Making sense of different illness realities: restructuring of illness meaning among Swedish-born women.

This study explores restructuring of illness meaning among eight Swedish-born female patients, assessed as somatizing, encountering caregivers imposing a "psychological language" of distress. Data were collected 1997-2001 from 32 interviews and analysed with a Grounded Theory approach. Two major trends were identified in the participants' process of restructuring illness meaning: first, a trend of accepting a "psychological language" of understanding distress and then of paying attention to stress and demanding work conditions. The term "burnout" was introduced. For participants, giving meaning to illness had been a continuous and interactive process in which new meanings had been integrated within a framework of both constancy and change. Restructuring illness meaning had not been uncomplicated. Participants tried to bridge illness perspectives and treatment strategies within their daily life situations of handling distress. The social context had been important for bridging gaps in illness perspectives and in creating coherence between frames of meanings. The results support the view that Antonovsky's concept of Sense of Coherence (SOC) may have relevance when considering the process of restructuring illness meaning, and that constructing coherence between experience, expression, past and new meanings given to illness, may be significant for patients' recovery. The results stress the importance of research exploring the interaction between individuals and social and cultural groups in multicultural milieus in order to obtain insights as to how people make sense of their clinical encounter.