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TitleWhere is the Person in Symptom Cluster Research
LanguageEnglish
File Size2.0 MB
Total Pages439
Document Text Contents
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I



Table of contents

Table of contents .................................................................................................................................... I

List of Tables......................................................................................................................................... V

Abstract ............................................................................................................................................... VI

Acknowledgements .............................................................................................................................. X

Declaration ......................................................................................................................................... XII

Chapter 1: Introduction ........................................................................................................................ 1

1.1 Rationale for thesis ........................................................................................................................ 1

1.2 Structure of thesis .......................................................................................................................... 8

Chapter 2: The illness experience ................................................................................................... 13

2.1 Introduction ................................................................................................................................. 13

2.2 Illness or disease? ........................................................................................................................ 13

2.3 The biomedical model .................................................................................................................. 17

2.3.1 Benefits of the biomedical model ...................................................................................... 18

2.3.2 Critique of the biomedical model ...................................................................................... 21

Chapter 3: The study of symptom clusters in patients with cancer ................................................ 42

3.1 Introduction ................................................................................................................................. 42

3.2 The definition of a symptom ........................................................................................................ 43

3.3 Conceptual frameworks of symptom clusters ............................................................................. 48

3.4 Empirical studies of symptom clusters in patients with cancer ................................................... 58

Chapter 4 Methodology ................................................................................................................ 70

4.1 More than a method.................................................................................................................... 72

4.2 My epistemological position ........................................................................................................ 77

4.3 Qualitative research methodologies ............................................................................................ 79

4.4 Rationale for using IPA ................................................................................................................ 91

Chapter 5 Study methods ............................................................................................................. 94

5.1 Introduction ................................................................................................................................. 94

5.2 Aim of the study ........................................................................................................................... 94

5.3 Study design................................................................................................................................. 95

5.4 Patient population ....................................................................................................................... 95

5.4.1 Clinical site ......................................................................................................................... 95

5.4.2 Sampling strategy and sample size .................................................................................... 96

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was when she was diagnosed with lung cancer and how she thought

it would happen to other people but never happen to her:



Roma: „Cause you were, you were saying there, you know,

you thought it‟d be other people ...

Suzie: Mm hmm, mmm mmm ...

Roma ... and not me ...

Suzie Mm hmm ...

Roma Why, why do you think that?

Suzie: I don't, I don't, I really don't know. I'd always

eaten well and looked after myself and you think sometimes it
happens to people that don't look after themselves and maybe

don't eat well and abuse their bodies – smoke; I've never done

any oh these things and yet it, it .. I think it was more a shock
then (Suzie, interview 1, page 2).



In the above quote, in addition to the feelings of shock overtly stated

by Suzie, there is also a sense that she feels that her cancer

diagnosis was unjust. Such findings may be referenced to the „just

world hypothesis‟, which states that people believe that they live in a

world where people generally get what they deserve (van den Bos

and Maas 2009). There is a sense that Suzie feels that her lung

cancer was not deserved, as she has „looked after herself‟ as opposed

to most people who develop this disease, who, in her opinion, have

„abused‟ their bodies. The use of the word „abuse‟ suggests that

Suzie associates such people as having maltreated and neglected

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