Meaning-Making, Illness Acceptance, and Quality of Life Among Patients Living With Advanced Cancer: A Qualitative Inquiry
Keywords:
Advanced cancer, Meaning-making, Illness acceptance, Quality of life, Palliative care, Qualitative inquiry, Patient experienceAbstract
Objective: This study aimed to explore the experiences of meaning-making, illness acceptance, and quality of life among patients living with advanced cancer in Canada.
Methods and Materials: This qualitative inquiry was conducted among 26 adult patients diagnosed with advanced or metastatic cancer who were receiving oncology or palliative care services in Canada. Participants were selected through purposive sampling to ensure variation in age, gender, cancer type, treatment status, and care setting. Data were collected through semi-structured interviews, a demographic and clinical information form, and researcher field notes. The interviews explored patients’ understanding of illness, experiences of acceptance, sources of meaning, perceived changes in identity and relationships, and definitions of quality of life during advanced disease. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. Coding was performed through repeated reading, identification of meaning units, development of initial codes, formation of categories, and extraction of overarching themes. Credibility, dependability, confirmability, and transferability were supported through peer discussion, reflexive memo writing, an audit trail, and detailed description of the research context.
Findings: The analysis identified three major themes. The first theme, reconstructing meaning in the face of advanced illness, showed that participants attempted to preserve identity, reinterpret life priorities, confront mortality, and find coherence through relationships, spirituality, contribution, and reflection. The second theme, negotiating acceptance without surrender, indicated that illness acceptance was not experienced as giving up, but as a fluctuating process of living with uncertainty, maintaining agency, balancing hope and realism, and preparing emotionally and practically for the future. The third theme, redefining quality of life in advanced cancer, revealed that participants associated quality of life with relief from physical suffering, dignity, relational closeness, normalcy in daily life, freedom from being a burden, and peace in the present.
Conclusion: The findings suggest that meaning-making, illness acceptance, and quality of life are reciprocal and dynamic processes among patients with advanced cancer. Patient-centered palliative oncology should therefore address existential meaning, emotional adjustment, dignity, family concerns, symptom relief, and personal definitions of quality of life.
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Copyright (c) 2026 Kamdin Parsakia (Author); Seyed Hadi Seyed Ali Tabar
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