A secondary qualitative analysis exploring the emotional and physical challenges of living with type 2 diabetes

Background: Many feel that their new identity as ‘someone living with diabetes’ does not fit with their biography. Some individuals may be able to re-assess life goals, adapt their identity and adjust to living with type 2 diabetes mellitus (T2DM). For others, the biographical disruption experienced with their condition may negatively affect their emotional well-being and identity. Aim: To conceptualise and explore the emotional challenges experienced living with T2DM, using biographical disruption as analytical references. Design and setting: Secondary qualitative analysis of data collected from 31 semi-structured interviews. Method: Semi-structured interviews were conducted with people with T2DM in England. Data analysis was informed by constant comparative techniques. Results: People with T2DM undergo a cognitive process when their biography suddenly becomes interrupted. Suboptimal T2DM can bring a feeling of loss of control over one’s future, and loss of independence. What used to be perceived as ‘normal’ is now perceived as something that requires regular management, negatively impacting their daily routine and ability to carry out activities that once used to be effortless. Conclusions: Living with T2DM that is socially stigmatised can lead to poor well-being and may disturb one’s life biography. Strategies must take place to bring awareness to healthcare professionals of the impact and disruption that T2DM can have on an individual’s biography, identity and diabetes management.

Exploring prostate cancer experiences among Jordanian Muslim men

<p><b>Over the last decade, prostate cancer has been the most common cancer among men around the world. This study explores the experiences of this illness among a group of Jordanian Muslim men. The study aims to identify the impacts and challenges these men face throughout their experiences with cancer. Through the exploration, the study also focuses on the effects of these impacts and challenges on the men’s bodies, lives, and their identity, particularly gender. The study used ‘biographical disruption’ and ‘liminality’ theoretical concepts of illness narrative and the works of Connell (2000, 2002, 2005) on gender as a theoretical framework. It adopted a qualitative narrative approach in order to understand this cancer experience among these men. Fifteen Jordanian Muslim men, who had been treated with radiotherapy and hormonal therapy, were recruited, and interviewed to narrate their stories with prostate cancer. Three narrative analytical approaches (thematic, holistic form, and Bamberg’s positioning model) were used and integrated with the study’s theoretical framework for analysing the men’s stories.</b></p> <p>Five main key findings resulted from the analysis as follows. First, there is a range of common and specific disruptive impacts and challenges facing these men compared with other men who have similar experiences. Second, there are differing experiences of prostate cancer among these men across the cancer trajectory and over time. Third, the family of the affected men are involved and become a part of this illness experience along with the direct involvement of the healthcare providers with the men. Fourth, there are interactions and influences between the cancer experience and the men’s masculinity. Fifth, the complexity of this experience has an influence on the men’s identity as Jordanian Muslim men. The study, therefore, adds to the existing knowledge about the experience of prostate cancer by understanding how it can be from (Jordanian) Arabic Middle Eastern and Islamic contexts. The study concludes with implications and recommendations for nursing practice, for education, and for illness narrative and narrative research.</p>

Exploring prostate cancer experiences among Jordanain Muslim men

<p><b>Over the last decade, prostate cancer has been the most common cancer among men around the world. This study explores the experiences of this illness among a group of Jordanian Muslim men. The study aims to identify the impacts and challenges these men face throughout their experiences with cancer. Through the exploration, the study also focuses on the effects of these impacts and challenges on the men’s bodies, lives, and their identity, particularly gender. The study used ‘biographical disruption’ and ‘liminality’ theoretical concepts of illness narrative and the works of Connell (2000, 2002, 2005) on gender as a theoretical framework. It adopted a qualitative narrative approach in order to understand this cancer experience among these men. Fifteen Jordanian Muslim men, who had been treated with radiotherapy and hormonal therapy, were recruited, and interviewed to narrate their stories with prostate cancer. Three narrative analytical approaches (thematic, holistic form, and Bamberg’s positioning model) were used and integrated with the study’s theoretical framework for analysing the men’s stories.</b></p> <p>Five main key findings resulted from the analysis as follows. First, there is a range of common and specific disruptive impacts and challenges facing these men compared with other men who have similar experiences. Second, there are differing experiences of prostate cancer among these men across the cancer trajectory and over time. Third, the family of the affected men are involved and become a part of this illness experience along with the direct involvement of the healthcare providers with the men. Fourth, there are interactions and influences between the cancer experience and the men’s masculinity. Fifth, the complexity of this experience has an influence on the men’s identity as Jordanian Muslim men. The study, therefore, adds to the existing knowledge about the experience of prostate cancer by understanding how it can be from (Jordanian) Arabic Middle Eastern and Islamic contexts. The study concludes with implications and recommendations for nursing practice, for education, and for illness narrative and narrative research.</p>

