Kampen for livet i vemodets slør : å leve i spenningsfeltet mellom livets mulighet og dødens nødvendighet

The overallpurpose of this research is to develop knowledge about health and suffering in connection with serious cancer disease through the development of a contextual model describing how patients live their lives between the possibility of life and the necessity of death. The research takes its point of departure from a caring science perspective, and Gadamer's hermeneutical philosophy is chosen as the overall methodology. In addition to the caring science perspective, the existential philosophy of Kierkegaard constructs a framework of interpretation. The research consists of three empirical studies. In two of the studies 21 patients participated, whilst 8 nurses took part in the remaining study. The patients were seriously ill and the nurses had long experience of caring for seriously ill patients. Scientific conversations were used for data collection. The findings from the patient studies show that the relationship with one-self, others, God or the supernatural and nature, constitute the unit of meaning, in which the struggle between health and suffering takes place. This struggle takes the form of a dialectic movement between being delivered and being accommodated and confirmed. The patients strive, in their delivery, for health and integration, for being a self by being reconciled with one self. The patients are lonely in this struggle, as conversations related to existence and death seldom occurs with either the natural or the professional caregivers. Themes related to patients' death remain mainly unarticulated. The patients' life struggle appears on the existential level as a threefold struggle against time and annihilation, towards being accommodatedand confirmed and for restoration and reconciliation. Through the hermeneutic process the struggle at the ontological level appears as a struggle of the will between anxiety and love. The patients in this research experience their life's tragedy. A holistic interpretation of living under the pressure created between the possibility of life and the necessity of death appears to be a struggle for life in the veil of pensiveness. The nurses want to be involved in the patients' struggle, and they show a deep desire to support the dignity of the patients. The depth in the nurses' view of their responsibility for the patient as an entityof body, soul and spirit seems to be related to the nurses' understanding of life.