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Having a brother or sister who has a chronic illness (lasting >6 months and requiring long-term care) or life-limiting condition (LLC; where cure is highly unlikely and the child is expected to die) has major impacts on siblings. Parent–sibling illness-related communication may contribute to siblings’ capacity to cope.
Objectives
In this study, we aimed to explore parent–sibling illness-related communication, from the perspectives of parents and siblings. We also aimed to qualitatively compare participants’ responses according to illness group (chronic illness vs. LLCs).
Methods
We collected qualitative data from siblings (32 with a brother/sister with a chronic illness, 37 with a brother/sister with an LLC) and parents of a child with a chronic illness (n = 86) or LLC (n = 38) using purpose-designed, open-ended survey questions regarding illness-related communication. We used an inductive qualitative content analysis and matrix coding to explore themes and compare across illness groups.
Results
Two-thirds of siblings expressed satisfaction with their family’s illness-related communication. Siblings typically reported satisfaction with communication when it was open and age-appropriate, and reported dissatisfaction when information was withheld or they felt overwhelmed with more information than they could manage. Parents generally favored an open communication style with the siblings, though this was more common among parents of children with an LLC than chronic illness.
Significance of results
Our findings show that while many siblings shared that they felt satisfied with familial illness-related communication, parents should enquire with the siblings about their communication preferences in order to tailor illness-related information to the child’s maturity level, distress, and age.
Hard-to-treat childhood cancers are those where standard treatment options do not exist and the prognosis is poor. Healthcare professionals (HCPs) are responsible for communicating with families about prognosis and complex experimental treatments. We aimed to identify HCPs’ key challenges and skills required when communicating with families about hard-to-treat cancers and their perceptions of communication-related training.
Methods
We interviewed Australian HCPs who had direct responsibilities in managing children/adolescents with hard-to-treat cancer within the past 24 months. Interviews were analyzed using qualitative content analysis.
Results
We interviewed 10 oncologists, 7 nurses, and 3 social workers. HCPs identified several challenges for communication with families including: balancing information provision while maintaining realistic hope; managing their own uncertainty; and nurses and social workers being underutilized during conversations with families, despite widespread preferences for multidisciplinary teamwork. HCPs perceived that making themselves available to families, empowering them to ask questions, and repeating information helped to establish and maintain trusting relationships with families. Half the HCPs reported receiving no formal training for communicating prognosis and treatment options with families of children with hard-to-treat cancers. Nurses, social workers, and less experienced oncologists supported the development of communication training resources, more so than more experienced oncologists.
Significance of results
Resources are needed which support HCPs to communicate with families of children with hard-to-treat cancers. Such resources may be particularly beneficial for junior oncologists and other HCPs during their training, and they should aim to prepare them for common challenges and foster greater multidisciplinary collaboration.
Chapter 3 treats the staging of tiny props in both the Globe and Blackfriars theaters. In Shakespeare’s Cymbeline and Antony and Cleopatra as well as Massinger’s The Picture, minuscule objects are deployed as metonymic evidence purporting to offer privileged, indubitable knowledge about a woman’s inscrutable body. The chapter demonstrates that the objects’ epistemological limitations, as detailed in the playtexts, became a phenomenological impasse in the playhouse. The very conditions of the props’ theatrical display in the large outdoor amphitheater and the small indoor hall would have variously exacerbated their narrative failures, undermining spectators’ attempts to see the objects clearly. At an historical moment when new empiricist methodologies promised to mitigate uncertainty, if not eradicate it entirely, the theater involved spectators in the failures of forensic investigation only to posit itself as a site for the capacious fulsomeness of spectacular display. The chapter ultimately argues that the very ephemerality of theatrical spectacle becomes, in all three plays, the alternative to the permanence of partial knowledge.
By attending to a common theatrical convention – the representation of both dead and apparently dead bodies by actors – Chapter 1 offers a new history of early modern English tragicomedy. In all theatrical performance, the actor’s body is semiotically volatile, for its liveliness can never be entirely circumscribed by the onstage fiction. This chapter demonstrates that the early modern theater frequently exacerbated that necessary instability by requiring its actors to feign death. Tracking instances of apparent death from the late 1580s through the opening of the seventeenth century, the chapter shows that theater practitioners increasingly invited their spectators to apprehend the ambiguity of the lively stage corpse, entwining them in uncertainty by offering them less and less interpretive guidance about the actor’s inevitable signs of life. Audiences gradually came to expect that they could not know the fictional status of apparent corpses. The conventions that eventually coalesced around stage corpses enabled the rise of English tragicomedy, the hybrid genre that allowed for seemingly dead bodies to resurrect themselves without warning.
