Table 2.

Major Themes and Exemplary Quotations

Theme	Subthemes	Quotations
Diagnosis naming or describing pathophysiology	Diagnosis name	Stage 4 breast cancer, metastatic in bones liver spleen, multiple lymph nodes. Uncertain mortality
	Not understanding/not knowing	I don’t know anything about it, I praise God and take medicine
	Pathophysiology	From what I’ve been told, the valves in my heart are weak. They are not pumping off the right amount of blood
Illness history	Medical interventions	CHF, along with other problems, have had 7 bypasses and a defibrillator. It is a constant effort with medications and procedures
	Cycles of treatments	Lung cancer, stage 3B or 4, two different doctors have told him different stages. Cancer not big, but concentrated where it cannot be removed. Been through radiation 2 times, chemo 3 times. Went in remission and has come back before
	Comorbidities	They say I have CHF, I’m diabetic, SOB, colostomy. The erratic, heart doing 2/3rds of what it’s should do, was 1/3 a year ago
Symptoms	Physical symptoms	I have both CHF and COPD, and I think it’s mostly CHF. I don’t know how it operates. SOB is principal symptom. Lack of energy, totally blah
	Limited function	It affects my life in some ways. Things I can’t do that I used to do. Not a whole lot can be done for me, only medicine
Causality	Smoking	Come from my smoking—others tell me, chemical industry that sprayed on that tobacco, worked in wood working, run a sanding machine without a mask
Prognosis	Specific prognosis	I have non-small cell lung cancer, stage 3B-4, mets to mediastinal lymph nodes. Some pleural effusion, unilateral. Prognosis is 1–3 % survival after 5 years
	General prognosis	That it is life threatening from a medical standpoint