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The pendulum time of life: the experience of time, when living with severe incurable disease—a phenomenological and philosophical study

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Abstract

The aim of this study was to gain a deeper understanding of the experience of time when living with severe incurable disease. A phenomenological and philosophical approach of description and deciphering were used. In our modern health care system there is an on-going focus on utilizing and recording the use of time, but less focus on the patient’s experience of time, which highlights the need to explore the patients’ experiences, particularly when life is vulnerable and time is limited. The empirical data consisted of 26 open-ended interviews with 23 participants receiving palliative care at home, in hospital or in a nursing home in Norway. The theoretical frameworks used are mainly based upon K. Martinsens philosophy of care, K. E. Løgstrup phenomenological philosophy, in addition to C. Saunders’ hospice philosophy, L. Feigenberg’s thanatology and U. Qvarnström’s research exploring patient’s reactions to impending death. Experience of time is described as being a movement that moves the individual towards death in the field of opposites, and deciphered to be a universal, but a typical and unique experience emerging through three integrated levels: Sense of time; where time is described as a movement that is proceeding at varying speeds. Relate to time; where the awareness of limited life changes the understanding of time to be more existential. Being in time; where limited time seems to clarify the basic living conditions and phenomena of life. The existence of life when the prospect of death is present is characterized by emotional swings that move within polarizing dimensions which is reflected in the experience of time illustrated as the moves of the pendulum in a grandfather clock. The diversity of the experience of time is oscillating between going fast or slow, being busy or calm, being unpredictable but predictable, safe or unsafe and between being good or bad, depending on the embodied situation of the individual.

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References

  • Alvsvåg, H. 2010. Kari Martinsen: philosophy of caring. In Nursing theorists and their work, 7th ed, ed. M.R. Alligood, and A.M. Tomey. St.Louis, MO: Mosby Elsevier.

    Google Scholar 

  • BBC News 2006. http://news.bbc.co.uk/2/hi/5104778.stm. Accessed 28 Oct 2013.

  • Borreani, C., G. Miccinesi, C. Brunelli, and M. Lina. 2004. An increasing number of qualitative research papers in oncology and palliative care: does it mean a thorough development of the methodology of research? Health and quality of life outcomes 22: 2–7.

    Google Scholar 

  • Caldas, C.P., and C. Bertero. 2012. A concept analysis about temporality and its applicability in nursing care. Nursing Forum 47: 245–252.

    Article  Google Scholar 

  • Clark, D. 2007. From margins to centre: A review of the history of palliative care in cancer. The lancet Oncology 8: 430–438.

    Article  Google Scholar 

  • Dahlberg, H., and K. Dahlberg. 2003. To not make definite what is indefinite. A phenomenological analysis of perception and its epistemological consequences. Journal of the Humanistic Psychologist 31: 34–50.

    Article  Google Scholar 

  • Dalgaard, K. M. 2007. At leve med uhelbredelig sygdom. PhD Thesis, Aalborg Universitet.

  • Dalgaard, K.M., and C. Delmar. 2008. The relevance of time in palliative care Nursing practice. International Journal of Palliative Nursing 14: 472–476.

    Article  Google Scholar 

  • Delmar, C. 2006a. The phenomenology of life phenomena–in a nursing context. Nursing Philosophy: An International Journal for Healthcare Professionals 7: 235–246.

    Article  Google Scholar 

  • Delmar, C. 2006b. Tillid og magt En moralsk udfordring. København: Munksgaard.

    Google Scholar 

  • Ellingsen, S., Å. Roxberg, K. Kristoffersen, J. H. Rosland, and H. Alvsvåg. 2013b. Being in transit and in transition. The experience of time at the place, when living with severe incurable disease—a phenomenological study. Scandinavian Journal of Caring Science. doi:10.1111/scs.12067.

  • Ellingsen, S., Å. Roxberg, K. Kristoffersen, J.H. Rosland, and H. Alvsvåg. 2013a. Entering a world with no future. A phenomenological study describing the embodied experience of time when living with severe incurable disease. Scandinavian Journal of Caring Science 27: 165–174.

    Article  Google Scholar 

  • Eriksen, B.T. 1999. Tidens historie. Finland: Tiderne Skifter.