By the commercial theater’s closure in 1642, frequent playgoers commanded a vast trove of knowledge regarding the devices, tropes, character types, and genres of the commercial theater. But those conventions were as exploitable as they were familiar, and Chapter 5 shows how theater practitioners managed to surprise those spectators with especially long horizons of dramatic expectation. The chapter examines the striking durability of revenge tragedy in the commercial theater by juxtaposing two plays that nearly bookend its heyday: Thomas Kyd’s The Spanish Tragedy and Philip Massinger’s The Roman Actor. In revealing the ways that The Roman Actor exploits spectators’ knowledge of Kyd’s play, as well as the tropes of revenge tragedy more broadly, the chapter outlines the techniques by which Caroline theater practitioners made the eminently familiar newly strange.
By the Caroline era, London’s broader theatergoing public contained within it the smaller subset of a theatrical community – those playgoers collectively invested in the cultivation of their dramatic knowledge and interpretive acuity. Chapter 4 offers a phenomenological prehistory of this community, locating its activation in the moment of performance itself. The chapter traces the formation of this theatrical community alongside the dramatic trope of impersonation, which constructed the unknown depths and vicissitudes of individual identity as a function of the bifurcated structure of the playhouse. Through readings of Shakespeare’s Twelfth Night and The Comedy of Errors, the anonymous Look About You, John Fletcher’s Love’s Cure, and Dekker and Middleton’s The Roaring Girl, this chapter argues that the formation of spatially relational identities in impersonation plots extended from the stage to the amphitheater: constituted as a series of mirror images only partially revealed, London’s theatrical community was produced by spectators’ mutual recognition of their uncertainty about one another.
The coda considers the effect of the eighteen-year closure during the Interregnum on the commercial theater’s phenomenology of uncertainty. When Thomas Killigrew and William Davenant were granted patents to form theater companies by Charles II in 1660, they did not return to the practices of the earlier theatrical era, instead outfitting playhouses with the perspective sets and proscenium frames of court and Continental performance. The coda demonstrates that heroic drama, the first major genre to emerge under these new performance conditions, favored resolution rather than ambiguity. In John Dryden’s vision of the new genre, majestic spectacles that aimed to control spectators’ imaginations replaced the ambivalent metatheatricality of the earlier theater. The Restoration theater, the coda suggests, ultimately rejected the uncertainty that had defined theatrical experience from the late sixteenth to mid-seventeenth century.
Chapter 2 argues that the early modern theater’s techniques for the production of narrative suspense emerged from its cultivation of spectators’ phenomenological uncertainty. Attending to moments of temporal suspension in history plays, including Christopher Marlowe’s Edward II, William Shakespeare’s Richard II, and John Ford’s Perkin Warbeck, the chapter shows that theater practitioners regularly aimed to resist the unrelenting forward momentum of live performance by grinding dramatic time to a halt. Narrative suspense was especially hard to come by in the history play, which emerged as a new genre in the 1590s by dramatizing well-known chronicles of English kings. But the playgoers who flocked to theaters to see these stories of succession were living through a succession crisis of their own, for Elizabeth I’s lack of an heir rendered England’s dynastic future crucially opaque. The theatrical invitation to unknow England’s past trained spectators in speculative thinking oriented toward their own politically uncertain future. History plays transformed the anxious wait for Elizabeth’s successor, that is, into the pleasure of theatrical possibility.
The introduction sets out the two key techniques by which the early modern theater entwined its spectators in uncertainty, ultimately offering a new model of this theater’s process of performance – one that encouraged its spectators’ imaginative participation by, paradoxically, frustrating it. The practitioners of this highly experimental theater regularly drew attention to the technologies of stagecraft, inviting spectators’ uncertainty about the stage’s fictional representations by calling attention to them as performances. The introduction also pushes back against the established account of a Jacobean and Caroline theater that catered to the increasingly sophisticated theatrical acuity of its spectators, arguing that practitioners’ eagerness to exploit familiar conventions into the seventeenth century regularly upended even knowing playgoers’ dramatic expectations. Finally, the introduction argues that these moments of interpretive unsettling should be considered a fundamental, even primary, element of the early modern theatrical experience.
Lauren Robertson's original study shows that the theater of Shakespeare and his contemporaries responded to the crises of knowledge that roiled through early modern England by rendering them spectacular. Revealing the radical, exciting instability of the early modern theater's representational practices, Robertson uncovers the uncertainty that went to the heart of playgoing experience in this period. Doubt was not merely the purview of Hamlet and other onstage characters, but was in fact constitutive of spectators' imaginative participation in performance. Within a culture in the midst of extreme epistemological upheaval, the commercial theater licensed spectators' suspension among opposed possibilities, transforming dubiety itself into exuberantly enjoyable, spectacular show. Robertson shows that the playhouse was a site for the entertainment of uncertainty in a double sense: its pleasures made the very trial of unknowing possible.
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