AimsTo explore individuals' stories of chronic kidney disease, particularly those aspects of experience that are difficult to discuss using language (i.e. unsayable). BackgroundChronic kidney disease is continuous, but it is also life-threatening and sometimes people ask difficult questions about life and death that can be challenging and for some, impossible to discuss. These unsayables' are the focus of this article. The unsayable may reside both within and beyond language. Careful analysis of narratives of illness for sayable and unsayable aspects of the experience can help illuminate new areas of concern for people with chronic kidney disease. DesignNarrative inquiry, located in a social constructionist framework, guided this study. MethodsSecondary data analysis was conducted with 46 in-depth interviews (collected between 2008-2011) with 14 people living with chronic kidney disease. FindingsThrough narrative thematic analysis, we identify that the unsayable includes the following five themes: living with death, embodied experiences that were difficult to language, that which was unthinkable, unknowable mystery and that which was untold/unheard. Whereas the first four themes attend to that which is unsayable for people living with chronic kidney disease, the last theme acknowledges that which is unsayable to people living with chronic kidney disease. ConclusionNot all experiences of illness can be explicitly articulated in language. Listening for both the sayable and unsayable aspects of life with chronic and life-threatening illness is an important nursing role.
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Indiana Univ, Richard L Roudebush VA Med Ctr, Indianapolis, IN USAMeyer Childrens Hosp IRCCS, Nephrol & Dialysis Unit, Florence, Italy
Agarwal, Rajiv
Chan, Juliana C. N.
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Chinese Univ Hong Kong, Prince Wales Hosp, Li Ka Shing Inst Hlth Sci, Dept Med & Therapeut, Hong Kong, Peoples R China
Chinese Univ Hong Kong, Prince Wales Hosp, Hong Kong Inst Diabet & Obes, Shatin, Hong Kong, Peoples R ChinaMeyer Childrens Hosp IRCCS, Nephrol & Dialysis Unit, Florence, Italy
Chan, Juliana C. N.
Levin, Adeera
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Univ British Columbia, Dept Med, Div Nephrol, Vancouver, BC, Canada
Prov Hlth Serv Author, BC Renal, Vancouver, BC, CanadaMeyer Childrens Hosp IRCCS, Nephrol & Dialysis Unit, Florence, Italy
Levin, Adeera
Kalyesubula, Robert
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African Community Ctr Social Sustainabil, Nakaseke, Uganda
Makerere Univ, Coll Hlth Sci, Dept Physiol, Kampala, UgandaMeyer Childrens Hosp IRCCS, Nephrol & Dialysis Unit, Florence, Italy
Kalyesubula, Robert
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Karam, Sabine
Nangaku, Masaomi
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Univ Tokyo, Div Nephrol & Endocrinol, Bunkyo City, Tokyo, JapanMeyer Childrens Hosp IRCCS, Nephrol & Dialysis Unit, Florence, Italy
Nangaku, Masaomi
Rodriguez-Iturbe, Bernardo
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INCMN Salvador Zubiran, Dept Nephrol & Mineral Metab, Mexico City, MexicoMeyer Childrens Hosp IRCCS, Nephrol & Dialysis Unit, Florence, Italy
Rodriguez-Iturbe, Bernardo
Anders, Hans-Joachim
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Maximilians Univ, Hosp Ludwig, Dept Med 4, Div Nephrol, Munich, GermanyMeyer Childrens Hosp IRCCS, Nephrol & Dialysis Unit, Florence, Italy
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Univ Calif Irvine, Div Nephrol Hypertens & Kidney Transplantat, Orange, CA 92668 USA
Tibor Rubin Vet Affairs Med Ctr, Long Beach, CA USAUniv Calif Irvine, Div Nephrol Hypertens & Kidney Transplantat, Orange, CA 92668 USA
Kalantar-Zadeh, Kamyar
Jafar, Tazeen H.
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Duke NUS Grad Med Sch, Singapore, Singapore
Singapore Gen Hosp, Dept Renal Med, Singapore, Singapore
Duke Global Hlth Inst, Durham, NC USAUniv Calif Irvine, Div Nephrol Hypertens & Kidney Transplantat, Orange, CA 92668 USA
Jafar, Tazeen H.
Nitsch, Dorothea
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London Sch Hyg & Trop Med, Fac Epidemiol & Populat Hlth, London, England
United Kingdom Renal Registry, Bristol, Avon, England
Royal Free London NHS Fdn Trust, Dept Nephrol, London, EnglandUniv Calif Irvine, Div Nephrol Hypertens & Kidney Transplantat, Orange, CA 92668 USA
Nitsch, Dorothea
Neuen, Brendon L.
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Univ New South Wales Sydney, George Inst Global Hlth, Sydney, NSW, AustraliaUniv Calif Irvine, Div Nephrol Hypertens & Kidney Transplantat, Orange, CA 92668 USA
Neuen, Brendon L.
Perkovic, Vlado
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Univ New South Wales Sydney, Fac Med, Sydney, NSW, AustraliaUniv Calif Irvine, Div Nephrol Hypertens & Kidney Transplantat, Orange, CA 92668 USA
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Hop Europeen Georges Pompidou, AP HP, Serv Urol, F-75015 Paris, France
Univ Paris 05, F-75006 Paris, FranceCHU Montpellier, Serv Urol & Transplantat Renale, F-34090 Montpellier, France
Timsit, M. O.
Kleinclauss, F.
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CHRU Besancon, Serv Urol & Transplantat Renale, F-25030 Besancon, France
Univ Franche Comte, F-25030 Besancon, France
INSERM, UMR 1098, F-25030 Besancon, FranceCHU Montpellier, Serv Urol & Transplantat Renale, F-34090 Montpellier, France