Chronic Illness Narratives: Conceptualizations of a Cancer Diagnosis Among Chronically Ill Older Adults.

摘要

Chronically-ill older adults (age 65+) who receive a new cancer diagnosis face many unique challenges (e.g., medication management, fractioning of care, etc.), yet very little had been known about how this group of individuals understood and attached meaning to their experiences. This qualitative study therefore sought to describe, in part, how chronically ill, older individuals experienced a new cancer diagnosis and the effects this had on their overall healthcare trajectories and notions of personal health, well-being, and life satisfaction. Thus, a series of three, semi-structured interviews was conducted with each of fifteen informants over the course of approximately three weeks. The interviews asked questions that explored each person's life history (Interview One), individual experiences of co-morbid, chronic disease (Interview Two), and direct experiences with cancer and their cancer diagnosis, in particular (Interview Three). The audio-recorded interviews were transcribed for subsequent large-level coding and analyses. Interviews were analyzed thematically to describe how the sample of individuals presented and described the personal meaning of the cancer experience through descriptions of their diagnosis and the events preceding it: the stories of illness, its meaning, and its consequences. In this way, three overarching themes arose from the data: (1) Time in Illness, (2) Meaning of Illness, and (3) Identity as Affected by Illness. There were a variety of subthemes and these are all discussed at length throughout the dissertation. Understanding how each of these areas connects to the illness experience enhances the quality of illness management by eliciting common areas of stress throughout the diagnosis and illness experience for older individuals, particularly in light of multi-morbidity.