Understanding the experience of developing and being diagnosed with lung cancer : exploring the potential of narrative

Lung cancer is a significant issue within the United Kingdom and in countries around the world. Many individuals are diagnosed with late stage disease which is not amenable to potentially curative surgical resection. This has led to calls for the disease's earlier diagnosis. Individuals facilitate diagnosis by consulting a GP but much time can elapse between the initial symptomatic experience and presentation for medical advice. Related to this, individuals often do not interpret their experience as related to the disease with which they are subsequently diagnosed. The purpose ofthis study was to make a contribution to the earlier diagnosis of lung cancer through seeking to understand the experience of developing and being diagnosed with the disease. Of particular interest was how individuals interpret the symptomatic experiences associated with lung cancer and why individuals may not interpret them as related to it. Situated within the interpretive paradigm and adopting a case study approach, this study sought to develop an understanding of the pre-diagnosis experience of lung cancer. The principal data were illness narratives generated in interviews with 33 individuals who had been diagnosed with the disease, though other data were also drawn upon to facilitate the understanding. Techniques of 'narrative analysis' and 'analysis of narrative' (polkinghorne 1995) were applied to the illness narratives. Ofthe 33 participants, only two had interpreted their symptomatic experience as related to lung cancer prior to presenting for medical advice. Many of the remaining participants interpreted their symptoma~ic experiences as related to normal life or normal illness. These and other study findings highlight the significance of narrative for how individuals interpret and respond to symptomatic experiences. Indeed, it is proposed that individuals interpret their symptomatic experiences through drawing upon storied meaning and emplotting their experience into a narrative plot in a process of experiential emplotment. This positions interpretation as an active and creative process and acknowledges that any interpretation occurs within a particular social context. Narratives of specific diseases are just one type of plot which an individual can draw upon to bring meaning to their experience. However many individuals who develop lung cancer cannot see themselves in the disease's narrative and therefore cannot interpret their experience as related to it. Health education interventions based on this understanding would strive to construct and communicate narratives of lung cancer which are faithful to how the disease is experienced and in whom so as to influence the availability, visibility and acceptability of the narrative plot. With this, the interpretation of lung cancer would be accessible to those who may need to draw upon it and the potential for the earlier diagnosis of lung cancer would become a distinct possibilityEThOS - Electronic Theses Online ServiceGBUnited Kingdo