“Being Sick Does Not Define You”: Communicated Narrative Sense-Making of Autoimmune Disease in Emerging Adult Women in the U.S.

Jacqueline N. Gunning, Jody Koenig Kellas
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Abstract

The onset of autoimmune disease (AD) in emerging adulthood is a disruptive illness experience that is difficult to make sense of. Compounded by hegemonic ideologies, including the master illness narrative of restitution and stereotype of the hysterical female patient, women with AD struggle with narrative coherency. Guided by the retrospective storytelling heuristic of communicated narrative sense-making theory (CNSM), the present study investigates the meanings, values, and beliefs found in emerging adult women’s narratives of AD onset and diagnosis. Using qualitative in-depth interviews, findings identify how young women experiencing disruptive chronic illness at a formative age make sense and meaning of their experience, highlighting the role of identity (re)construction and resistance to dominant narratives. Framed as lessons learned, themes include rediscovering trust in self, separating self from illness, creating and committing to new normals, challenging assumptions about illness, and recognizing privilege and disparities in care. Theoretical and practical implications are discussed.
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"生病并不能定义你":美国成年女性对自身免疫性疾病的认知叙事
自身免疫性疾病(AD)在成年期发病是一种难以理解的破坏性疾病经历。再加上霸权意识形态,包括恢复原状的主要疾病叙事和歇斯底里的女性患者的刻板印象,患有自身免疫性疾病的女性患者在叙事连贯性方面挣扎不已。本研究以沟通式叙事感知理论(CNSM)的回顾性故事启发式为指导,调查了成年女性关于注意力缺失症发病和诊断的叙事中的意义、价值观和信念。通过深入的定性访谈,研究结果确定了在成长阶段经历慢性疾病干扰的年轻女性如何理解其经历和意义,突出了身份(重新)建构和抵制主流叙事的作用。作为经验教训,主题包括重新发现对自我的信任、将自我与疾病区分开来、创建并致力于新的规范、挑战对疾病的假设,以及认识到护理中的特权和差异。讨论了理论和实践意义。
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