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Individual experiences of communication with health care providers during chemotherapy period : a hermeneutic study


Communication and providing information to individuals in need of cancer care is, in my
opinion, one of the foundations on which nursing is based. It is essential to both the process
and outcome of cancer care. Many people assume that the diagnosis of cancer heralds very
unpleasant treatments followed by a universally gloomy outcome. This is a socially
constructed interpretation around the word cancer (Fallowfield and Jenkins, 1999).
Seeking information is one strategy that many people use to help them cope with the
challenge that cancer brings. It is a way of coping with the practical aspects of the illness
and its treatments and can help to manage any fears and anxieties experienced. Abma
(2002) states that one way of recognising the importance individuals diagnosed with cancer
have in the development of health care is by ‘giving them space/voice’ in the academic
My study was a hermeneutic study underpinned by Gadamer’s philosophy of fusion of
horizons in which individuals’ experiences with cancer and communication with health
care providers during their chemotherapy treatment have been interpreted using narrative
analysis. The purpose of my study was to gain a new and deeper understanding of
experiences from individuals with cancer and from communication with health care
providers during the chemotherapy period. I present six different narratives of individuals
with cancer and I was committed to letting the narratives of my dialogue partners speak for
themselves. Though I asked my dialogue partners to concentrate on their experiences of
communication with health care providers during the chemotherapy period, five of them
started from the beginning of experiencing symptoms. For all of them treatment was
successful and they told of looking to the future. The seventh narrative, my reflective
stance and development of self through the dialogue process, came to light along with my
interpretation of significant aspects of the six narratives in terms of communication.
I began to realize how hermeneutic research is truly a learning process, how understanding
is informed by writing and that voicing myself by reflecting on the process of learning
rather than stating what I knew. I realised that my reflective journey in finding a voice
through my study was parallel to my dialogue partners’ journey. Our texts were running
parallel in a communicative narrative where two waves emerged:
• Regaining a Stance by Holding on to Personhood
• Collaboration
The enlightening thing was that not only did I interpret theses aspects from my dialogue
partners’ narratives, but that they were also in accordance with the waves in my own
reflective narrative in gaining a voice in the academic world and finding out that true
communication involves collaboration between all parties, whether in a research process or
within the health care environment, built on dignity, mutual respect, trust and care. It came
to my understanding that in the communication trajectory the core concern is personhood
and collaboration.
There were certain aspects from the narratives which I draw out as significant in my study
in terms of communication. They were all important issues, either enhancing or
diminishing personhood. These aspects were: Stigma; A Person or a Case; Listening;
Respect and Trust; Hope; Environmental Atmosphere and Attitude; Collaboration
and Cure – Care: Antitheses or Parallel Meanings.


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