The Art of Living with Chronic Health Conditions: A Qualitative Study

Background/Purpose:Among the top 10 leading causes of death in the US, eight are health conditions including heart disease, cancer, strokes, and diabetes. One thing shared by a majority of those who are affected by these conditions is a struggle with depression and a decrease in overall quality of life. The prevalence of depression among those affected is astounding (for persons with heart disease, 31 to 45%; strokes 29 to 36%; 19 to 43% with HIV/AIDS; and, diabetes is twice the general population). These depressive symptoms greatly complicate the treatment of physical illness given its characteristics of sadness, hopelessness, decreased interest in activities, such as adhering to treatment plan. Understanding how people successfully manage these comorbidities is important to guide treatment. Thus, the purpose of this study was to analyze the experiences of people faced with various physical illnesses to learn how they found peace in the wake of diagnosis and treatment.

Methods:This study utilized a phenomenological hermeneutical method to analyze the data of a collection of first-person stories (n = 10) that capture the essence of experiences of people facing various physical illnesses, most specifically to learn how they found peace in the wake of diagnosis and treatment. Data were coded in Atlas.ti using systematic steps for increasing the analytic rigor and exploring the textual interpretation of ten stories from different storytellers. Stories were coded independently using low-inference descriptors. To achieve triangulation of analysts, the authors met to review emerging codes, discuss various interpretations of the coding process, and identify negative cases (e.g., stories that may have contradicted the codes).

Findings: Analysis of the storytellers’ accounts resulted in several themes and subthemes as per this methodology. From the initial naïve understanding of the text emerged sub-themes and main themes, four (4) phases: (1) First Impressions, (2) Turning Point, (3) Resiliency…Limitation as an Opportunity, and (4) Paying it Forward. These are expanded on in this section, with supporting quotations from the storytellers. It was found that though treatment of the physical illness is primary, leaving the possible depression and other emotional consequences of physical illness untreated is detrimental to the overall healing process, and those with comorbid physical illness and depression have worse outcomes than those who have only the physical illness.

Conclusions and Implications: Thus, it is important to learn what those who thrive in the wake of physical illness have done outside of treatment of the illness and depression to move forward. As healers work with those facing physical illness, not only should the usual activities be undertaken (e.g., treatment of physical symptoms, medication for depression, engaging of support systems in treatment planning), but also, there should be efforts to help those who are affected with illness to move through reshaping their identities, creatively unloading their trials, and focusing on helping others in similar situations.These findings may help professionals in healthcare and other settings when working with people living with chronic physical illnesses. Practitioners and clinicians can share such stories with individuals affected with similar physical diagnoses.