Disrupted lives and threats to identity: The experiences of people with cancer within the first year following diagnosis

Citation

Hubbard G, Forbat L, Cunningham N, McCann LA, Cayless S, Kidd L, Wengstrom Y & Kearney N (2009) Disrupted lives and threats to identity: The experiences of people with cancer within the first year following diagnosis. Psycho-Oncology, 18 (Supplement 2), pp. S35-S35. https://doi.org/10.1002/pon.1594

Abstract
BACKGROUND: The concept ‘biographical disruption' was coined by Michael Bury in the early 1980s as both a descriptor of people's experiences of chronic illness and as an explanatory device to comprehend how people respond and adapt to chronic illness. A key facet of ‘biographical disruption' is disruption to identity and loss of self within the context of illness. The relevance of the concept ‘biographical disruption' for people living with and beyond cancer can be addressed empirically. METHOD: A longitudinal qualitative study to explore 66 people's experiences of cancer within the first year following diagnosis was conducted. Purposive sampling was used, designed to ensure a range of characteristics known to shape experiences of cancer. Three depth interviews over the course of the year were carried out. During analysis, we drew on biographically informed approaches of understanding chronic illness, particularly the work of Bury (1982; 2001; 1991) and Charmaz (1994; 1983; 1995; 2002) to explore the extent to which people within the first year following diagnosis experience cancer as biographically disruptive. RESULTS: Some people appeared to experience cancer as ‘biographical disruption' because it represented a threat to their identity. However, not all individuals experienced cancer as a threat to identity. People with cancer can experience illness as a physical and emotional assault which disrupts their daily lives but without it being an assault on their identity. A number of possibly inter-related factors may have influenced why some individuals experienced cancer as disruptive but not biographically so. These include having a ‘hard life' such as, previous experience of a life-threatening illness either personally or in the family. CONCLUSIONS: Universal application of the concept ‘biographical disruption' to the experience of cancer within the first year of diagnosis is not appropriate. Unless illness threatens identity then the illness may be disruptive but not biographically so. RESEARCH IMPLICATIONS: Cancer has traditionally been conceptualised as an acute illness (Tritter and Calnan, 2002), however, more people are living longer with the consequences of a cancer diagnosis and treatment and thus, it is a disease which may increasingly fall within the category of a chronic condition. Hence, the concept ‘biographical disruption' may be a useful description of people's experiences of living with cancer and it may also be a useful explanatory device to comprehend these experiences. CLINICAL IMPLICATIONS: The findings of the study call for the development of interventions to support those people who experience cancer as an assault on their identity and to support their biographical work as they experience living with and beyond cancer. ACKNOWLEDGEMENT OF FUNDING: Scottish Government Health Department funded this study.

Notes
Output Type: Meeting Abstract

Journal
Psycho-Oncology: Volume 18, Issue Supplement 2

People

Dr Nicola Cunningham

Lecturer (MacMillan Cancer Support), Health Sciences Stirling

Professor Liz Forbat

Professor, Faculty of Social Sciences