Living through gynaecological cancer: three typologies.

AIMS AND OBJECTIVES: The aim of this qualitative study is to highlight how women experienced living through gynaecological cancer. BACKGROUND: The increasing number of long-term survivors after cancer has created a greater need for knowledge about how patients live through the illness. DESIGN: A qualitative design, with a phenomenological-hermeneutical perspective, provided the framework for the study. METHOD: Thirty-two unstructured in-depth interviews with 16 women were conducted. Each woman was interviewed twice: one year apart, and five and six years after treatment, respectively. Stepwise meaning condensation was used to analyse the data. RESULTS: Based on the women's first-hand stories about their experiences with cancer, we identified three typologies, describing different ways in which the women negotiated encountering and living through cancer. These typologies are the emotion- and relationship-oriented women, the activity-oriented women and the self-controlled women. CONCLUSIONS: There are substantial differences regarding how women process the experience of cancer. The findings add valuable knowledge about the impact cancer can have on women's lives and can be of help for nurses who support patients during treatment and follow-up. RELEVANCE TO CLINICAL PRACTICE: Understanding different ways women can experience living through cancer is fundamental for the development and improvement of cancer care. Allowing time for the women to talk with nurses about their cancer experiences could be essential during treatment and follow-up. Nurses can support the women by listening to their stories, accepting their emotions and informing them in detail. The findings in this study imply that strengthening nurses' listening and conversational competence can be of importance for supporting patients after cancer. By building on the women's own stories, it might be possible to create a follow-up process that is individually tailored for each cancer patient.

The (dis)appearance of the dying patient in generalist hospital and care home nurses' talk about the patient.

This article explores interview data from a study of 50 Norwegian generalist nurses' focus group accounts of caring for dying patients in the hospital and care home. An eclectic discourse analytic approach was applied to nurses' accounts of the patient and three discursive contexts of reference to the patient were identified: the 'taken as read' patient, the patient paired with particular characteristics and the patient as psychologically present. Talk about the patient falls mainly into the first two contexts, which position the patient in relation to three closely related discursive processes: individualization, anonymization and objectification. The third context presents the patient as a person with a particular identity. The analysis is discussed in a broader philosophical and sociological context in which we return to some of the theoretical work on death and dying of the 1990s and the topic of sequestration. We suggest that nurses' talk about the patient can be heard to participate in a continuing sequestration of the dying patient in healthcare institutions focused on 'result-oriented' care.