title: Ensnared by positivity: a constructivist perspective on 'being positive' in cancer care.
abstract: BACKGROUND
  The concept of 'positive thinking' emerged in cancer care in the 1990s. The usefulness of this approach in cancer care is under increasing scrutiny with existing research, definitions and approaches debated. Nurses may wish to judiciously examine the debate in context and consider its relevance in relation to their experience and clinical practice.
  
  
  OBJECTIVE
  To offer a constructivist perspective on 'being positive' we extract data from a constructivist grounded theory study on humour in healthcare interactions in order to identify implications for practice and future research.
  
  
  METHODS
  We offer three areas for consideration. First, we briefly review the emergence of 'positive thinking' within cancer care. Second, we present data from a grounded theory study on humour in healthcare interactions to highlight the prevalence of this discourse in cancer care and its contested domains. We conclude with implications for practice and future research.
  
  
  RESULTS
  Patients actively seek meaningful and therapeutic interactions with healthcare staff and 'being positive' may be part of that process. Being positive has multiple meanings at different time-points for different people at different stages of their cancer journey. Patients may become ensnared by positivity through its uncritical acceptance and enactment.
  
  
  CONCLUSIONS
  Positive thinking does not exist in isolation but as part of a complex, dynamic, multi-faceted patient persona enacted to varying degrees in situated healthcare interactions. Nurses need to be aware of the potential multiplicity of meanings in interactions and be able (and willing) to respond appropriately.
authors.affiliation: Nursing and Midwifery, University of Stirling, Stirling, Scotland, UK. may.mccreaddie@stir.ac.uk
authors.forename: May
authors.initials: M
authors.lastname: McCreaddie
authors.forename: Sheila
authors.initials: S
authors.lastname: Payne
authors.forename: Katherine
authors.initials: K
authors.lastname: Froggatt
mesh_terms: D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000451:nursing / Q000523:psychology; D003142:Communication; D034462:Dissent and Disputes; D005260:Female; D017144:Focus Groups; D006801:Humans; D009013:Morale; D009720:Nurse Clinicians / Q000458:organization & administration / Q000523:psychology; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D009859:Oncology Nursing / Q000379:methods*; D010687:Philosophy, Nursing; D033302:Postmodernism; D013727:Terminal Care / Q000379:methods / Q000523:psychology; D013850:Thinking; D014925:Wit and Humor as Topic / Q000523:psychology