The 1997 Helene Hudson Memorial Lecture. Reaching to the depths of the soul: understanding and exploring meaning in illness.

The nurse who hopes to respond to the experience of individuals and their families with a diagnosis of cancer must understand and explore meaning in illness. Meaning has been described as a fundamental dimension of personhood (Cassel, 1982). There can be little understanding of the person's behaviour and responses to cancer without understanding the meaning of illness in their lives. The meaning ascribed to a situation can have a profound impact on the individual and family's coping and adjustment and may influence their relationships with the health care team. Meaning in illness may be influenced by cultural beliefs, religion, values, life philosophy and past experience. Meaning goes beyond the surface reactions of the individual to the very depths of the person's soul and can be a source of despair and suffering. Meaning evolve throughout the illness trajectory and can have a profound influence on the person's lived experience. The skills required to understand meaning and the lived experience of illness for the individual are extensive. It is only through true presence, mutual understanding and a sharing of the life of the other that nurses are able to understand and co-construct meaning. It is a respect and understanding of the individual within the whole context of their personhood and the meanings assigned to their experience of cancer which allows the nurse to practice beyond the surface, to touch the person's soul.