Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-24T00:28:04.576Z Has data issue: false hasContentIssue false
  • English
  • Français

Activity and meaning making in the everyday lives of people with advanced cancer

Published online by Cambridge University Press:  26 November 2009

Karen la Cour ,
Helle Johannessen  and
Staffan Josephsson
Karen la Cour*
Affiliation:
Institute of Public Health, Research Unit Health, Man and Society, University of Southern Denmark, Odense, Denmark School of Occupational Therapy, University College Sjælland, Naestved, Denmark
Helle Johannessen
Affiliation:
Institute of Public Health, Research Unit Health, Man and Society, University of Southern Denmark, Odense, Denmark
Staffan Josephsson
Affiliation:
NVS Department, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
*
Address correspondence and reprint requests to: Karen la Cour, J. B. Winsløws Vej 9, 5000 Odense, Denmark. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

This study aims to explore and understand how people with advanced cancer create meaning and handle everyday life through activity.

Methods:

A purposive sample of seven participants was recruited from a larger study. Data were collected through qualitative interviews and participant observations conducted in the participants' home environments while they were engaged in activities to which they assigned particular value. Interpretive analysis was conducted using narrative theory and relevant literature.

Results:

The study shows how people in conditions of advanced cancer fashion narratives useful for handling everyday life with advanced cancer. A meta-narrative of “saying goodbye in a good way” provided an overall structure for the participants as they attempted to create desired narratives negotiated in context of the individuals' sociocultural life and in the proximity of death. A narrative of “being healthy although ill” provided an arena for exploring the contrast between simultaneously feeling well and severely ill. Further emplotment of activities in “routines and continuity” was identified as a means to provide a safe, familiar framework stimulating participants' everyday agency. “My little Mecca” was identified as a narrative reflecting the activity of life-confirming experiences and taking time out.

Significance of results:

The identified narratives performed and told in daily life may guide the development of palliative care services to support people with advanced cancer in creating meaning in the remains of their lives.

