Chemotherapy: thoughts and images of patients with cancer.

Cognitive therapists believe that an individual's emotional reaction to a stressful situation is influenced by his or her perception of that situation. This article reports the findings of a cross-sectional survey comparing thought and image patterns in patients with cancer receiving first-time chemotherapy with patients receiving subsequent treatments. The 30 patients in each sample listed their thoughts and images before, during, and after chemotherapy. In both samples, a higher percentage of positively rated self-talk units were expressed; most negative thoughts took place before the chemotherapy. Qualitative content analysis revealed that, in first-time chemotherapy recipients, the most frequently reported thought categories were questions and concerns about chemotherapy, positive evaluations of treatment, positive coping, and negative feelings. In the subsequent-treatment recipients, they were positive coping, physiologic reactions, hope, and positive evaluations of treatment. Nursing implications and future research directions also are discussed.