Confronting the Forthcoming Death: A Classic Grounded Theory

Harstäde, Carina Werkander; Sandgren, Anna

doi:10.4172/2165-7386.1000289

Cited by 9 publications

(9 citation statements)

References 45 publications

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“…The need to use a range of metaphors may be indicative of the contradictory and conflicting experiences that people with advanced cancer have. Due to the effects of the illness and the emotional stress caused by their situation, they may no longer be able to engage in and profit from their ordinary life in the same way as before, leading to a feeling of both loss of control, having their lives put on hold [19] and a need to confront their forthcoming death in different ways [20]. Using metaphors associated with all the four source domains explored here can be seen as a way of articulating these different perceptions and physical as well as emotional experiences.…”

Section: Discussionmentioning

confidence: 99%

Battle, Journey, Imprisonment and Burden: patterns of metaphor use in blogs about living with advanced cancer

2020

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Background: The significance of metaphors for the experience of cancer has been the topic of extensive previous research, with "Battle" and "Journey" metaphors standing out as key. Adaptation to the patient's use of metaphor is generally believed to be an important aspect of person-centered care, especially in palliative care. The aim of this study was to investigate the use of metaphors in blogs written in Swedish by people living with advanced cancer and explore possible patterns associated with individuals, age and gender. Methods: The study is based on a dataset totaling 2,602,479 words produced some time during the period 2007-2016 by 27 individuals diagnosed with advanced cancer. Both qualitative and quantitative procedures were used, and the findings are represented as raw frequencies as well as normalized frequencies per 10,000 words. Our general approach was exploratory and descriptive. The Mann-Whitney U test was used to analyze statistical significance. Results: Our results confirm the strong foothold of "Journey" and "Battle" metaphors. "Imprisonment" and "Burden" metaphors were also used by the majority of the individuals. The propensity to use metaphors when describing the cancer experience was found to differ extensively across the individuals. However, individuals were not found to opt for one conceptualization over the other but tended to draw on several different metaphor domains when conceptualizing their experience. Socio-demographic factors such as age or gender were not found to be strong predictors of metaphor choice in this limited study. Conclusions: Using a range of different metaphors allows individuals with advanced cancer to highlight different aspects of their experience. The presence of metaphors associated with "Journey", "Battle", "Imprisonment" and "Burden" across individuals could be explained by the fact that the bloggers are part of a culturally consistent cohort, despite variations in age, sex and cancer form. Awareness of metaphors commonly used by patients can enhance health professionals' capacity to identify metaphorical patterns and develop a common language grounded in the patients' own metaphor use, which is an important requisite for person-centered palliative care.

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Section: Discussionmentioning

confidence: 99%

Battle, Journey, Imprisonment and Burden: patterns of metaphor use in blogs about living with advanced cancer

2020

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“…2. Carina Werkander Harstade and Anna Sandgren (2016), “Confronting the Forthcoming Death: A Classic Grounded Theory,” Journal of Palliative Care & Medicine 6, no. 6: 1, doi:10.4172/2165–7386.1000289; N García-Rueda et al (2016), “The Experience of Living with Advanced-stage Cancer: A Thematic Synthesis of the Literature,” European Journal of Cancer Care 25, no.…”

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confidence: 99%

Coping by metaphors: the versatile function of metaphors in blogs about living with advanced cancer

2019

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Living with a life-limiting cancer illness can entail a turmoil of feelings such as constant fear of loss, suffering and dying. Because patients live longer with life-limiting illness, there is a need for enhanced understanding of how people make sense of and cope with the complicated aspects that this life situation brings on. In this article, we explore how bloggers with advanced cancer use metaphors as ways of making sense of their experiences. Our study is theoretically grounded in Conceptual Metaphor Theory, where metaphors are seen as a powerful phenomenon that both reflects and affects our thinking. The data consist of a corpus of blogs written in Swedish by individuals with advanced cancer, and the findings from our linguistic metaphor analysis are consistently interpreted against the backdrop of literature on coping. Our study thus highlights the intersection of linguistic metaphor analysis and psychological theories of coping by illustrating the many and complex functions metaphors can have as part of sense-making processes. Our hermeneutic approach enables us to show some differences among the three most pervasive metaphor domains in our material, battle, journey and imprisonment: the journey and imprisonment domains are more flexible than the battle domain in terms of the different kinds of coping strategies that are actualised by the bloggers’ use of metaphors. One particular finding from our analysis is the way in which the bloggers make use of metaphors to compartmentalise experiences and emotions. Our contention is that careful attention to the metaphors used by patients can improve communication in healthcare and enhance understanding of the complex role language use plays in coping processes more generally. By highlighting the relation between metaphor use and coping, our analysis also provides a way to discuss coping strategies based on the patient’s own use of language.

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“…The next-of-kin know what lies ahead for the ill person; however, at the same time they cannot foresee when this will happen. This uncertainty leads them to either ignore or face reality, which becomes more prominent when patients themselves talk about their forthcoming death [26]. Healthcare professionals can help next-of-kin in their efforts to have an everyday life by facilitating contacts between hospital and home and being available to support when there is a risk that next-of-kin's energy might run out.…”

Section: Discussionmentioning

confidence: 99%

“…Financial support was received from the Cancerfoundation in Region Kronoberg, Sweden (No. 2017- [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. The funders had no role in the study design, collection, analysis, and interpretation of the data, the writing of the report or the decision to submit the article for publication.…”

Section: Fundingmentioning

confidence: 99%

Constructing stability - a classic grounded theory of next-of-kin in palliative cancer care

Harstäde

Sandgren

2020

BMC Palliat Care

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Background: Being next-of-kin to someone with cancer requiring palliative care involves a complex life situation. Changes in roles and relationships might occur and the next-of-kin thereby try to adapt by being involved in the ill person's experiences and care even though they can feel unprepared for the care they are expected to provide. Therefore, the aim of this study was to develop a classic grounded theory of next-of-kin in palliative cancer care. Method: Forty-two next-of-kin to persons with cancer in palliative phase or persons who had died from cancer were interviewed. Theoretical sampling was used during data collection. The data was analysed using classic Grounded Theory methodology to conceptualize patterns of human behaviour. Results: Constructing stability emerged as the pattern of behaviour through which next-of-kin deal with their main concern; struggling with helplessness. This helplessness includes an involuntary waiting for the inevitable. The waiting causes sadness and frustration, which in turn increases the helplessness. The theory involves; Shielding, Acknowledging the reality, Going all in, Putting up boundaries, Asking for help, and Planning for the inescapable. These strategies can be used separately or simultaneously and they can also overlap each other. There are several conditions that may impact the theory Constructing stability, which strategies are used, and what the outcomes might be. Some conditions that emerged in this theory are time, personal finances, attitudes from extended family and friends and availability of healthcare resources. Conclusions: The theory shows the complexities of being next-of-kin to someone receiving palliative care, while striving to construct stability. This theory can increase healthcare professionals' awareness of how next-of-kin struggle with helplessness and thus generates insight into how to support them in this struggle.

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Confronting the Forthcoming Death: A Classic Grounded Theory

Cited by 9 publications

References 45 publications

Battle, Journey, Imprisonment and Burden: patterns of metaphor use in blogs about living with advanced cancer

Battle, Journey, Imprisonment and Burden: patterns of metaphor use in blogs about living with advanced cancer

Coping by metaphors: the versatile function of metaphors in blogs about living with advanced cancer

Constructing stability - a classic grounded theory of next-of-kin in palliative cancer care

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