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Qualitative Health Research
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Making Sense of Living Under the Shadow of Death: Adjusting to a Recurrent Breast Cancer Illness

Elisabeth Kenne Sarenmalm

University of Gothenburg, Gothenburg, Sweden

Anna-Lisa Thorén-Jönsson

University of Gothenburg, Gothenburg, Sweden

Fannie Gaston-Johansson

University of Gothenburg, Gothenburg, Sweden

Joakim Öhlén

University of Gothenburg, Gothenburg, Sweden

Women with recurrent breast cancer face many difficulties and challenges, from clinical symptoms of disease progression and treatment to a range of emotional responses. Guided by grounded theory methodology, we explored the main concerns of women with recurrent breast cancer, and how they were dealing with their situations. Data were collected from 40 in-depth interviews with 20 women diagnosed with recurrent breast cancer. The core category illustrated the process of "making sense of living under the shadow of death," and was based on the women's experiences of adjusting to living with a persistent life-threatening illness. Confronting a recurrence of breast cancer was a life-altering event. Moving through a difficult and challenging time, women eased their distress by letting go of losses and reassessing important values. Through a personal transition women transcended living with a life-threatening illness. These findings emphasize the importance of recognizing existential distress in clinical practice.

Key Words: breast cancer • chronic illness • distress • existential approaches • grounded theory • illness and disease • life-threatening • palliative care • psychosocial issues • quality of life • transition theory

Qualitative Health Research, Vol. 19, No. 8, 1116-1130 (2009)
DOI: 10.1177/1049732309341728


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