A dimensional analysis of inner strength in people ageing with serious illness

Abstract

Older adults are living longer, in part due to advances in medical science, public health initiatives, and global economic growth. However, the reality of an extended life expectancy for the majority of Americans includes living with multiple chronic conditions as they age (National Institute of Aging, 2016). Further, chronic illnesses make up seven out of the ten leading causes of death, so most will die from one of those conditions (Kochanek, Murphy, Xu, & Arias, 2019). Though nomenclature has changed over time, the terminal phase of chronic illness has more recently been called serious illness (Kelley, 2014). Serious illness impacts life expectancy, function, and overall well-being (Kelley, 2014). Understanding the resources that people use to respond to, process, and move forward with serious illness is key in targeting nursing-directed care for this population. Inner strength encompasses 'an internal developmental capacity that supports positive movement through challenging life events' and has implications for quality of life (Smith, Dingley, & Roux, 2019, p. 38). Older adults living with serious illness may use inner strength as a resource. However, previous conceptual and theoretical models of inner strength are limited in their applicability to people in the terminal phase of a chronic illness. A refined understanding of the nature of inner strength is imperative for informing nursing care that addresses the needs of people who face ageing with serious illness.

Opportunities for Poetic Analysis in Qualitative Nursing Research

“…The study included a convenience sample of two dyads of individuals with dementia and their care partners. I interviewed each pair four times—first together, then each separately, and then together again using a semistructured interview guide based in prior conceptual research (Morgan, 2020a). I audio-recorded and transcribed the interviews for analysis (Ravitch & Carl, 2016).…”

“…Study 2 In Study 2, the second author used poetic analysis as part of a pilot study exploring inner strength in people living with dementia (Morgan, 2020b). Inner strength is one's internal process of moving through challenging circumstances (Morgan, 2020a). The study included a convenience sample of two dyads of individuals with dementia and their care partners.…”

Clinician distress in seriously ill patient care: A dimensional analysis

“…However, researchers have recently applied the method with a concept analysis framework to explore phenomena present in research literature. 40,41 Through the application of dimensional analysis to existing literature, adjacent concepts will help inform the description of the previously undefined concept of clinician distress.…”

Existential Care in Daily Nursing Practice

“…Taking a life course perspective . The existential experience is a dynamic process that shifts throughout the illness trajectory, punctuated by moments—such as no longer being able to accomplish an activity of daily living without help—that spotlight an aspect of living with illness and trigger existential contemplation 24. Spotlighting can occur even before diagnosis, as individuals first notice symptoms and consider seeking care 25.…”

“…For example, a person experiencing cognitive changes wonders if their symptoms are simply age related or a harbinger of illness. At diagnosis, people with serious illness describe feeling the same yet irrevocably changed, causing them to consider and sometimes question their morals, values, and priorities (see Excerpted Illustrative Accounts: Everything and Nothing Changes ) 24. Prognosis discussions highlight mortality awareness and foreground existential concerns 26.…”