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Morhaf Al Achkar| Qualitative Study of Making Meaning and Coping with Incurable Cancer With Reflections by The Researcher as a Physician and A Patient

April 22, 2019

Morhaf Al Achkar, MD, Ph.D. was born in Aleppo-Syria and migrated to the United States after finishing medical school. He obtained a Ph.D. in Research Inquiry Methodology in Social Sciences from Indiana University School of Education. Currently, he is a practicing family physician and a faculty member at the University of Washington.

In 2016, Dr. Al Achkar was diagnosed with stage 4 lung cancer. Since then, his research has focused on the experience of patients living with lung cancer. His writing is based on interviews he did with 39 patients who live, like him, with incurable cancers. He explores how these patients find meaning, cope, and build resilience.

Giving Voice to Patients

Over 40 participants from various departments across the university joined the first virtual QUAL speaker series talk. Dr. Al Achkar spoke about his work as a multi-disciplinary scholar and how he utilizes qualitative methods to conduct a variety of research projects such as health policy related to pain and opioids, patient experiences, and educational frameworks of medical residents. The majority of the QUAL discussion focused on Dr. Al Achkar’s recent autoethnographic and fieldwork-based book about patients with incurable lung cancer, Roads to Meaning and Resilience with Cancer.

Dr. Al Achkar explained that lung cancer is both a very serious disease and is highly stigmatized, and his research lends voice for lung cancer patients to share their own stories. Through qualitative interviews with 39 patients with certain types of lung cancer, Dr. Al Achkar sought to understand how patients find meaning, build strength and resilience, and cope with the struggles of cancer. Dr. Al Achkar provided a discussion about his research team, research design, theological underpinnings, and methods of qualitative analysis, as well as the results of his study.

In his study he found that many people built meaning through their lung cancer, relying on religion or philosophies. However, some did not find meaning outside of relying on their immediate experience. Others found meaning through the notion of service to others or relationships with others.

The patients in his study built their resilience through family, friends, religion, or faith, as well as learning more about the disease through personal research. Others shared that they have always been resilient or have had life experiences that lead them to see themselves as resilient, but some shared that they weren’t strong or didn’t always feel that they had strength.

In exploring how to cope with the struggle of cancer, Dr. Al Achkar found that many patients did not see themselves as someone who has lost agency but rather as having reconstructed their identity and maintained agency by holding on to relationships, shifting frameworks, living life in the here-and-now, and resting.

In summary, Dr. Al Achkar found that people bring a lot of their previously lived experiences to their cancer, such as privileges of or access to agency that they’ve had before or coping strategies they’ve learned before. He found that people live the experience of cancer in diverse ways.

Data analysis for this project was conducted concurrently with the data collection. Dr. Al Achkar explained his rigorous process for analysis consisted of 1) low-level coding; 2) meaning filed analysis; 3) validity reconstruction; and 4) an iterative process of organizing themes.

Dr. Al Achkar shared that his future research includes writing his own memoir and studying questions around identity, life and death, and existential experiences.

Advice for Qualitative Researchers

The virtual QUAL talk closed with a discussion about many practical aspects of qualitative research, such as how best to transcribe interviews, how to choose software for qualitative analysis, and advice on best practices for coding.