    Google Scholar 

  • Feigenberg, L. 1980. Terminal care friendship contracts with dying cancer patients. New York: Brunner/Mazel Publishers.

    Google Scholar 

  • Gysels, M., C. Shipman, and I.J. Higginson. 2008. Is the qualitative research interview an acceptable medium for research with palliative care patients and carers? BMC medical ethics 9: 7.

    Article  Google Scholar 

  • Heidegger, M. 1962. Being and time. USA: Harper & Row.

    Google Scholar 

  • Heidegger, M. 1992. The concept of time. Oxford: Blackwell Publishers.

    Google Scholar 

  • Holm-Hansen, L. 2007. Innledning. In Væren og tid, ed. Martin Heidegger. Oslo: Pax Forlag.

    Google Scholar 

  • Husserl, E. 1964. The phenomenology of internal time-consciousness. Bloomington, IN: University press.

    Google Scholar 

  • Jagger, M., & Richards, K. 1974. Time waits for no one. Released on the album It’s Only Rock ‘n Roll.

  • Kjær, T. A., & Martinsen, K. 2012. Vil du mig noget- om sårbarhet og fantasi i sundhedvæsenets travlhed. Herlev: Herlev Hospital.

  • La Cour, K., and H.P. Hansen. 2011. Aesthetic Engagements: “being” in evryday life with advanced cancer. The American Journal of Hospice & Palliative Care 29(2): 126–133.

    Article  Google Scholar 

  • La Cour, K., S. Josephsson, C. Tishelman, and L. Nygård. 2007. Experiences of engagement in creative activity at a palliative care facility. Palliative & Supportive Care 5: 241–250.

    Google Scholar 

  • La Cour, K., H. Johannessen, and S. Josephsson. 2009a. Activity and meaning making in the everyday lives of people with advanced cancer. Palliative & Supportive Care 7: 469–479.

    Article  Google Scholar 

  • La Cour, K., K. Nordell, and S. Josephsson. 2009b. Everyday lives of people with advanced cancer: Activity, time, location, and experience. OTJR 29(9): 154–162.

    Google Scholar 

  • Løgstrup, K.E. 1978. Skabelse og tilintetgørelse: religionsfilosofiske betragtninger. København: Gyldendal.

    Google Scholar 

  • Løgstrup, K.E. 1983. Kunst og erkendelse. Denmark: Gyldendal.

    Google Scholar 

  • Løgstrup, K.E. 1984. Ophav og omgivelse. Denmark: Gyldendal.

    Google Scholar 

  • Løgstrup, K.E. 1987. Solidaritet og kærlighed: og andre essays. København: Gyldendal.

    Google Scholar 

  • Løgstrup, K.E. 1997. The ethical demand. Indiana: University of Notre Dame Press.

    Google Scholar 

  • Martinsen, K. 2002. Rommets tid, den sykes tid, pleiens tid. In Møte mellom pasient og sykepleier, ed. I. Bjørk, S. Helseth, and F. Nortvedt. Gyldendal akademisk: Oslo.

    Google Scholar 

  • Martinsen, K. 2003a. Fenomenologi og omsorg. Oslo: Universitetsforlaget.

    Google Scholar 

  • Martinsen, K. 2003b. Omsorg, sykepleie og medisin. Oslo: Universitetsforlaget.

    Google Scholar 

  • Martinsen, K. 2006. Care and vulnerability. Oslo: Akribe.

  • Martinsen, K. 2012. Løgstrup og sykepleien. Oslo: Akribe.

  • Matthew In the Bible. http://www.bibleing.com/versions/kjv/kjv_matthew26.htm. Accessed 25 May 2014.

  • Munhall, P.L. 2012. Nursing research: A qualitative perspective. Sudbury, MA: Jones and Bartlett.

    Google Scholar 

  • Nurminen, M. 2009. Tid och det tidlösa i tiden Time and the timeless within time. PhD thesis, Åbo: Akademi University.

  • Qvarnström, U. 1979a. På dødsleiet Tanker og opplevelser ved livets slutt. Tiden Norsk Forlag.

  • Qvarnström, U. 1979b. Patients’ reactions to impending death. International Nursing Review 26: 117–119.

    Google Scholar 

  • Qvarnström, U. 1982. På dødsleiet. Tanker og opplevelser ved livets slutt. Larvik: Tiden Norsk forlag.

