Talking With Death at a Diner: Young Women's Online Narratives of Cancer

Jessica Keim-Malpass

Richard Steeves

adolescent, palliative care, cancer
ONF 2012, 39(4), 373-378. DOI: 10.1188/12.ONF.373-378

Purpose/Objectives: To gain a unique perspective of the experiences of young women with cancer (age 20-39 years at diagnosis) through analysis of their online illness blogs.

Design: A qualitative analysis of online narratives based on hermeneutic phenomenology.

Setting: Online illness blogs found through young adult cancer Web sites and social media sites such Twitter.

Sample: 16 women, aged 20-39 years, who self-identified as being diagnosed with cancer and who initiated and maintained an illness blog based on their cancer experience.

Methods: Ethnographic immersion in online culture, thematic analysis based on line-by-line coding, and construction of themes and meanings.

Main Research Variables: Transitions from diagnosis, through treatment, to long-term survivorship.

Findings: Themes were identified as the women processed their diagnosis: living in the middle, new normal, urgency, and transition into the abyss.

Conclusions: The narratives shared on illness blogs offer an online place for expression of emotion, information exchange, and online social support. Emotional catharsis in the young women's narrative elucidated the experiences of transition through diagnosis, treatment, and survivorship that allow a better understanding of their emotional and psychosocial needs.

Implications for Nursing: Illness narratives are a naturalistic form of inquiry that allow nurses to understand the experience of the patient beyond the traditional clinic setting. This initial study provides a point for understanding the content of online narratives and has vast implications for nursing-based interventions.

Jump to a section


    Bach, L.A. (2008). Blogging during terminal care: Communication, color schemes, and creating a community. Journal of Clinical Oncology, 26, 4504-4506. doi:10.1200/JCO.2007.15.4443
    Bleyer, A. (2007). Young adult oncology: The patients and their survival challenges. CA: A Cancer Journal for Clinicians, 54, 242-255. doi:10.3322/canjclin.57.4.242
    Bleyer, A., & Barr, R. (2007). Cancer in adolescents and young adults. Heildelberg, Germany: Springer.
    Bleyer, A., & Barr, R. (2009). Cancer in young adults 20 to 39 years of age: Overview. Seminers in Oncology, 36, 194-206. doi:10.1053/j.seminoncol.2009.03.003
    Bleyer, W.A. (2002). Cancer in older adolescents and young adults: Epidemiology, diagnosis, treatment, survival, and importance of clinical trials. Medical and Pediatric Oncology, 38, 1-10. doi:10.1002/mpo.1257
    Cohen, M.Z., Kahn, D.L., & Steeves, R.H. (2000). Hermeneutic phenomenological research: A practical guide for nurse researchers. Thousand Oaks, CA: Sage.
    Geiger, A.M., & Castellino, S.M. (2011). Delineating the age ranges used to define adolescents and young adults. Journal of Clinical Oncology, 29, e492-e493. doi:10.1200/JCO.2011.35.5602
    Kim, S.Y. (2009). Content analysis of cancer blog posts. Journal of the Medical Library Association, 97, 260-266. doi:10.3163/1536-5050.97.4.009
    Laccetti, M. (2007). Expressive writing in women with advanced breast cancer. Oncology Nursing Forum, 34, 1019-1024. doi:10.1188/07.ONF.1019-1024
    Lincoln, Y., & Guba, E. (1985). Naturalistic inquiry. Beverly Hills, CA: Sage.
    Morris, D.B. (2011). Narrative and pain: Towards an integrative model. In R.J. Moore (Ed.), Handbook of pain and palliative care (pp. 733-752). New York, NY: Springer.
    Narimatsu, H., Matsumura, T.M., Kishi, Y., Yugi, K., Kami, M., Komatsu, T., … Nakata, Y. (2008). Detailed analysis of visitors to cancer-related Web sites. Journal of Clinical Oncology, 26, 4219-4223. doi:10.1200/JCO.2008.18.7468
    Pennebaker, J.W., & Seagal, J.D. (1999). Forming a story: The health benefits of narrative. Journal of Clinical Psychology, 55, 1243-1254. doi:10.1002/(SICI)1097-4679(199910)55:10<1243::AID-JCLP6>3.0.CO;2-N
    Shaha, M. (2003). The omnipresence of cancer. European Journal of Oncology Nursing, 7, 191-196. doi:10.1016/S1462-3889(03)00026-7
    Shaha, M., & Bauer-Wu, S. (2009). Early adulthood uprooted: Transitoriness in young women with breast cancer. Cancer Nursing, 32, 246-255. doi:10.1097/NCC.0b013e31819b5b2e
    Shaha, M., Cox, C.L., Hall, A., Porett, T., & Brown, J. (2006). The omnipresence of cancer: Its implications for colorectal cancer. Cancer Nurse Practice, 5(4), 35-39. doi:10.1016/S1462-3889(03)00026-7
    Steeves, R.H., & Kahn, D.L. (1987). Experience of meaning in suffering. Journal of Nursing Scholarship, 19, 114-116. doi: 10.1111/j.1547-5069.1987.tb00605.x (2010). I'm too young for this. Retrieved from
    Thielst, C.B. (2007). Weblogs: A communication tool. Journal of Health Management, 52, 287-289.
    Treadgold, C.L., & Kuperberg, A. (2010). Been there, done that, wrote the blog: The choices and challenges of supporting adolescents and young adults with cancer. Journal of Clinical Oncology, 28, 4842-4849. doi:10.1200/JCO.2009.23.0516
    van Manen, M. (1994). Researching lived experience: Human science for an action sensitive pedagogy. New York, NY: State University of New York Press.
    Zickuhr, K. (2010). Generations 2010. Washington, DC: Pew Internet andAmerican Life Project. Retrieved from