Living with a Chronic Wound: A Heideggerian Hermeneutical Analysis

Dissertation, Virginia Commonwealth University (1998)
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Abstract

One of the changes occurring with the increased longevity of the population is the emergence of a growing segment of individuals with chronic health care problems. Among the costlier sequelae of chronicity is the occurrence of chronic wounds. A wound, in the broadest sense, is a disruption of the normal anatomic structure and function. Acute wounds progress through an orderly and timely sequence of repair leading to the restoration of anatomic and functional integrity. Time is relative, and wound healing is dependent on the pathologic process and the overall health of the patient. In a chronic wound, the normal, timely process of repair is disrupted. The orderly sequence of healing goes awry. The focus of this research was the emotional factors; what is it like to live with a wound that does not heal? ;Heideggerian hermeneutics, which is one of several approaches to interpretive scholarship, was used for this study. Heideggerian hermeneutics seeks to reveal meanings, through interpreting language or texts. Central to Heideggerian phenomenology is its concern with existential ontology, the science of being, and Being, the condition that allows being to be. Heidegger described the exploration of being as the authentic way of being-in-the world. ;Ten participants with chronic wounds were interviewed. Data analysis on the transcripts were done using a qualitative software program, "MARTIN", and then using Diekelmann's framework of Heideggerian hermeneutical analysis. Further analysis was done by a person familiar with linguistics. Themes were grouped into two constitutive patterns. ;The pattern of Contending with the Wound, consisted of five themes. They were, noticing, oozing and smelling, losing sleep, being in pain, and surviving techno-therapeutic regimes. The other constitutive pattern, Staying home: Staying back was comprised of two themes, being isolated, and trouble walking. ;The textual exemplars of the themes were in the participants' own words. Having a chronic wound is a different way of "being-in-the-world" than being healthy, and wound-free. Often the wound consumed their "average everydayness". Ways for healthcare providers to create caring contexts can be based on an understanding gained by listening to the participant's stories. Surviving techno-therapeutic regimes is an area for further investigation

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