LIVING WITH LEUKEMIA: THE PERSONAL MEANING ATTRIBUTED TO ILLNESS AND TREATMENT BY ADULTS UNDERGOING A BONE MARROW TRANSPLANTATION.
Contributors: University of Washington.
Published: 1987
Number of pages: 384
Subjects: Health Sciences, Nursing.
Description: The personal and social meanings that evolved during the early phase of leukemia and the preparatory stage of bone marrow transplantation (BMT) were examined in the current study. Three dimensions of meaning were documented in detail: symptom meaning, beliefs in personal control, and explanatory models of leukemia and BMT. Twenty-three adults with acute or chronic leukemia were selected by a purposive sampling strategy and interviewed prior to undergoing BMT. A qualitative methodology was utilized that combined aspects of grounded theory, ethnography, and phenomenology.

Study results gave evidence that ambiguity, created by a condition of prolonged uncertainty, was the hallmark of living with leukemia. Uncertainty surrounded gaining an initial awareness of leukemia, seeking diagnostic confirmation, and the awareness of being at-risk to relapse and early death. Explanatory models partially mitigated the effects of uncertainty by explaining the cause, pathophysiologic mechanisms, and expected severity of leukemia. A paradoxical self-image evolved as persons viewed themselves as healthy, yet living with a fatal illness. People compared themselves with others who had leukemia to consolidate the boundaries of this inconsistent self-image. Perceptions of personal control were brought into alignment with the realities of the disease. Control that was relinquished to health providers was circumscribed and compensated for by exercising control in other areas of life. The decision to undergo BMT centered on the statistical odds of achieving a cure and on concerns of an untimely death. To construct a mental image of the unknown aspects of BMT, individuals formed loosely-knit explanatory models of BMT, reviewed their own leukemia biographies, and compared themselves to other BMT recipients. A ubiquitous lack of control was anticipated to occur during BMT. To maximize further the odds for a cure, control was readily turned over to health providers and the BMT protocol.

Implications for nursing include the use of preparatory information to reduce uncertainty; to help persons anticipate how they might cognitively and behaviorally manage BMT; and to structure systematically explanatory models of leukemia and BMT, and how time is perceived and ordered during treatment. Perceptions of control and preferences for control can be explored and negotiated.
Notes: Source: Dissertation Abstracts International, Volume: 48-03, Section: B, page: 0703.

Thesis (PH.D.)--UNIVERSITY OF WASHINGTON, 1987.

School code: 0250.