Activity and meaning making in the everyday lives of people with advanced cancer

Abstract

Objective: This study aims to explore and understand how people with advanced cancer create meaning and handle everyday life through activity.

Methods: A purposive sample of seven participants was recruited from a larger study. Data were collected through qualitative interviews and participant observations conducted in the participants' home environments while they were engaged in activities to which they assigned particular value. Interpretive analysis was conducted using narrative theory and relevant literature.

Results: The study shows how people in conditions of advanced cancer fashion narratives useful for handling everyday life with advanced cancer. A meta-narrative of "saying goodbye in a good way" provided an overall structure for the participants as they attempted to create desired narratives negotiated in context of the individuals' sociocultural life and in the proximity of death. A narrative of "being healthy although ill" provided an arena for exploring the contrast between simultaneously feeling well and severely ill. Further emplotment of activities in "routines and continuity" was identified as a means to provide a safe, familiar framework stimulating participants' everyday agency. "My little Mecca" was identified as a narrative reflecting the activity of life-confirming experiences and taking time out.

Significance of results: The identified narratives performed and told in daily life may guide the development of palliative care services to support people with advanced cancer in creating meaning in the remains of their lives.