Pearce, Susie; (2018) A narrative study exploring representations of identity for young adults with cancer: from diagnosis through treatment. Doctoral thesis (Ph.D), UCL (University College London).

Abstract

This study aimed to explore the impact of cancer on young adults’ evolving sense of self and identity, by listening to their stories over one year from the time of diagnosis. Data were collected using a range of methods: in depth, free association narrative interviews at three time points; photographs taken by participants; and extensive reflexive field notes. Forty interviews were conducted with eighteen young adults, sixteen to thirty years of age. Eight of the participants took part in three interviews, six participants in two interviews, five participants took photographs. Eight longitudinal cases were analysed in depth, visual images were analysed from discussion in the narrative text. Through memoing, coding and comparison themes were developed across all cases and all participant’s data. Five cases have been reported as longitudinal stories to illustrate the interplay between the internal and external over the year from diagnosis. Higher order themes across all the data demonstrate the renegotiation of self over time, both developmental and in terms of ‘cancer time’, through the core components of: the inner world, (psyche, emotion and coping); self as embodied; self as relating to others, and self as relating to place. The study offers new insights into the experience of young adults with cancer and the value of basing care on individual experience beyond age but situated within biography and identity. The findings demonstrate the intensity of the juxtaposition of cancer and developmental stage and highlight the importance of visual and oral narratives and a psychosocial lens in both research and practice. The study suggests the value of narrative as a prospective intervention in health care to support sense making, identity renegotiation and revision; to give patients a voice. The study also highlights the importance professionals to be supported in ‘being with’ and in walking alongside people going through life changing illness.

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