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Chronic illness: the process of integration
Author(s) -
Whittemore Robin,
Dixon Jane
Publication year - 2008
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/j.1365-2702.2007.02244.x
Subject(s) - context (archaeology) , quality of life (healthcare) , medicine , descriptive statistics , interpersonal communication , ethnic group , psychology , gerontology , nursing , social psychology , statistics , mathematics , sociology , anthropology , paleontology , biology
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.