Stories of Aging with HIV: (Un)Certainty and Sense Making

dc.contributor.authorBeuthin, Rosanne E.
dc.contributor.supervisorSheilds, Laurene Elizabeth
dc.contributor.supervisorBruce, Winifred Anne
dc.date.accessioned2014-09-09T18:22:04Z
dc.date.available2014-09-09T18:22:04Z
dc.date.copyright2014en_US
dc.date.issued2014-09-09
dc.degree.departmentSchool of Nursing
dc.degree.levelDoctor of Philosophy Ph.D.en_US
dc.description.abstractTo live HIV positive and age into older adulthood is a new phenomenon. Research is helping to identify how the body is biologically impacted by the complex convergence of the virus, antiretroviral drug treatment, and aging. And yet there is more. One has to live in their body. Believing that stories of living with illness hold meaning, we also need to understand the lived experience of persons aging with HIV. When we engage and listen to stories of everyday lived experience, we are afforded a way to gain insight into particulars of aging with HIV, and this in turn generates understanding and compassion that can connect and teach all of humanity about the broader experience of life. The intent of this dissertation is to present the narrative inquiry I have undertaken over a five year period. I begin with an introduction to the phenomenon of aging with HIV and then present four manuscripts, two that highlight research findings related to metaphors and themes within stories, and two that focus on the interview process and narrative practice. In a concluding chapter I weave together my emergent understanding of what it means to age with HIV, narrative inquiry, and discuss implications of the findings that may take nursing and nursing care forward. In the first manuscript I address tensions that arose and troubled my narrative interviewing approach. Tensions arose when a) presence was tempered by performance, b) power by equality, c) leading by following, d) insider by outsider, e) being non-influential by social influences, and f) trust tempered by responsibility. These tensions, which I refer to as a dynamic process of breathing in the mud, can act as catalysts that ignite clarity and advance narrative interviewing. In the second manuscript I explore metaphors within the stories of 5 adults’ experiences of aging with HIV. Metaphors reveal a complex struggle of living in-between tensions of uncertainty and hope, of facing death and living in the moment, and of hurt amidst joys of evolving identity. The overarching metaphor of “shadows and sunshine” reveals that to age with HIV is to survive and live in a fragile state, balancing multiple shadows such as stigma and side effects with joyful experiences of support and belonging. In the third manuscript I present results of a narrative analysis exploring HIV and aging stories of five adults, age 55-62, who have lived with HIV for 13-24 years. In analyzing the co-constructed stories, six common storylines were identified: the illness embodied, the journey of sense making of, intimacy with death and loss, ongoing secrets and stigma, evolving identity, and living in connection. These findings illustrate the vitalness of telling one’s illness story, as sense making happens in the telling and supports one to adapt. The final manuscript is a call to action and emphasizes cultivating a narrative sensibility in nursing practice. I offer the mnemonic STORIED to help nurses weave together essential elements of a narrative practice approach: Subjective, Tell/Listen, Openness, Reflection, Invite/Intention, Engage, and Document.en_US
dc.description.proquestcode0569en_US
dc.description.proquestemailrosanne.beuthin@shaw.caen_US
dc.description.scholarlevelGraduateen_US
dc.identifier.bibliographicCitationBeuthin, R. (2014). Breathing in the mud: Tensions in narrative interviewing. International Journal of Qualitative Methods, 13, 122-134.en_US
dc.identifier.bibliographicCitationBeuthin, R. (2014). Cultivating a narrative sensibility in nursing practice. Journal of Holistic Nursing, 32(2) online.en_US
dc.identifier.bibliographicCitationBeuthin, R., Bruce, A, & Sheilds, L. (2014). Storylines of aging with HIV: Shifts toward sense making. Qualitative Health Research. In press.en_US
dc.identifier.bibliographicCitationBeuthin, R., Sheilds, L., and Bruce, A. (2014) Shadows and sunshine: What metaphors reveal about aging with HIV. Canadian Journal of Nursing Research. In press.en_US
dc.identifier.urihttp://hdl.handle.net/1828/5670
dc.languageEnglisheng
dc.language.isoenen_US
dc.rights.tempAvailable to the World Wide Weben_US
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/ca/*
dc.subjectmetaphoren_US
dc.subjectnarrative inquiryen_US
dc.subjectstoriesen_US
dc.subjectagingen_US
dc.subjectHIV/AIDSen_US
dc.subjectnursing practiceen_US
dc.subjectsocial constructionismen_US
dc.subjectrelationalen_US
dc.subjectstigmaen_US
dc.titleStories of Aging with HIV: (Un)Certainty and Sense Makingen_US
dc.typeThesisen_US

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