title: Clock time and embodied time experienced by patients with inoperable lung cancer.
abstract: In this study, we explore how patients with inoperable lung cancer (LC) discuss their experiences of time, based on content analysis of open interviews with 35 patients 1 year after diagnosis, using Davies' distinction between "clock time" and "embodied time" as sensitizing concepts. Two interrelated themes were derived: (1) aspects related to the healthcare system, with 3 subthemes: waiting times in the healthcare system, limited time for patient-professional contact, and limited time for coordination of services, and (2) existential aspects, with subthemes: the future with LC and managing an uncertain and finite life with LC. Time could be experienced as problematic for these patients, when limited or lacking or through long periods of waiting, especially when these periods occurred without adequate preparation or information. This contributed to exacerbation of these patients' existing sense of uncertainty, their perception of care as impersonal and insecure, and their need to remain alert and act on their own behalf. Awareness of the seriousness of their disease and the prospect of a limited lifetime was described as increasing uncertainty about dying and fear of certain death. People also described efforts to constructively deal with their situation by reprioritizing their remaining time, having increased appreciation of some aspects of daily life, and living consciously in the present. This analysis suggests a collision between clock time, which steers the healthcare system, and embodied time, as experienced by individuals. Greater attention to psychosocial needs is suggested as one means of positively affecting patients' experiences of time and uncertainty.
authors.affiliation: School of Health and Social Sciences, Högskolan Dalarna, 791 88 Falun, Sweden. mlv@du.se
authors.forename: Malin
authors.initials: M
authors.lastname: Lövgren
authors.forename: Katarina
authors.initials: K
authors.lastname: Hamberg
authors.forename: Carol
authors.initials: C
authors.lastname: Tishelman
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008175:Lung Neoplasms; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D013315:Stress, Psychological; D013637:Tape Recording; D013997:Time Factors; D013998:Time Perception; D014342:Truth Disclosure; D035501:Uncertainty