The components of courage in chronically ill adolescents: a phenomenological study




Haase, Joan

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The problem of this study was: What are the common components of the lived-experience of courage in chronically ill adolescents? An essential structure of courage as experienced by chronically ill adolescents was derived. The conceptual orientation was phenomenological. The sample was purposive, consisting of 9 chronically ill adolescents between 15 and 21 years of age. An unstructured interview was used to obtain the participants' subjective experiences of courage. The descriptions were analyzed phenomenologically using an adaptation of Colaizzi's (1978) procedure. Significant statements were extracted, meanings were formulated, themes were identified. Thirty-one theme clusters in 9 categories were derived.

The essential structure of courage includes the following characteristics: A health-related event occurs which is perceived as an unreal, unclearly defined danger. The sense of unreality emerges into a gradual personal awareness of the situation as being one of courage. An evaluation process occurs to more clearly define the nature of the situation and to make decisions about how to deal with it. Coping strategies were identified or developed to deal actively, but also to avoid dealing exclusively with the situation. The situation of courage is dynamic and occurs in a spiral regressive-progressive manner. Awareness of the situation as one of courage occurs through daily encounters with many mini-situations of courage and through the interpersonal context of relationships with others. Physical changes occur. Procedures and treatments are endured. Relationships are altered. Behavioral and affective responses occur. Supportive relationships with health care personnel, family and others with similar conditions aid the progress towards resolution of the situation. Transcendence themes of hope and faith aid in the progress towards awareness and resolution. Resolution is characterized by a sense of mastery, accomplishment and competence. As a part of resolution, there is motivation to maintain or improve the situation and to help and inspire others. There is an acknowledgement and acceptance that the lived-experience of courage has contributed to the creation of self. A sense of God's presence and control is acknowledged.

The relationship of courage to heroism, creativity, humor, stress and coping are discussed as are the implications of the study for health care personnel.



Chronic illness, Adolescents, Courage