Keywords

Activity in daily lifeAdvanced cancerNarrativeMeaning making
Type
Original Articles
Information
Palliative & Supportive Care , Volume 7 , Issue 4 , December 2009 , pp. 469 - 479
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Alsaker, S. & Josephsson, S. (2003). Negotiating occupational identities while living with chronic rheumatic disease. Scandinavian Journal of Occupational Therapy, 10, 167–176.CrossRefGoogle Scholar
Breitbart, W. (2002). Spirituality and meaning in supportive care: Spirituality- and meaning-centered group psychotherapy interventions in advanced cancer. Supportive Care in Cancer, 10, 272–280.CrossRefGoogle ScholarPubMed
Bruner, J. (1990). Acts of Meaning. Cambridge, MA: Harvard University Press.Google Scholar
Bury, M. (1982). Chronic illness as biographical disruption. Sociology of Health & Illness, 4, 167–182.CrossRefGoogle ScholarPubMed
Charmaz, K. (1991). Good Days, Bad Days: The Self in Chronic Illness and Time. New York: McGraw-Hill.Google Scholar
Charmaz, K. (1999). ‘Discoveries’ of self in illness. In Health, Illness, and Healing. Society, Social Context, and Self, Charmaz, K. & Paterniti, D.A. (eds.), pp. 72–82. Los Angeles: Roxbury Publishing Company.Google Scholar
Davies, C.A. (2001). Reflexive Ethnography, A Guide to Researching Selves and Others. London: Routledge.Google Scholar
Goffman, E. (1971). The Presentation of Self in Everyday Life. Middlesex, England: Penguin Books Ltd.Google Scholar
Goffman, E. (1963). Stigma, Notes on the manágen of the Spoiled Idenity. London: Penguin Books.Google Scholar
Grønvold, M., Pedersen, C., Jensen, C.R., et al. (2006). Kræftpatientens verden. En undersøgelse af hvad danske kræftpatienter har brug for. [Cancer patients' worlds. An investigation of Danish cancer patients' needs]. Palliativ Medicinsk Afdeling, H:S/Bispebjerg Hospital.Google Scholar
Hutchings, D. (2007). Struggling in change at the end of life: A nursing inquiry. Palliative and Supportive Care, 5, 31–39.CrossRefGoogle ScholarPubMed
Hydén, L.C. & Hydén, M. (1997). Att studera berättelser [Studying narratives]. Falköping: Liber.Google Scholar
Jackson, J. (1996). Living a meaningful existence in old age. In Occupational Science: The evolving discipline, Zemke, R. & Clark, F. (eds.), pp. 339–362. Philadelphia, PA: F.A. Davis Co.Google Scholar
Kvale, S. (1996). Interview. An Introduction to Qualitative Research Interviewing. Thousand Oaks, CA: Sage.Google Scholar
La Cour, K., Josephsson, S. & Luborsky, M. (2005). Creating connections to life during life-threatening illness: Creative activity experienced by elderly people and occupational therapists. Scandinavian Journal of Occupational Therapy, 12, 98–109.CrossRefGoogle ScholarPubMed
La Cour, K., Nygård, L., Tishelman, C., et al. (2007). Experiences of engagement in creative activity at a palliative care facility. Palliative and Supportive Care, 5, 1–10.CrossRefGoogle Scholar
Lawton, J. (2000). The Dying Process. Patients' Experiences of Palliative Care. London: Routledge.Google Scholar
Luborsky, M. & Rubinstein, R.L. (1995). Sampling in qualitative research: Rationales, issues, and methods. Research on Aging, 17, 89–113.CrossRefGoogle ScholarPubMed
Luoma, S.W., & Hakamies-Blomquist, E. (2003). Quality of life in patients with metastatic breast cancer receiving either docetaxel or sequential methotrexate and 5-fluorouracil. A multicenter randomised phase III trial by the Scandinavian breast group. Journal of Clinical Oncology, 36, 1411–1417.Google Scholar
Mattingly, C. (1998). Healing Dramas and Clinical Plots: The Narrative Structure of Experience. Cambridge, UK: Cambridge University Press.CrossRefGoogle Scholar
Merleau-Ponty, M. (2002). Phenomenology of Perception, Colin Smith, C. (trans.). London: Routledge (original work first published 1945).CrossRefGoogle Scholar
Murphy, R.F. (1990). The Body Silent. London: Norton.Google Scholar
Öhlen, J. (2000). Att vara I en fristad. Berättelser om lindrat lidande inom palliativ vård. [Being in a lived retreat: Narratives of alleviated suffering within palliative care]. Doctoral dissertation. Göteborg: Institutionen för vårdpedagogik, Göteborg Universitet.Google Scholar
Pizzi, M.A. & Briggs, R. (2004). Occupational and physical therapy in hospice, The facilitation of meaning, quality of life, and well-being. Topics in Geriatric Rehabilitation, 20, 120–130.CrossRefGoogle Scholar
Polkinghorne, D.E. (1988). Narrative Knowing and the Human Sciences. Albany: State University of New York Press.Google Scholar
Polkinghorne, D.E. (2004). Ricoeur, narrative and personal identity. In Changing Conceptions of Psychological Life, Lightfoot, C. et al. (eds.) pp. 49–70. Mahwah, NJ: Lawrence Erlbaum.Google Scholar
Pörn, I. (1993). Health and adaptedness. Theoretical Medicine, 14, 295–303.CrossRefGoogle ScholarPubMed
Ricoeur, P. (1985). Time and Narrative (Vol. II). Chicago: University of Chicago Press.Google Scholar
Salander, P., Bergenheim, A.T. & Henriksson, R. (2000). How was life after treatment of a malignant brain tumor? Social Science and Medicine, 51, 589–598.CrossRefGoogle Scholar
Strauss, A. (1993). Continual Permutations of Action. New York: Aldine de Gruyter.Google Scholar
Taylor, K. & Currow, D. (2003). A prospective study of patients' identified unmet activity of daily living needs among cancer patients at a comprehensive cancer care centre. Australian Journal of Occupational Therapy Journal, 50, 79–85.Google Scholar
Ville, I. & Khlat, M. (2007). Meaning and coherence of self and health: An approach based on narratives of life events. Social Science & Medicine, 64, 1001–1014.CrossRefGoogle ScholarPubMed
World Health Organization. (2002). National Cancer Control Program: Policies and Managerial Guideline (2nd ed.) Geneva: Author.Google Scholar
Wilcock, A. (2006). An Occupational Perspective of Health. Thorofare, NJ: SLACK Incorporated.Google Scholar
Zachariae, B. & Mehlsen, M.Y. (2004). Kræftens psykologi, Psykologiske og sociale aspekter ved kræft [Cancer psychology, psychological and social aspects of cancer]. Copenhagen: Hans Reitzels Press.Google Scholar