Titre du document / Document title

Liminality : A major category of the experience of cancer illness

Auteur(s) / Author(s)

LITTLE M. ⁽¹⁾ ; JORDENS C. F. ⁽¹⁾ ; PAUL K. ⁽¹⁾ ; MONTGOMERY K. ⁽¹⁾ ; PHILIPSON B. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Centre for Values, Ethics and the Law in Medicine, Department of Surgery, University of Sydney, Sydney 2006 NSW, AUSTRALIE

Résumé / Abstract

Narrative analysis is well established as a means of examining the subjective experience of those who suffer chronic illness and cancer. In a study of perceptions of the outcomes of treatment of cancer of the colon, we have been struck by the consistency with which patients record three particular observations of their subjective experience: 1) the immediate impact of the cancer diagnosis and a persisting identification as a cancer patient, regardless of the time since treatment and of the presence or absence of persistent or recurrent disease; (2) a state of variable alienation from social familiars, expressed as an inability to communicate the nature of the experience of the illness, its diagnosis and treatment; and (3) a persistent sense of boundedness, an awareness of limits to space, empowerment and available time. These subjectivities were experienced in varying degree by all patients in our study. Individual responses to these experiences were complex and variable. The experiences are best understood under the rubric of a category we call liminality . We believe that all cancer patients enter and experience liminality as a process which begins with the first manifestations of their malignancy. An initial acute phase of liminality is marked by disorientation, a sense of loss and of loss of control, and a sense of uncertainty. An adaptive, enduring phase of suspended liminality supervenes, in which each patient constructs and reconstructs meaning for their experience by means of narrative. This phase persists, probably for the rest of the cancer patient's life. The experience of liminality is firmly grounded in the changing and experiencing body that houses both the disease and the self, Insights into the nature of the experience can be gained from the Existentialist philosophers and from the history of attitudes to death. Understanding liminality helps us to understand what it is that patients with cancer land other serious illnesses) seek from the system to which they turn for help. Its explication should therefore be important for those who provide health care, those who educate health care workers and those concerned to study and use outcomes as administrative and policy making instruments.

Revue / Journal Title

Social science & medicine    ISSN  0277-9536   CODEN SSMDEP 

Source / Source

1998, vol. 47, n^o10, pp. 1485-1494 (37 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, Kidlington, ROYAUME-UNI  (1982) (Revue)

Mots-clés anglais / English Keywords

Malignant tumor

;

Personal experience

;

Self perception

;

Public health

;

Evaluation

;

Human

;

Australia

;

Oceania

;

Social perception

;

Mots-clés français / French Keywords

Tumeur maligne

;

Expérience personnelle

;

Autoperception

;

Santé publique

;

Evaluation

;

Homme

;

Australie

;

Océanie

;

Perception sociale

;

Mots-clés espagnols / Spanish Keywords

Tumor maligno

;

Experiencia personal

;

Autopercepción

;

Salud pública

;

Evaluación

;

Hombre

;

Australia

;

Oceania

;

Percepción social

;

Localisation / Location

INIST-CNRS, Cote INIST : 13689, 35400007156160.0090