Life-story perspective on caring within cultural contexts experiences of severe illness and of caring

Abstract: People are afflicted by severe illnesses and adversities in life and they practice care privately and professionally in different cultural contexts from the view of their own life-story perspective. Five studies with a qualitative approach were linked together with the overall aim of disclosing the experience of severe illness and caring with a life-story perspective in different cultural contexts. Audio-recorded, transcribed narrative and reflective interviews were analysed with a phenomenological hermeneutic approach. Data were from 34 people living with a stroke in Sweden and Vietnam, five Vietnamese relatives and 29 professional carers caring for people with a stroke in Vietnam, with dementia in Sweden and girls living on the streets in East Africa. In this study, living with a stroke meant living with a sudden, adverse event that had interrupted the past of the life story from continuing in a similar fashion in the future. Apparently, some interviewees had not integrated the stroke event with their narrative identity and their life stories. They seemed to be confused about what had happened to them. The sensed feelings of living with a stroke in the study from Sweden were conveyed with the use of a metaphoric language. Living with a stroke in Vietnam meant feeling as a weakened thread in the family net. Caring professionally in this context meant collective narrative identity with a view of being assistants, advisers and supporters of a ‘family network’. Carers identified as good at achieving an understanding of people with dementia used maternal thinking emanating from personal experience together with knowledge about each resident’s life stories and the course of the disease. These carers used affect attunement and personal talents. The carers tuned into a resident’s affective state, noticed signs, put these into sentences and stories that corresponded with the narrative identity and the life story of the resident in the caring situation. Professional carers working among girls living on the streets in East Africa felt that they became committed to caring and had motherly feelings when they met with the girls. Caring for these girls meant fighting against the grip of street life, but also experience of satisfaction and hope. It meant experiencing powerlessness and frustration, and the carers felt squeezed between integrated values and the perceived demands from the girls in their meeting with them, whilst conveying visions to the girls of a better future. Inspired by Ricoeur’s philosophy on language and personal identity, the findings from the five papers indicate that a life-story perspective can serve as a framework for bringing human experience in various cultural contexts and different ages into comprehensible language. This perspective should be useful in professional nursing when caring for people who encounter adversities in life as an afflicted person or relative. It is suggested that a life-story perspective can serve as a framework for professional nursing care that aims at a good quality of care.