title: The meaningfulness of time; Narratives of cancer among chronically ill older adults.
abstract: This study, using ethnographically-based interviews, sought to describe how chronically ill older adults experience a new cancer diagnosis and the effects of this on their interpretations of personal health, aging, and the future. Three semi-structured interviews were conducted with each of the fifteen informants. We asked questions that explored each individual's life history, chronic illness occurrence, and direct experiences with cancer. Interviews were structured to provide social and historical contexts to enhance our understanding of the informants' illness narratives. Interview transcripts were analyzed thematically to describe how individuals described the cancer experience, its meaning, and its consequences. One of the major findings of our study was the role of cancer in disrupting individual biography, an interruption that fragmented time into three distinct segments: the Recalled Past, the Existent Present, and the Imagined Future. We highlight three main themes around the experience of illness-related time: (1) disruption found in individual biographical accounts as a result of fragmented time dimensions; (2) altered projections of a continuous sense of self into the future; and (3) modified treatment decisions resulting from a perceived altered life course and the finitude of advancing age. We further introduce the concept of Anomalous Time as a permutation of time central to individual experiences of cancer. Implications for how older adults understood their cancer and individual reactions relevant to seeking care are discussed.
authors.affiliation: Cancer Epidemiology, Prevention, and Control Training Fellowship, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Rm. 263, Baltimore, MD 21205, United States. Electronic address: shannum@jhsph.edu.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Hannum
authors.affiliation: Department of Sociology and Anthropology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, United States. Electronic address: rrubinst@umbc.edu.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Rubinstein
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology / Q000523:psychology*; D002908:Chronic Disease / Q000523:psychology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008016:Life Change Events; D008297:Male; D033262:Narration; D009369:Neoplasms / Q000523:psychology*; D018434:Sickness Impact Profile; D019452:Terminally Ill / Q000523:psychology
keywords: Cancer; Chronic illness; Lived experience; Narrative inquiry; Older adults; Phenomenology