The impact of cancer on young people superimposed on the developmental processes toward adulthood is recognised (NICE 2005). Despite this there has been limited in-depth research to understand the experiences of young adults with cancer.
This study aimed to explore the issues that contribute to the impact of cancer, on young adults' evolving sense of self and identity, by listening to the stories of young adults over one year from the time of diagnosis.
This longitudinal narrative study was grounded in Ricoeur's (1984) notion of narratives as stories of experience. 18 young adults (16 to 30 years of age) took part in the study. Eight of the participants took part in three interviews over a year, 6 participants in two interviews. Data included conversational style interviews using free association; reflection of images taken; and detailed reflexive notes. Regular psychotherapeutic debriefing and an ongoing psychosocial research seminar group at the Tavistock Clinic created the space for reflection and awareness. Data were analysed longitudinally across individual cases; an integrated data framework from all the data was then developed.
One participant is used to illustrate the interplay between the psyche and the social, the internal and external worlds in the year from diagnosis to the end of life. This also illustrates the framework across all the data involving the renegotiation of self over time, expressed in narrative, through the core components of: the inner world, (psyche, emotion and coping); self as embodied; self as relating others, and self as relating to place.
This study demonstrates the value of storytelling over time for making sense, for patient centred practice and getting beneath the surface of experience. The importance of exploring both the ‘said’ and ‘unsaid’; the challenge of ‘being with’ and ‘standing alongside’; and the nature of psychosocial reflexivity all have important implications for empathic and compassionate care .
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