Browsing by Author "Smit, Anri"

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    Breast cancer stories : exploring the multimodal narratives of twelve South African women with recurrent disease
    (Stellenbosch : Stellenbosch University., 2020-03) Smit, Anri; Coetzee, Bronwyne; Roomaney, Rizwana; Swartz, Leslie; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
    ENGLISH ABSTRACT: Breast cancer is a major global health burden. While advances in the detection and treatment of breast cancer have improved survival rates, a considerable proportion of women with breast cancer will experience disease recurrence. With more research emphasis directed at understanding the experiences of breast cancer survivors, less is known about women’s experiences of recurrent disease. In this dissertation, I explore the breast cancer stories of 12 South African women with recurrent disease. I present and discuss the participants’ stories, as gathered across multimodal narrative data (i.e., narrative interviews, diaries and body maps), including meanings they attached to their experiences. I conducted a thematic analysis across all narrative data to understand the content of participants’ stories. Thereafter, by using the interpretive framework of Frank’s (1995) narrative types (restitution, chaos, and quest), I undertook a narrative analysis in order to examine the structure of the stories. I then synthesized the thematic and narrative analyses to identify patterns of responses across the narrative types. Three narrative types emerged: four participants described their experience of recurrence as a temporary situation, which would soon end if the necessary treatments were adhered to. These stories followed the restitution plot and maintained a linear order characteristic of this narrative type. For another participant, her cancer recurrence seemed to have caused a great deal of anxiety, which manifested in a fragmented account; lacking narrative order. I interpreted her story as a chaos narrative. The seven remaining participants described their recurrent disease as an opportunity for self-discovery, personal growth, and for helping other women with breast cancer. These stories followed the quest narrative, though, at times, contained elements of the other narrative types. Although the findings corroborate Frank’s (1995) narrative types, the stories of recurrence seemed to be more complex than conventional, episodic, illness stories. Overall, I understood participants’ meanings of recurrence to be shaped by their responses to illness (illness appraisal and coping) and tied to their identities in relation to the illness. In some stories, participants’ illness appraisals and coping strategies moved beyond Frank’s (1995) original formulation, and in a few, changes in identity seemed to transpire into changes in narrative type. I reflect on the value of a multimodal narrative methodology and the triangulation of multiple data sets in order to arrive at a complex and nuanced understanding of breast cancer stories. I discuss the findings of my study in relation to both the broader literature and Frank’s (1995) narrative types, after which I offer directions for future research investigating breast cancer stories.