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CHAPTER 30 Carolyn L. Wiener; Marylin J. Dodd 597

MAJOR CONCEPTS & DEFINITIONS—cont’d
types of work and, ultimately, one’s identity are were highly dynamic and responsive and occurred in
transformed. varied combinations and configurations across the
A major contribution of this work was the delin- illness trajectory for different players in the organiza-
eation of types of uncertainty abatement work (Table tion. Those enacting these strategies affected the
30–2). These activities were enacted to lessen the conception of self when they monitored others’ re-
impact of the varied states of uncertainty induced by sponses to the strategy as they attempted to manage
undergoing cancer chemotherapy. These strategies living with illness.

TABLE 30-1 Illness Trajectory: States of Uncertainty
Domain Sources of Uncertainty Dimensions of Uncertainty

UNCERTAIN TEMPORALITY Life is perceived to be in a Loss of temporal predictability prompts
constant state of flux related concerns surrounding:
to illness and treatment.
Taken-for-granted expectations The self of the past is viewed • Duration: how long
regarding the flow of life events differently (e.g., the way it used • Pace: how fast
are disrupted. to be). • Frequency: how often the experience
A temporal disjunction in the Expectations of the present of time is distorted (i.e., stretched out,
biography self are distorted by illness constrained, or limitless)
and treatment.
Anticipation of the future self
is altered.
UNCERTAIN BODY Faith in the body is shaken Ambiguity in reading body signs.
(body failure). Concerns surrounding:
Changes related to illness and The conception of the former • What is being done to the body
treatment are centered in body (the way it used to be) • Jeopardized body resistance
one’s ability to perform usual comingles with the altered state • Efficacy and risks of treatment
activities involving appearance, of the body at present and the • Disease recurrence
physiological functions, and changed expectations for how
response to treatment. the body may perform in the
future.
UNCERTAIN IDENTITY Body failure and difficulty reading Expected life course is shattered.
Interpretation of self is distorted the new body upset the former Evidence gleaned from reading the body
as the body fails to perform in conception of self. is not interpretable within the usual
usual ways, and expectations Skewed temporality impairs the frame of understanding.
related to the flow of events expected life course. Hope is sustained despite changing
(temporality) are altered by circumstances.
disease and treatment.

Use of Empirical Evidence chemotherapy treatment. The sample for the larger
The Theory of Illness Trajectory was expanded through study included 100 patients and their families. Each
a secondary analysis of qualitative data collected dur- patient had been diagnosed with cancer (including
ing a prospective longitudinal study that examined breast, lung, colorectal, gynecological, or lymphoma)
family coping and self-care during 6 months of and was in the process of receiving chemotherapy for