Narrative meaning making and integration: Toward a better understanding of the way falling ill influences quality of life

Summary & key facts

This article offers a new humanities-based theory about how falling seriously ill can affect a person’s quality of life. The authors combine ideas about contingency (the feeling that life could have been different), narrative identity (how people make life stories), and quality of life to explain how people make meaning of illness. They present a model that names key concepts (for example, life event, worldview, ultimate life goals, narrative meaning making, and narrative integration), give testable hypotheses, and describe a self-report questionnaire based on the model. The article is theoretical and calls for empirical testing of the model.

Key facts:

• The paper proposes a theoretical model that links falling ill to quality of life through concepts such as life event, worldview, ultimate life goals, experience of contingency, narrative meaning making, and narrative integration.
• The authors combine theories on contingency (the idea that events could have been otherwise), narrative identity (forming life stories), and existing quality-of-life theory to build their model.
• They note that commonly used health-related quality-of-life measures (for example, EQ-5D and EORTC QLQ-C30) mainly assess symptoms, side effects, and functioning, and do not capture the processes of meaning making.
• The article presents testable hypotheses and describes a self-report questionnaire that was developed from the theoretical model.
• The authors argue that falling seriously ill often conflicts with people’s personal goals and expectations and raises existential questions that may require narrative reconstruction of the person’s life story.
• This work is a theoretical and humanities-informed approach; it does not report new empirical tests of the full model and therefore calls for further research to evaluate its claims.

Abstract

Falling seriously ill is often experienced as a life event that causes conflict with people's personal goals and expectations in life and evokes existential questions. This article presents a new humanities approach to the way people make meaning of such events and how this influences their quality of life. Incorporating theories on contingency, narrative identity, and quality of life, we developed a theoretical model entailing the concepts life event, worldview, ultimate life goals, experience of contingency, narrative meaning making, narrative integration, and quality of life. We formulate testable hypotheses and describe the self-report questionnaire that was developed based on the model.

Topics

Identity, Memory, and Therapy Optimism, Hope, and Well-being Resilience and Mental Health

Categories

Applied Psychology Psychology Social Sciences

Tags

Aesthetics Contingency Epistemology Existentialism Falling (accident) Identity (music) Linguistics Meaning (existential) Meaning-making Narrative Narrative identity Philosophy Psychiatry Psychology Psychotherapist Quality (philosophy) Quality of life (healthcare) Social psychology