TRANSCENDENCE AS A HUMAN RESPONSE TO LIFE THREATENING ILLNESS: DESCRIPTION AND UNDERSTANDING THROUGH NARRATIVES (TERMINAL ILLNESS).

Description

This study explored the phenomenon of transcendence as it occurs in the context of life-threatening illness. Transcendence is a term that is frequently used to describe a patient's response to suffering, but it is an elusive, poorly understood phenomenon. Narrative interviewing and analysis was the method. Participants diagnosed with terminal cancer provided personal accounts of their experience during in-depth interviews. Three participants were interviewed after being selected by professional nurses working in an oncology clinic as having transcended their illness. The linguistic approach to systematic study of the accounts (Gee, 1985, 1986, 1991; Riessman, 1993) and the voice-centered relational method of thinking about the data (Brown and Gilligan, 1992) were applied. Written interpretations of each account (including graphic representations of the entire accounts and schematic transcriptions of selected narrative segments) and a comparison across accounts were completed. One of the participants exhibited the wisdom, connectedness, and sense of peace consistent with the tentative definition of transcendence I proposed. Comparison of the accounts revealed that they were similar in the degree of cognitive awareness and the ability to manage the physical manifestations of illness and treatment. Differences were seen in attitude, communication patterns, perceived support and acknowledgement of prognosis. Displaying the profound dilemma posed by hoping for life while facing death, the accounts emphasized living and paid unequal attention to preparing for death. The study contributes to the description and understanding of transcendence by providing an example of one case that is compatible with definitions and descriptions in recent literature and examples of similar but essentially different responses. Patient narratives provided a way to achieve deep understanding of the complex human experience of life-threatening illness. Implications for research, practice and education are identified.

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