Narrative meaning-making at the crossroads between life and death: a qualitative study into contemplating literary texts with advanced cancer patients.

purposeAdvanced cancer patients may perceive their disease as an experience of contingency: a (sudden) disruption of the life-narrative evoking existential concerns such as loss of meaning and identity. The research project In Search of Stories aimed to investigate whether and how reading and discussing literary texts assisted participants in integrating their diagnosis as the experience of contingency into their life-narrative.

methodsThis qualitative study reports on interviews with 25 advanced cancer patients, who read a story from a curated collection of 10 literary texts. They discussed the story with a spiritual caregiver, using a reading guide to structure the conversation. The interviews were thematically analyzed using template analysis.

resultsParticipants identified with contingency experiences and related existential concerns presented in the texts, including loss of meaning and identity, bodily alienation, and social estrangement. Reading and discussing literary texts also enabled participants to engage in self-regulation; in exploring how to relate to devalued emotions and attitudes, and in further developing their identity post-diagnosis.

conclusionsA structured reading of literary texts revolving around contingency experiences enables advanced cancer patients to identify with and articulate emotions, attitudes, and existential concerns such as loss of meaning and identity. This allows them to break down barriers in talking about their illness experiences and to transition towards acceptance of their diagnosis as the experience of contingency. IMPLICATIONS FOR CANCER SURVIVORS: Reading and discussing literary texts about contingency may support people with advanced cancer to integrate their own experience of contingency into the life-narrative.