Exploring prostate cancer experiences among Jordanain Muslim men

<p><b>Over the last decade, prostate cancer has been the most common cancer among men around the world. This study explores the experiences of this illness among a group of Jordanian Muslim men. The study aims to identify the impacts and challenges these men face throughout their experiences with cancer. Through the exploration, the study also focuses on the effects of these impacts and challenges on the men’s bodies, lives, and their identity, particularly gender. The study used ‘biographical disruption’ and ‘liminality’ theoretical concepts of illness narrative and the works of Connell (2000, 2002, 2005) on gender as a theoretical framework. It adopted a qualitative narrative approach in order to understand this cancer experience among these men. Fifteen Jordanian Muslim men, who had been treated with radiotherapy and hormonal therapy, were recruited, and interviewed to narrate their stories with prostate cancer. Three narrative analytical approaches (thematic, holistic form, and Bamberg’s positioning model) were used and integrated with the study’s theoretical framework for analysing the men’s stories.</b></p> <p>Five main key findings resulted from the analysis as follows. First, there is a range of common and specific disruptive impacts and challenges facing these men compared with other men who have similar experiences. Second, there are differing experiences of prostate cancer among these men across the cancer trajectory and over time. Third, the family of the affected men are involved and become a part of this illness experience along with the direct involvement of the healthcare providers with the men. Fourth, there are interactions and influences between the cancer experience and the men’s masculinity. Fifth, the complexity of this experience has an influence on the men’s identity as Jordanian Muslim men. The study, therefore, adds to the existing knowledge about the experience of prostate cancer by understanding how it can be from (Jordanian) Arabic Middle Eastern and Islamic contexts. The study concludes with implications and recommendations for nursing practice, for education, and for illness narrative and narrative research.</p>

Lived Experience of Hereditary Chronic Pancreatitis – A Qualitative Interview Study

Objectives Hereditary chronic pancreatitis is a rare condition characterized by intermittent acute episodes of pancreatitis and long-term impairment of pancreatic functions. However, the subjective perspective of individuals affected by hereditary chronic pancreatitis has been little studied. This qualitative study investigates the experience of hereditary chronic pancreatitis patients and their relatives because the awareness of the needs of those affected is an essential component of a patient-centered management of chronic conditions. Methods Semi-structured qualitative interviews were conducted with hereditary chronic pancreatitis patients and their relatives. Data were analysed using qualitative content analysis. The concepts of ‘biographical contingency,’ ‘biographical disruption’ and the ‘shifting perspectives model’ served as theoretical frameworks. Results A total of 24 participants (17 patients, 7 relatives) were interviewed individually. Four main themes were identified: (1) The unpredictable clinical course of hereditary chronic pancreatitis; (2) hereditary chronic pancreatitis as a devastating experience; (3) hereditary chronic pancreatitis as part of a normal life; and (4) being reduced to hereditary chronic pancreatitis. Discussion The ‘shifting perspectives model’ of chronic illness covers the four dimensions adequately and can serve as a theoretical model to explain hereditary chronic pancreatitis patients’ experience. A better understanding of the patients and their families’ experience and the shifting character of hereditary chronic pancreatitis can help healthcare professionals to tailor the care to meet the needs of those affected.

Experiences of transitioning between settings of care from the perspectives of patients with advanced illness receiving specialist palliative care and their family caregivers: A qualitative interview study

