“My bus is here”: A phenomenological exploration of “living-with-dying”.

Abstract

ObjectivesThis paper has two aims. The first is to demonstrate how the application of an innovative qualitative methodology generated novel insights into the experience of living with advanced cancer. The paper's second aim is to challenge the idea that the identification of shared themes provides the researcher with access to the meaning and significance of the experience of 'living with dying'. MethodsThe research presented in this paper employed object elicitation together with existentiallyinformed hermeneutic phenomenological analysis. The analysis is based on ten semi-structured interviews with people who are living with advanced cancer. FindingsThe paper presents three brief case studies demonstrating the variability in accounts that characterizes the data set as a whole. This is followed by reflections on the way in which despite striking individual differences all participants seemed to experience 'living with dying' as an existential challenge which demands that the individual concerned finds a way of coming to terms with the very parameters of human existence. ConclusionThe paper advocates a thoroughly idiographic approach which stays with the diversity that characterizes the experience of living with advanced cancer. The paper argues that in order to make sense of the remarkable differences between the research participants' accounts of their experiences of living with a diagnosis of advanced cancer, a focus on process (ie. what happens when people encounter their mortality ?) and meaning (ie. what does it mean to them ?) helps us to understand these as different responses to the challenge of death awareness.3

A concept map of death-related anxieties in patients with advanced cancer

“…The experience of time running out may be central to the psychology of incurable disease, which may fundamentally be a problem of time 38. Nonetheless, patients with advanced cancer may present with different individual configurations or profiles of death-related concerns.…”

Reflections on the use of object elicitation.

“…All of these offer insight into how meaning is made and maintained as participants negotiate their experience of moving closer to the end of their lives. And although this experience is characterized by the distress and suffering that accompanies the process of coming to terms with losing first one's health and then one's life (see Willig, 2015), it does not mean that the experience is all about absences. The use of object elicitation provided us with an opportunity to gain insight into what is present, into the meanings participants create and what they put in the space that opens up when the end of life comes into view.…”

“…The study employs semi-structured interviews supported by object elicitation to collect data and existentially-informed hermeneutic phenomenological analysis to interpret the data. This paper is concerned with data collection; reflections on the process of 6 analysis have been published elsewhere (Willig, 2015). Research participants were recruited via Maggie's Cancer Centre.…”

Life Café. A Co-Designed Method of Engagement

“…Lab4Living often use object elicitation as a method in research because it can give the researcher a rich understanding into a person's life before exploring potential ideas for the future. Other researchers have written about the successful application of this method, for example, a recent paper by Carla Willig, '"My Bus Is Here": A Phenomenological Exploration of "Living-With-Dying"' demonstrates the use of objects in a research project closely related to Design to Care, where the researcher "generated novel insights into the experience of living with advanced cancer" (Willig, 2015) through using this innovative qualitative method.…”