Cancer patients' effort to return to normal life: a hermeneutic study

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Cancer is one of the main causes of human death in the world, but its mortality rates have been in continual decline for the past two decades 1. Cancer is a growing problem in Middle Eastern countries. The Middle East includes a broad range of economically different countries, from industrial countries with high‐rank cancer care to countries with little or no cancer cure capabilities 2. In Iran, cancer is the third most common reason of death, after heart disease and road accidents. The incidence of cancer in Iran is anticipated to be around 48–112 and 51–144 cases per year per million people for women and men 3. Sadly, the cultural ideas about cancer are still present among Iranian people, demonstrating that the cancer taboo has not yet been broken and cancer is a taboo subject. In Iran, talking about cancer is very challenging. There is a general idea in Iranian culture that cancer diagnosis is considered as a symbol of death. Thus, the perception of cancer is affected by culture 4.
The increasing population of patients with cancer highlights the need to develop an understanding of the lived experiences about living with diseases 6. A wide range of studies about living with cancer have been documented. Results of a research in the USA revealed that patients who viewed God as highly engaged in their life situation experienced a significantly greater increase in psychological well‐being, decreased psychological distress and decreased concern about cancer recurrence 7. A study in the UK emphasises the processes leading to a positive or negative adaptation trajectory among patients with cancer 8. Patients with cancer in Belgium state very individual symptom experiences and symptom‐management styles, which are formed by individual factors such as perceived level of control 9. Also, in Korea patients with cancer expressed avoiding negative thoughts as their strategy to live with cancer 10.
Philosophers have pointed out that severe experiences may become existential turning points in life. Heidegger (1962) claims that we as human beings can exist in the world in different ways. Another subject is that humans are self‐interpreting beings. As such, we do not come into the world predefined, but rather become defined by living a life. We are constantly engaged in, and constituted by, our interpretive understandings of the surroundings and every encounter is an interpretation based on this background. Consequently, we are all a result of a cultural interpretation. Results of phenomenological research show meaning embedded in lived experiences. The nature of language and meaning in life experiences can be considered in phenomenological study 11.
In this regard, in order to gain an understanding of the reasons and types of strategies that patients use to deal with cancer, qualitative study designs are necessary. In fact, a qualitative study focused on the cultural context in which cancer is experienced provides significant insight into the cancer – living phenomenon. It is therefore appropriate to carry out a qualitative research in this area.
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