Medical pluralism in the aftermath of cancer: health seeking actions and cancer patients’ shaping of trajectories to healing

Abstract

Improved treatment methods for cancer are increasing the number of survivals in Norway. In turn, the group of people struggling with late effects after the treatment is growing. Late effects could be physical, psychological or existential conditions caused by treatment or the experience of illness. This qualitative study explores health-seeking actions among nine Norwegian people with cancer, and how they shape their trajectories to healing. Various health-seeking actions were identified through content analysis, and categorized as conventional, CAM, self-care, religious coping and traditional healing. Medical pluralism particularly flourished in the aftermath of cancer. We found that the phenomenon is characterized by: 1) implementation of contradicting models of reality and making pragmatic choices, 2) continuity and change of health seeking actions, 3) medical pluralism as a process, and 4) increased use of CAM and self-care to improve health and well-being in situations where the conventional care system has few available treatment options. To support people with long-term conditions, we need to know how they choose and make sense of their health-seeking activities. We argue that trajectories to healing are dynamic and shaped by people making choices. This process could be understood in greater depth by applying the concept of medical landscapes.

Keywords:

• Medical pluralism
• medical landscapes
• health seeking actions
• CAM
• self-care
• medical anthropology
• cancer

Acknowledgement

The authors are grateful to all the participants who shared their stories and experiences. Furthermore, we thank the Norwegian Cancer Society and Regional Health Authority for the financial assistance. We are grateful for the technical support given by Brit J Drageset, Per Schrader, and Åsa Sohlèn.

Ethical approval

The Regional Committees for Medical and Health Research Ethics (REK) approved the study (2009/1293/REK Nord).

Disclosure statement

The authors report no conflicts of interest in this work.

Notes

1 Since Julie because of practical reasons was not able to participate in the fourth conversation, the fourth and fifth interview (with summary of the last 12 months) were merged together.

Additional information

Funding

This work was supported by the Regional Health Authority (Helse Nord) under Grant HST1024-11; Norwegian Cancer Society (Kreftforeningen) under Grant S-581431001.