Joakim Öhlén

Transforming Desolation Into Consolation: Being a Mother with Life-Threatening Breast Cancer

The purpose of this study is to describe lived experiences of being ill with breast cancer for mothers with dependent children. A special focus is to explore meanings of desolation and consolation, and meanings of transforming the consolation. Stories of Swedish women who took part in a supportive network for young women with breast cancer were interpreted phenomenological-hermeneutically as transforming desolation into consolation. This means a changed direction in the longing and desires of the woman from outward to inward, from others to self, from emphasis on past and delimited presence to presence and future, and ending up in balancing between these opposites. Implications for women with breast cancer and their need for support are reflected upon.

Exploration of communicative patterns of consultations in palliative cancer care

Building on the research conducted on institutional communication, and the analysis of actual communication taking place in clinical settings, this study describes and highlights features of palliative care consultations and focuses on the distribution of discursive space (i.e., share of words, lengths of turns), occurring topics and conversational frames. Six consultations between physicians, patients and significant others were videotaped and all participants took part in audio-taped interviews. The recordings were transcribed and analysed in regard to expectations of, the discursive space of, and topics addressed in the consultations. The distribution of the discursive space was unequal; the physicians had the greatest share of words and length of turns in all six consultations, and they mostly initiated discussion of medical issues connected to examinations and treatment, while only patients initiated the topic of the patients future. During the consultations, institutional framing tended to dominate over client framing. There was found to be room for further study of the structure and content of palliative care consultations with emphasis on how the voice of the patient can manifest itself within the framework of the medical agenda of the consultation and its significance for palliative cancer team work.

Searching for knowledge and understanding while living with impending death*a phenomenological case study

In this article, expression of the quest for knowledge and understanding while living with the threat of fatal cancer is explored. By means of a case study, recurrent narrative interviews and participant observations were performed with one 71-year-old man and the oncology nurse taking care of him. The data were analysed phenomenologically and the results disclose three paths during the illness trajectory at the end-of-life; the stable path, the turning point and the waiting. Existential uncertainty is managed in the stable path, while confronting existential uncertainty is characterized by the turning point, and there is a shift towards living existential certainty during the waiting. The significance of openness towards the intertwinement of the experiential and existential dimensions of living in end-of-life care is emphasized. Research into patients’ multidimensional learning at the end of life is needed in order to expand knowledge of how the patient makes sense of their situation particularly in relation to the information they receive from palliative care professionals.

Spouses' grief before the patient's death: Retrospective experiences related to palliative home care in urban Sweden

Abstract Based on the lived experience research model, this study retrospectively explores the experiences of spouses of persons who died after being admitted to palliative home care, in order to achieve a deeper understanding of the meaning(s) of spouses grief before the patients death. The context for the study was palliative home care in urban Sweden. The transcripts from interviews with 12 spouses were analysed according to a hermeneutic phenomenological method. Six themes were found: realizing that the partner would soon die, changed relationship, fear-inducing feelings, focusing on doing the utmost for the sick partner, trying to live as usual, and time slipping away while also standing still. These themes were interpreted as aspects of grief: initializing grief, the emergence of grief, lacking the space to grieve, holding grief at a distance, handling grief, and a temporality paradox of grief. Among the most salient aspects of this research was the finding that spouses often put their own feelings at a distance, and endured suffering in silence. This suggests the need for support for spouses that not only aims to enhance their ability to facilitate the end-of-life situation for the sick partner, but also helps them to master their own lives.