Content area
Full text
Purpose: To present the Shifting Perspectives Model of Chronic Illness, which was derived from a metasynthesis of 292 qualitative research studies.
Design: The model was derived from a metasynthesis of qualitative research about the reported experiences of adults with a chronic illness. The 292 primary research studies included a variety of interpretive research methods and were conducted by researchers from numerous countries and disciplines.
Methods: Metastudy, a metasynthesis method developed by the author in collaboration with six other researchers consisted of three analytic components (meta-data-analysis, meta-- method, and metatheory), followed by a synthesis component in which new knowledge about the phenomenon was generated from the findings.
Findings: Many of the assumptions that underlie previous models, such as a single, linear trajectory of living with a chronic disease, were challenged. The Shifting Perspectives Model indicated that living with chronic illness was an ongoing and continually shifting process in which an illness-in-the-foreground or wellness-in-the-foreground perspective has specific functions in the person's world.
Conclusions: The Shifting Perspectives Model helps users provide an explanation of chronically ill persons' variations in their attention to symptoms over time, sometimes in ways that seem ill-advised or even harmful to their health. The model also indicates direction to health professionals about supporting people with chronic illness.
[Key words: chronic illness, metasynthesis, qualitative research]
The Shifting Perspectives Model is a model of chronic illness that arose from the synthesis of qualitative research findings. This model allows users to extend the contributions of previous attempts to describe the experience of chronic illness, clarify certain perplexities that have confronted students of chronic illness in the past, and offer new understanding about why people with chronic illness may manifest behaviors that at first glance seem ill-- advised and even harmful. Many paradoxes that occur in living with a chronic illness, as well as some unintended outcomes when people with chronic illness attempt to use the health care system, are revealed.
Research Design
The data for this paper were derived from a metasynthesis, or a metastudy, of 292 qualitative research reports pertaining to chronic physical illness. The metastudy research team consisted of seven investigators; the author was the principal investigator. Metastudy is a systematic analytic and synthesis research method (Thorne & Paterson, 1998). It is an...