title: Stories of chronic kidney disease: listening for the unsayable.
abstract: OBJECTIVE
  To explore individuals' stories of chronic kidney disease, particularly those aspects of experience that are difficult to discuss using language (i.e. unsayable).
  
  
  BACKGROUND
  Chronic kidney disease is continuous, but it is also life-threatening and sometimes people ask difficult questions about life and death that can be challenging and for some, impossible to discuss. These 'unsayables' are the focus of this article. The unsayable may reside both within and beyond language. Careful analysis of narratives of illness for sayable and unsayable aspects of the experience can help illuminate new areas of concern for people with chronic kidney disease.
  
  
  METHODS
  Narrative inquiry, located in a social constructionist framework, guided this study.
  
  
  METHODS
  Secondary data analysis was conducted with 46 in-depth interviews (collected between 2008-2011) with 14 people living with chronic kidney disease.
  
  
  RESULTS
  Through narrative thematic analysis, we identify that the unsayable includes the following five themes: living with death, embodied experiences that were difficult to language, that which was unthinkable, unknowable mystery and that which was untold/unheard. Whereas the first four themes attend to that which is unsayable for people living with chronic kidney disease, the last theme acknowledges that which is unsayable to people living with chronic kidney disease.
  
  
  CONCLUSIONS
  Not all experiences of illness can be explicitly articulated in language. Listening for both the sayable and unsayable aspects of life with chronic and life-threatening illness is an important nursing role.
authors.affiliation: Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Kara L Schick
authors.initials: KL
authors.lastname: Makaroff
authors.forename: Laurene
authors.initials: L
authors.lastname: Sheilds
authors.forename: Anita
authors.initials: A
authors.lastname: Molzahn
mesh_terms: D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007676:Kidney Failure, Chronic / Q000451:nursing / Q000523:psychology*; D008297:Male; D033262:Narration; D064647:Nephrology Nursing
keywords: communication; narrative, chronic illness; renal nursing