Latching onto life: living in the area of tension between the possibility of life and the necessity of death

AIM: To present one of the findings from a large-scale hermeneutic research project focusing on promoting a deeper understanding of health and suffering because of serious cancer disease. BACKGROUND: Although suffering is a main concern for caring science, there is limited research focusing on the suffering of the patients with a serious cancer disease from the patients' perspective and few studies focusing on the patient's health resources and the dialectic between these. DESIGN: The study has a hermeneutic design inspired by Gadamer's ontological hermeneutics. METHOD: Fifteen Norwegian patients with cancer disease were interviewed. They were informed about the seriousness of their situation and that there was no more curative treatment to offer. RESULTS: The results show that the patients lived their lives in a dialectic oscillation, a struggle between health and suffering. They expressed health through striving towards normal life, aspiring for hope, taking responsibility for their own life and experiencing belongingness with their next of kin. Suffering was expressed through experiences of bodily aversion, uncertainty and fear of the future, sorrow and needs, anxiety, despair and loneliness. The patients were lonely in this struggle, as conversations about existence and death did not occur, neither with the nurses nor with their next of kin. Death remained veiled in silence. CONCLUSIONS: In confronting one's own death, there seems to be striving for health, striving for wholeness and for becoming a self in a life dominated by suffering. Becoming a self implies a desire to be a responsible human being and to experience integrity and dignity in life despite increasing dependency on others. RELEVANCE TO CLINICAL PRACTICE: There seems to be a great need in clinical practice to give priority to, and increase, the consciousness and competence of nurses to see and respond to the spiritual/existential concerns of patients with a serious cancer disease.