview prompts such as “Can you tell me more about how that felt to you?” many FCG participants reverted to “we” terms. There is an opportunity for nursing and biobehavioral researchers to evolve poetic analysis methods that invite individual and dyadic participants who navigate shared disease trajectories to do so without restraint while highlighting the relational nature of the phenomenon. Lastly, our study is marked by our self-reflexivity, honesty, and data transparency (Tracy, 2010), yet we recognize these poems may be biased by our a priori knowledge about cancer FCGs.

Conclusion

The findings suggest that constructed I-Poem contribute to new knowledge grounded in narrative text and exemplify how caring in cancer relationships fosters the personal becoming of the FCG. I-Poems are a novel creative arts research method used to uncover new facets of the human experience of caring. Additionally, as a form of poetic inquiry, I-Poems invite the reader to walk alongside the narrator and envision their lived experience while facilitating empathy and humanistic values. We implore other nurse researchers to consider utilizing poetic inquiry and other forms of creative research methods to expand nursing science beyond the boundaries of traditional biomedical paradigms.

Funding Statement:

Charlotte Weiss is supported by the National Institutes of Health, National Institute of Nursing Research Ruth L. Kirschstein National Research Service Award training program [T32NR009356]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Biography

Charlotte R. Weiss, PhD, MSN, ACNP-BC, is a Post-Doctoral Fellow at the University of Pennsylvania, NewCourtland Center for Transitions and Health, Philadelphia, PA. At the time the primary study for this secondary analysis was completed, she was a PhD candidate at the University of Colorado-Anschutz Medical Campus, College of Nursing, Denver, CO.

Rachel Johnson-Koenke, PhD, LCSW, is Assistant Professor, and Karen H. Sousa PhD, RN, FAAN is Professor, at the University of Colorado-Anschutz Medical Campus, College of Nursing, Aurora, CO.