title: Power relations in patient's experiences of suffering during treatment for cancer.
abstract: OBJECTIVE
  This paper is a report of how patients who have cancer experience suffering in the context of power relations.
  
  
  BACKGROUND
  Many studies in Sweden and in other countries have detected inequality in healthcare use and resources, including unseen influences that can be connected to gender and distribution of resources. Few studies have examined how multiple relations of power - such as gender, ethnicity, age and education - influence how people with cancer experience suffering during treatment.
  
  
  METHODS
  A hermeneutic design was used. Qualitative interviews were conducted with 12 women and 14 men receiving treatment for a variety of cancer diagnoses. The data collection was done at two hospitals in Sweden during 2008-2009. The interpretation of data was based on two theoretical perspectives - suffering and intersectionality.
  
  
  RESULTS
  The results highlight patients suffering where two or more positions of power relations interacted with each other. Three main themes were identified: the complexity of control, the vulnerable effects of body changes, and the internal battle of survival.
  
  
  CONCLUSIONS
  A vulnerable social situation for people with cancer concretely increased their suffering. Social inequalities, seemingly linked to social hierarchy, increased the suffering of people with cancer. For example, women with cancer with a low education belonging to an ethnic minority suffered more than highly educated patients belonging to the ethnic majority.
authors.affiliation: Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Huddinge, Sweden. lotta.saarnio@ki.se
authors.forename: Lotta
authors.initials: L
authors.lastname: Saarnio
authors.forename: Maria
authors.initials: M
authors.lastname: Arman
authors.forename: Per
authors.initials: P
authors.lastname: Ekstrand
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D005260:Female; D005783:Gender Identity; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000208:ethnology / Q000523:psychology* / Q000628:therapy; D015404:Nursing Methodology Research; D011209:Power, Psychological; D036301:Qualitative Research; D012649:Self Concept; D012737:Sex Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology*; D013534:Survival / Q000523:psychology*; D013548:Sweden; D035862:Vulnerable Populations / Q000208:ethnology / Q000523:psychology; D014930:Women / Q000523:psychology