Getting out or remaining in the cage of inauthentic self: The meaning of existential challenges in patients' with cancer

Abstract

Context:Cancer as a life-threatening disease develops a range of existential challenges in persons. These challenges cause the patients to encounter some existential questions and tensions. This study method focuses on a person's experience about them.Aims:The aim of this study is to illuminate the meaning of existential challenges in patients with cancer in Iran.Subjects and Methods:A hermeneutic phenomenological approach, influenced by the philosophy of Ricoeur, was used to analyze the experiences of 10 Iranian patients with cancer. Data analysis was based on three stages of simple and fast understanding, structural analysis, and comprehensive understanding.Results:The present study showed that existential challenges in patients with cancer can be considered as getting out or remaining in the cage of inauthentic self. This theme consists of two subthemes “Being exposed to the light of awareness that revealed the cage of inauthentic self” and “The tension between getting out of the cage or remaining.” First, being exposed to the light of awareness revealed the cage of inauthentic self which subjectively refers to the emergence of existential questions, the past, the fear of future, and the collapse of physical body identity. Second, the tension between getting out of the cage or still staying which is characterized by anger, denial, sense of loneliness, and depression.Conclusions:According to the results of this qualitative study, it is possible to form discussion groups with peers or have self-reflective practice teaching groups to reflect patients' questions and existential challenges. In this way, participants can express themselves, share their experiences, challenges, learn, and find the answers.

The effect of positive psychotherapy on the meaning of life in patients with cancer: A randomized clinical trial

“…[67] This sense of meaninglessness in life leads to absurdity and existential vacuum, in such a way that one quits trying to create a purposeful life. [891011] In this case, the person is uncertain and faces the concern that cancer has endangered his life. [12] Thinking about this issue and trying to understand it, get sick patients to ask questions such as why I got sick?…”

“…[13] Reker has put forward the meaning of life in five dimensions which are life purpose, death acceptance, freedom and responsibility, existential vacuum, and goal-seeking. [111415] Cancer patients experience five existential concerns, including death, separation, identity, freedom, and meaning. All matters, except the meaning of life, have a positive relationship with depression and existential thinking, and meaning-seeking represents positive existential thinking as well as a sense of purposefulness, coherence, satisfaction, and value of life in a person.…”

Educating the existential view to nurses in cancer care: A review

“…[ 5 6 ] Cancer patients suffer from several complications, such as changes in appearance, inability to work, losing social and family roles, and physical pain, but beyond that many times they have deeper concerns about the meaning of their lives. [ 7 8 ] Existential concerns would cause suffering and lead to a kind of spiritual pain. [ 9 10 ] This spiritual pain is associated with disappointment, losing the meaning of life, pessimistic views, personal dissatisfaction, social isolation, and fear of death,[ 7 ] which is called demoralization syndrome.…”

“…[ 7 8 ] Existential concerns would cause suffering and lead to a kind of spiritual pain. [ 9 10 ] This spiritual pain is associated with disappointment, losing the meaning of life, pessimistic views, personal dissatisfaction, social isolation, and fear of death,[ 7 ] which is called demoralization syndrome. Even individuals who do not believe any religion, might suffer from spiritual pains.…”

“…So, nurses’ knowledge about existential concepts is necessary for providing comprehensive care to the terminal patients. [ 7 11 12 ] Nurses usually do not receive sufficient education about these topics during their undergraduate education. [ 13 ] Nursing students must deal with end-stage patients; while they are not well prepared and many times have not dealt with the fear of death, which can influence the quality of care in these patients.…”