Exploring life changes for patients diagnosed with 'Alcoholic Liver Disease' - A qualitative study in Husserl's and Merleau-Ponty's thought.

This thesis explored life change with a diagnosis of Alcoholic Liver Disease (ALD). Qualitative, in-depth longitudinal interviews with eight participants attending hospital out-patients, provided a foundation to understand ‘alcoholic'. By applying Thematic Analysis within the social constructivism tradition at the initial analysis phase, combined with phenomenological-existential theories as a framework to bracket and generate socially shared meanings from the data, rich, detailed descriptions of the phenomena were illuminated. Altogether, human values in the generation of knowledge and how things are seen in the world form complex systems in themselves that are influenced by family, friends and health professionals to mention a few. Yet, what drives an individual to adapt and act through making sense of life involves mental processes that interconnect. The dominant paradigm showed these are bodily related involving self-evaluative behaviour that is weighed up under the gaze of others. These connections were embodied in various social identities and subjectivities related to living with a life-threatening disease and chronic illness. The philosophy of Husserl and Merleau-Ponty, provided critical support in the constitution of meaning in human experience of ALD-related cirrhosis and change in a person’s life. These turning points were central in learning how to live with it. Interwoven encapsulated issues of stigma, dying and death characterised by learning that demands the person thinks deeply about their life and responsibility to make decisions. Four paradigms across participants offered insights into a condition that emerged as: (a) often silent producing, (b) uncertainty across the life course. The concept of social identities delimitated: (c) difference, embodied by particular histories over time that were responsive to contextual conditions, and; (d) Identity work was necessary to restore a sense of self. Practice implications for nursing emphasised a person-centred approach for patients with ALD to preserve and restore autonomy, in order to prioritise self-management capability.