Meaning making processes in chronic illness: The nature of sense making and benefit finding in people living with chronic fatigue syndrome

Mr Timothy Lowry (). Meaning making processes in chronic illness: The nature of sense making and benefit finding in people living with chronic fatigue syndrome Professional Doctorate, School of Psychology, The University of Queensland.

       
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Author Mr Timothy Lowry
Thesis Title Meaning making processes in chronic illness: The nature of sense making and benefit finding in people living with chronic fatigue syndrome
School, Centre or Institute School of Psychology
Institution The University of Queensland
Thesis type Professional Doctorate
Supervisor Associate Professor Ken Pakenham
Total pages 242
Total black and white pages 242
Abstract/Summary Chronic illness can be a devastating and life altering experience that propels a search for meaning in life. Chronic fatigue syndrome (CFS) is one of the most incapacitating chronic health conditions, with evidence showing significant detrimental impacts on all aspects of daily living including relationships, self care, occupational functioning, and recreational pursuits. This research aims to explore the search for meaning or ‘meaning making’ in those with CFS. Theoretical perspectives hypothesise that experiences of adversity, such as chronic illness, can disrupt or shatter fundamental assumptions and positively skewed worldviews, thereby exposing an individual to their mortality and the fragility of life. Such exposure is said to confront the individual with a meaninglessness world, thereby propelling a search for meaning and triggering meaning reconstruction or ‘meaning making’ processes that may lead them to develop explanations for (sense making) and find benefits in (benefit finding) their adversity. These two construals of meaning have been found to impact on both positive and negative indicators of adjustment to adversity. While explored across other illness groups, research to date has not examined meaning making (sense making and benefit finding) in people living with CFS. The current research therefore seeks to address this gap in both the CFS literature specifically, and the broader chronic illness literature. Study one investigated the nature of sense making in people living with CFS, and relations of sense making with both demographic and illness-related variables, and adjustment. A mixed-methods approach was utilised incorporating both qualitative and quantitative analysis, with sense making conceptualised as both a dichotomous (sense made / sense not made) variable, and continuous variable (number of sense making explanations). Anticipated sense making in those who reported not having made sense of their CFS was also explored, however was found unrelated to all adjustment outcomes. Results showed that just over half the sample (54%) reported that they were able to make sense of their having CFS, with almost all of these participants (93%) able to generate sense making explanations for their illness. Content analysis of qualitative data revealed twelve prominent sense making themes including ‘Change to lifestyle’ (41%), ‘Causal explanation’ (39%), ‘Experienced growth’ (29%), and ‘Acceptance’ (21%). While many of these themes were similar to those reported by other illness groups, those with CFS were also found to generate other CFS-illness specific sense making explanations (e.g., ‘Resolution of past concerns’). Bivariate analyses revealed that the continuous sense making variable was related to gender, specifically, females reported a higher number of sense making categories than males. Sense making was found unrelated to all illness-related variables. Multivariate analyses revealed that sense making evidenced beneficial direct effects on adjustment outcomes after controlling for gender; specifically, making sense of CFS was related to higher levels of positive affect and life satisfaction, and lower levels of depression, while a higher number of sense making categories was related to greater life satisfaction and lower levels of anxiety. Study two investigated the nature of benefit finding in people living with CFS and relations with both demographic and illness-related variables, and adjustment. A mixed-methods approach was again utilised incorporating an established measure of benefit finding (Benefit Finding Scale [BFS]; Mohr et al., 1999), plus qualitative methods to explore additional benefits emerging from the CFS illness experience that were not included in the BFS. Findings demonstrated that despite the significant negative impacts of CFS, many people with the condition reported a wide range of benefits. Factor analysis of the benefit finding measure indicated three factors (‘Personal growth’, ‘Family relations growth’, and ‘Growth in independence’). Dimensions of benefit finding were found to be associated with age, and the illness-related variables illness duration, physical disability, and fatigue severity. Multivariate analyses revealed that dimensions of benefit finding displayed differential relations with adjustment domains. While the ‘Family relations growth’ factor was found to be unrelated to all adjustment outcomes, the ‘Personal growth’ factor was found to be associated with indicators of positive adjustment (positive affect, dyadic adjustment, and life satisfaction). Additionally, the ‘Growth in independence’ factor was positively associated with positive affect. Further, benefit finding was found unrelated to the negative adjustment domains of depression and anxiety supporting theory regarding the concurrent existence of both positively and negatively toned emotions. Qualitative analysis revealed that 41% of respondents reported additional benefits, with 10 benefit finding themes emerging including themes not included in the BFS (for example, ‘Health awareness and lifestyle change’, and ‘New possibilities / opportunities’) . This research provides the only examination of sense making and benefit finding in those with CFS, and adds to the limited number of studies examining meaning-making in chronic illness. Results indicate that those with CFS engage in meaning-making processes, specifically constructing explanations for the occurrence of the illness in their lives and identifying benefits emerging through their illness experience. Further, sense making and benefit finding appear to be multi-dimensional in nature, evidencing differential relations with both demographic and illness variables, and domains of positive and negative adjustment. Findings highlight the need for further longitudinal research in this area and the development of reliable and valid CFS specific multi-item and multi-dimensional measures for the comprehensive assessment of sense making and benefit finding. Findings from this research also hold potential clinical practice implications that could inform the development of meaning-based interventions not only for those with CFS, but also more broadly for those with chronic illness; specifically incorporating both distress-relieving and meaning-enhancing strategies.
Keyword Chronic illness
Chronic Fatigue Syndrome
Meaning making
Sense making
Benefit finding
Adjustment
Quantitative
qualitative

 
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Created: Tue, 16 Nov 2010, 10:53:28 EST by Mr Timothy Lowry