    Google Scholar 

  • Rasmussen, D.M., and B. Elverdam. 2007. Cancer survivors’ experience of time: Time disruption and time appropriation. Journal of Advanced Nursing 57: 614–622.

    Article  Google Scholar 

  • Saeteren, B., U.A. Lindstrom, and D. Naden. 2011. Latching onto life: Living in the area of tension between the possibility of life and the necessity of death. Journal of Clinical Nursing 20: 811–818.

    Article  Google Scholar 

  • Sand, L., M. Olsson, and P. Strang. 2009. Coping strategies in the presence of one’s own impending death from cancer. Journal of Pain and Symptom Management 37: 13–22.

    Article  Google Scholar 

  • Saunders, C. (ed.). 1978. The management of terminal disease. London: Edward Arnold Publishers.

    Google Scholar 

  • Saunders, C. 2003. Watch with me. Sheffield: Mortal press.

  • Saunders, C., and D. Clark. 2006. Cicely Saunders: Selected writings 1958–2004. Oxford: Oxford University Press.

  • Sigurdardottir, K.R., D.F. Haugen, C. Bausewein, I.J. Higginson, R. Harding, J.H. Rosland, and S. Kaasa. 2012. A pan-European survey of research in end-of-life cancer care. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer. 20(1): 39–48.

    Article  Google Scholar 

  • Slatten, K., L. Fagerstrom, and O.E. Hatlevik. 2010. Clinical competence in palliative nursing in Norway: The importance of good care routines. International Journal of Palliative Nursing 16: 81–86.

    Article  Google Scholar 

  • Thoresen, L., T. Wyller, and K. Heggen. 2011. The significance of lifeworld and the case of hospice. Medicine, Health Care and Philosophy 14(3): 257–263.

    Article  Google Scholar 

  • Toombs, S.K. 1988. Illness and the paradigm of lived body. Theoretical Medicine 9: 201–226.

    Article  Google Scholar 

  • Toombs, S. K. 1990. The temporality of illness: Four levels of experience. Theoretical Medicine 11, 227–241.

  • Toombs, S.K. 2004. Living and dying with dignity: Reflections on lived experience. Journal of Palliative Care 20: 193–200.

    Google Scholar 

  • WMA Declaration of Helsinki (2013) Ethical principles for medical research involving human subjects. http://www.wma.net/en/30publications/10policies/b3/. Accessed 28 Oct 2013.

  • World Health Organization. 2013. Definition of palliative care [Online]. http://www.who.int/cancer/palliative/definition/en/.

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Acknowledgments

Thanks to respondents who shared valuable time and stories and to staff who organized the selection of respondents and facilitated conditions so that it was possible to conduct an interview. Also thanks to thanks to Librarian Anne Berit Lie for support searching for relevant literature and to Professor Wilfred McSherry, and Associate Professor Vigdis Brekke for valuable commentary and undertaking English language manuscript preparation. The research is funded by Haraldsplass Deaconess University College with a Research Fellow position.

Conflict of interest

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.

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Authors and Affiliations

  1. Department of Nursing and Health Care, Haraldsplass Deaconess University College, Bergen, Norway

    Sidsel Ellingsen, Åsa Roxberg & Herdis Alvsvåg

  2. Department of Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway

    Sidsel Ellingsen

  3. School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden

    Åsa Roxberg

  4. Department of Psychosocial Health, University of Agder, Kristiansand, Norway

    Kjell Kristoffersen

  5. Sunniva Centre for Palliative Care, The Medical Department, Haraldsplass Deaconess Hospital, Bergen, Norway

    Jan Henrik Rosland

  6. Department of Surgical Sciences, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway

    Jan Henrik Rosland

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  1. Sidsel Ellingsen
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  2. Åsa Roxberg
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  3. Kjell Kristoffersen
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  4. Jan Henrik Rosland
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  5. Herdis Alvsvåg
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Correspondence to Sidsel Ellingsen.

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Ellingsen, S., Roxberg, Å., Kristoffersen, K. et al. The pendulum time of life: the experience of time, when living with severe incurable disease—a phenomenological and philosophical study. Med Health Care and Philos 18, 203–215 (2015). https://doi.org/10.1007/s11019-014-9590-9

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  • DOI: https://doi.org/10.1007/s11019-014-9590-9

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