Robin Whittemore1, Jane Dixon. 1. Yale School of Nursing, New Haven, CT 06536-0740, USA. robin.whittemore@yale.edu
Abstract
AIM: The aim of this study was to explore how adults with a chronic illness integrate the illness experience into their life context. BACKGROUND: Adults with chronic illnesses are challenged to learn self-management strategies to prevent complications and achieve an acceptable quality of life. Integration represents the process undertaken by an individual to achieve a sense of balance in self-managing a chronic illness and living a personally meaningful life. DESIGN: A mixed-method descriptive design was employed to recruit English-speaking adults with a chronic illness. A semi-structured interview was completed, transcribed verbatim and content analysed. Descriptive data were collected on demographics, co-morbidity and depressive symptoms. The research was undertaken in Connecticut, USA. RESULTS: The sample (n = 26) was diverse with respect to age (25-80 years), education (8-24 years), duration of illness (1-39 years), gender (63% female) and ethnicity (63% white). Participants reported a mean of four chronic illnesses and 31% of the sample had increased depressive symptoms. The process of integration was complex and multifactorial. Themes of integration included: shifting sands, staying afloat, weathering the storms, rescuing oneself and navigating life. Numerous factors including treatment side effects, a progressive or uncertain illness trajectory, co-morbidity, bad days, financial hardships and interpersonal/environmental challenges contributed to a disruption or difficulty in the integration process. CONCLUSION: All participants made considerable effort to integrate the illness into their life context and participate in a personally meaningful life. However, it was easy to be consumed with 'living an illness' as the daily tasks, the changing symptoms and the fluctuating emotions could be overwhelming. There was a complex co-existence between 'living a life' and 'living an illness'. RELEVANCE TO CLINICAL PRACTICE: There were numerous challenges to the process of integration and ongoing self-management, psychosocial, vocational and existential support appears indicated, particularly with individuals with multiple chronic illnesses, progressive chronic illnesses and limited resources.
AIM: The aim of this study was to explore how adults with a chronic illness integrate the illness experience into their life context. BACKGROUND: Adults with chronic illnesses are challenged to learn self-management strategies to prevent complications and achieve an acceptable quality of life. Integration represents the process undertaken by an individual to achieve a sense of balance in self-managing a chronic illness and living a personally meaningful life. DESIGN: A mixed-method descriptive design was employed to recruit English-speaking adults with a chronic illness. A semi-structured interview was completed, transcribed verbatim and content analysed. Descriptive data were collected on demographics, co-morbidity and depressive symptoms. The research was undertaken in Connecticut, USA. RESULTS: The sample (n = 26) was diverse with respect to age (25-80 years), education (8-24 years), duration of illness (1-39 years), gender (63% female) and ethnicity (63% white). Participants reported a mean of four chronic illnesses and 31% of the sample had increased depressive symptoms. The process of integration was complex and multifactorial. Themes of integration included: shifting sands, staying afloat, weathering the storms, rescuing oneself and navigating life. Numerous factors including treatment side effects, a progressive or uncertain illness trajectory, co-morbidity, bad days, financial hardships and interpersonal/environmental challenges contributed to a disruption or difficulty in the integration process. CONCLUSION: All participants made considerable effort to integrate the illness into their life context and participate in a personally meaningful life. However, it was easy to be consumed with 'living an illness' as the daily tasks, the changing symptoms and the fluctuating emotions could be overwhelming. There was a complex co-existence between 'living a life' and 'living an illness'. RELEVANCE TO CLINICAL PRACTICE: There were numerous challenges to the process of integration and ongoing self-management, psychosocial, vocational and existential support appears indicated, particularly with individuals with multiple chronic illnesses, progressive chronic illnesses and limited resources.
Authors: Beverly Rosa Williams; Keith Vargo; Diane K Newman; D Yvette Lacoursiere; Elizabeth R Mueller; John Connett; Lisa Kane Low; Aimee S James; Ariana L Smith; Kathryn H Schmitz; Kathryn L Burgio Journal: Urol Nurs Date: 2020 Nov-Dec