Searching for wisdom in oncology care: A scoping review

Abstract

ABSTRACTObjective:The concept of “wisdom” is beginning to emerge in the oncology literature, raising questions concerning: (1) how the concept of wisdom is used in oncology literature; (2) the ways in which wisdom has been a focus of inquiry within oncology care; and (3) how wisdom is characterized when the term is used.Method:A scoping review, using Arksey and O'Malley's five-step framework, was undertaken to address these questions. In consultation with oncology reference librarians, “wisdom”- and “oncology”-related search terms were identified, and four electronic databases were searched: CINAHL, SocINDEX, PubMed, and PsychINFO. After removal of duplicates and application of inclusion and exclusion criteria, 58 records were identified and included for analysis.Results:The concept of wisdom was employed with a breadth of meanings, and 58 records were schematized into 7 genres, including: (1) empirical research with wisdom foregrounded as a study focus (n= 2); (2) empirical research articles where “wisdom” appears in the findings (n= 16); (3) a quality-improvement project where wisdom is an embedded concept (n= 1); (4) essays where wisdom is an aspect of the discussion (n= 5); (5) commentary/opinion pieces where wisdom is an aspect of its focus (n= 6); (6) personal stories describing wisdom as something gleaned from lived experience with cancer (n= 2); and (7) everyday/taken-for-granted uses of wisdom (n= 26).Significance of Results:The notion of wisdom has a taken-for-granted presence in the published oncology literature and holds promise for future research into patient and clinician wisdom in oncology care. Nonetheless, the terminology is varied and unclear. A scholarly focus on wisdom has not been brought to bear in cancer care to the degree it has in other fields, and research is in the early stages. Various characterizations of wisdom are present. If such a resource as “wisdom” exists, dwelling in human experiences and practices, there may be benefit in recognizing wisdom as informing the epistemologies of practice in oncology care.