Background: Transitions between care settings (hospice, hospital and community) can be challenging for patients and family caregivers and are often an under-researched area of health care, including palliative care. Aim: To explore the experience of transitions between care settings for those receiving specialist palliative care. Design: Qualitative study using thematic analysis. Setting/participants: Semi-structured interviews were conducted with adult patients ( n = 15) and family caregivers ( n = 11) receiving specialist palliative care, who had undergone at least two transitions. Results: Four themes were identified. (1) Uncertainty about the new care setting. Most participants reported that lack of information about the new setting of care, and difficulties with access and availability of care in the new setting, added to feelings of uncertainty. (2) Biographical disruption. The transition to the new setting often resulted in changes to sense of independence and identity, and maintaining normality was a way to cope with this. (3) Importance of continuity of care. Continuity of care had an impact on feelings of safety in the new setting and influenced decisions about the transition. (4) Need for emotional and practical support. Most participants expressed a greater need for emotional and practical support, when transitioning to a new setting. Conclusions: Findings provide insights into how clinicians might better negotiate transitions for these patients and family caregivers, as well as improve patient outcomes. The complexity and diversity of transition experiences, particularly among patients and families from different ethnicities and cultural backgrounds, need to be further explored in future research.

Multimorbidity and its effect on perceived burden, capacity and the ability to self-manage in a low-income rural primary care population: A qualitative study

Introduction Multimorbidity is increasing in prevalence, especially in low-income settings. Despite this, chronic conditions are often managed in isolation, potentially leading to burden-capacity imbalance and reduced treatment adherence. We aimed to explore, in a low-income population with common comorbidities, how the specific demands of multimorbidity affect burden and capacity as defined by the Cumulative Complexity Model. Materials and methods Qualitative interviews with thirteen rural community health centre patients in Victoria, Australia. Participants were aged between 47–72 years and reported 3–10 chronic conditions. We asked about perceived capacity and burden in managing health. The Theory of Patient Capacity was used to analyse capacity and Normalisation Process Theory to analyse burden. All data specifically associated with the experience of multimorbidity was extracted from each burden and capacity domain. Results The capacity domains of biography, resource mobilisation and work realisation were important in relation to multimorbidity. Conditions causing functional impairment (e.g. chronic pain, depression) interacted with physical, psychological and financial capacity, leading to biographical disruption and an inability to realise treatment and life work. Despite this, few people had a treatment plan for these conditions. Participants reported that multimorbidity affected all burden domains. Coherence and appraisal were especially challenging due to condition interactions, with clinicians providing little guidance. Discussion The capacity and burden deficits highlighted by participants were not associated with any specific diagnosis, but were due to condition interactions, coupled with the lack of health provider support to navigate interactions. Physical, psychological and financial capacities were inseparable, but rarely addressed or understood holistically. Understanding and managing condition and treatment interactions was a key burden task for patients but was often difficult, isolating and overwhelming. This suggests that clinicians should become more aware of linkages between conditions, and include generic, synergistic or cross-disciplinary approaches, to build capacity, reduce burden and encourage integrated chronic condition management.

Disrupted mothering in Iranian mothers with breast cancer: a hybrid concept analysis

Background Defining the disrupted mothering would contribute to developing strategies to support mothers with breast cancer. The aim of this study was to analyze the concept of mothering disruption using a hybrid model. Methods The Hybrid method for concept analysis was implemented consisting of three phases: theoretical, fieldwork, and final analysis. In the theoretical phase, the literature was searched using electronic databases including PubMed, ScienceDirect, Scopus, ProQuest, Google Scholar, CINAHL, Wiley, Ovid, Magiran, and SID from 2000 to 2020. Any quantitative or qualitative studies published in English or Persian, which were focused on mothering disruption in mothers with breast cancer were included in the study. In the phase of fieldwork, 20 mothers were interviewed to explore the aspects of mothering disruption. The interviews were transcribed and analyzed with conventional content analysis. In the final phase, an overall analysis of the two previous phases was performed. Results In the theoretical phase, the following attributes were determined: “disturbance in maternal identity and roles”, “maternal insensitivity and unresponsiveness: disconnection physically and psychologically”, “the career disruption process” and “biographical disruption”. The fieldwork phase explored three themes including “the unbalance between multiple roles”, “role failure”, and “reduced maternal sensitivity”. The final synthesis yielded that the main integrated elements of mothering disruption are “disease as threating maternal role and identity”, “inability to interpret and respond to child behaviors and needs”, and “support for transitioning from being patient toward maternal competency”. Conclusion With a deeper understanding of the term ‘disrupted mothering’ or ‘mothering disruption’, healthcare providers will have a foundation to improve cancer care, deliver effective communication and help such mothers cross this disruption and achieve restoration of their mothering role. Future research is needed to validate this concept and explore connections with health outcomes.