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Decay, Transformation, and Growth: Meaning-Making Processes of Patients With Acute Leukemia Within the First Year After Diagnosis or Relapse

Constantina Papadopoulou
Bridget Johnston
Markus Themessl-Huber
ONF 2016, 43(2), E73-E81 DOI: 10.1188/16.ONF.E73-E81

Purpose/Objectives: To explore the processes through which patients construct their meanings of acute leukemia (AL).


Research Approach: An exploratory design was employed using serial, in-depth interviews, guided by Smith’s Interpretative Phenomenological Analysis approach.


Setting: Two inpatient hematology clinics in the United Kingdom.


Participants: 10 adult patients with AL. 


Methodologic Approach: Two serial interviews were conducted with each participant, two to four weeks apart, within the first year of diagnosis or post-relapse.


Findings: AL creates a state of imbalance, which may initiate a search for new equilibrium. Patients’ journeys toward making sense of their illness may involve three interchangeable processes: decay, transformation, and growth. As patients learned of their diagnosis and their treatment commenced, a sense of decay dominated their lives. Running in parallel, signs of transformation started to become more evident as time elapsed. Within growth, reprioritizing values was prominent. 


Conclusions: Findings of this contextually and methodologically novel study highlight the complex nature of sense-making for patients experiencing AL.


Interpretation: Nurses can take valuable lessons on how to manage the invisibility of AL, enhance trust in healthcare professionals, address the impact of isolation, and facilitate the making-sense processes of patients in ways that favor their short- and long-term psychosocial adjustment.

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