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The Notion of Time in Symptom Experiences

Henly, Susan J.; Kallas, Kathryn D.; Klatt, Colleen M.; Swenson, Karen K.


Background The experience of unpleasant sensations associated with the presence of symptoms prompts self-care or help seeking to obtain explanations for the symptoms, manage emotional responses, or obtain treatment for symptom alleviation and elimination.

Objective The purpose of this article is to summarize and comment on three existing symptom theories, with special attention to temporal factors.

Methods Existing theories are synthesized as the time dimensions of symptom experiences and symptom management processes are elucidated. Clinical examples and findings from empirical studies illustrate critical points.

Discussion Existing theories describing the symptom experience and the process of symptom management refer implicitly to the role of time or use limited dimensions of time. Symptom experiences in time (SET) theory is proposed as a synthesis and extension of existing theories. The SET theory conceives the symptom experience as a flow process that explicitly incorporates temporal dimensions. Four dimensions of time are recognized: clock-calendar, biologic-social, perceived, and transcendent time. The four temporal dimensions are placed against a backdrop of “meaning-in-time” that brings forth the potential for transformation in a symptom experience. Increasing sophistication in design, measurement, and data analysis is required to test and evaluate SET theory-based propositions.

Conclusions The SET theory extends previous work by incorporating multiple temporal dimensions that reflect the human experience of health and illness manifested in the expression and management of symptoms.

Susan J. Henly, PhD, RN, is Associate Professor, School of Nursing, University of Minnesota, Minneapolis.

Kathryn D. Kallas, MSN, RN, is doctoral student, School of Nursing, University of Minnesota, Minneapolis.

Colleen M. Klatt, MA, is doctoral student, Department of Communication Studies, University of Minnesota, Minneapolis.

Karen K. Swenson, MS, RN, is doctoral student, School of Nursing, University of Minnesota, Minneapolis.

Accepted for publication May 27, 2003.

The authors thank Kay Wicker for her preparation of the graphic art.

Corresponding author: Susan J. Henly, PhD, RN, School of Nursing, University of Minnesota, 6-101 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455 (e-mail:

© 2003 Lippincott Williams & Wilkins, Inc.