Illness Experiences among Chinese College Students: A Negotiation Process between Social Connections and Protection of Self-Image

Sunny ZQ LI (Guangzhou Yuekang Social Service Center, Guangzhou, China)
Johnston HC WONG (Faculty of Humanities and Social Sciences, BNU-HKBU United International College, Zhuhai, Guangdong, China)

Article ID: 4756



This study explored the experience of illness in relation to self-image, biographical disruption, and the process of coping through semi-structured interviews with students of a university in China. Twelve students were recruited under three categories, having a physical chronic illness, mental health illness, and chronic multiple morbidities. Indepth interviews were conducted and content analyses were applied to their recordings to identify major themes and subordinate themes in the illness experience. Results showed a distorted sense of self and biographical disruptions in young adulthood were common, as reported by the respondents. Students tried to cope with these disruptions with both individual strengths and social support, but not always with positive results. Reconstruction of self, in the analysis of illness experiences, was found a crucial strategy in overcoming disruptions. Social support of evaluative nature facilitated the adoption of the reconstruction strategy. A network-building approach is recommended for student services in higher education whereas further research is necessary to understand the processes of self-reconstruction.


Illness experience;Biographical disruption;Coping strategies;Higher education

Full Text:



[1] Wu, L., 2018. Health Management Blue Book China Health Management and Health Industry Development Report No. 1. Social Sciences Academic Press (China). 13/1067522.shtml.

[2] Jia, Y., Qi, Y., Han, Y., et al., 2018. Prevalence of Chronic Diseases among College Students in Qiqihaer. Chinese Journal of School Health. 39(3), 468-470.

[3] Centers for Disease Control and Prevention, 2016. Chronic diseases: The leading cause of death and disability in the United States. Retrieved September 18, 2020, from overview/.

[4] Jia, C.Z., 2016. A Research and Analysis of College Students’ Health Problems and Health Education Needs. Science-Technology and Management. 18(5), 119-113. DOI:

[5] Jung, K., 2003. Chronic illness and academic accommodation: Meeting disabled students’ “unique needs” and preserving the institutional order of the university. Journal of Sociology and Social Welfare. 30(1), 91-112.

[6] Katie, M.H., Janice, C., Stapley, 2013. The College Experience for Students with Chronic Illness: Implications for Academic Advising. NACADA Journal. 33(1), 61-70. DOI:

[7] Carroll, J.M., Muller, C., Pattison, E., 2016. Cooling Out Undergraduates with Health Impairments: The Freshman Experience. The Journal of Higher Education. 87(6), 771-800. DOI:

[8] Gao, G., 2017. Analysis of Diseases Affecting College Students’ Study in a University and its Preventive Measures. Guide of China Medicine. 15(10). DOI:

[9] Herts, K.L., Wallis, E., Maslow, G., 2014. College freshmen with chronic illness: A comparison with healthy first-year students. Journal of College Student Development. 55(5), 475-480. DOI:

[10] Herts, K.L., Wallis, E., Maslow, G., 2014. College freshmen with chronic illness: A comparison with healthy first-year students. Journal of College Student Development. 55(5), 475-480. DOI:

[11] Ferro, M.A., Rhodes, A.E., Kimber, M., et al., 2017. Suicidal Behaviour Among Adolescents and Young Adults with Self-Reported Chronic Illness. Canadian Journal of Psychiatry. 62(12), 845-853.

[12] Royster, L., Marshall, O., 2008. The Chronic Illness Initiative: Supporting College Students with Chronic Illness Needs at DePaul University. Journal of Postsecondary Education and Disability. 20(2), 120-125.

[13] Liao, R., Xia, C.C., 2019. Present Situation and Prospect of Psychological Service System for College Students with Mental Disorders. Beijing Education. 2019 (12).

[14] Couzens, D., Poed, S., Kataoka, M., et al., 2015. Support for students with hidden disabilities in universities: A case study. International Journal of Disability, Development and Education. 62(1), 24-41. DOI:

[15] Hagell, A., 2017. An Overview of Research on Key Issues in Student Health. Association for Young People’s Health. Retrieved October 1, 2020, from uploads/2017/04/AYPH-Student-Health-Briefing.pdf.

[16] Christian, B.J., D’Auria, J.P., 1997. The child’s eye: memories of growing up with cystic fibrosis. Journal of Pediatric Nursing. 12(1), 3-12. DOI:

[17] Spencer, G., Lewis, S., Reid, M., 2018. Living with a chronic health condition: Students’ health narratives and negotiations of (ill) health at university. Health Education Journal. 77(6), 631-643. DOI:

[18] Thorne, S., Peterson, B., 1998. Shifting images of chronic illness. Image: Journal of Nursing Scholarship. 30, 173-178. DOI:

[19] Parsons, T., 1951. The Social System. Free Press.

[20] Goffman, E., 1963. Stigma: Notes on the management of a spoiled identity. Prentice Hall.

[21] Bury, M., 1982. Chronic illness as biographical disruption. Sociology of Health & Illness. 4(2), 167-182. DOI:

[22] Charmaz, K., 2000. Experiencing Chronic Illness. In Albrecht, G. L., Fitzpatrick, R & Scrimshaw. S. C (Eds.), The Handbook of Social Studies in Health & Medicine. SAGE Publication Ltd. pp. 24-35.

[23] Pranka, M., 2018. Biographical disruption and factors facilitating overcoming it. 6th International Interdisciplinary Scientific Conference SOCIETY. HEALTH. WELFARE (Part II), Article 03007. DOI:

[24] Strauss, A.L., 2007. Mirrors and Masks: The Search for Identity. New Brunswick.

[25] Steinberg, H., 2020. Distance and acceptance: Identity formation in young adults with chronic health conditions. Advances in Life Course Research. DOI:

[26] Martire, L.M., Schulz, R., 2007. Involving family in psychosocial interventions for chronic illness. Association for Psychological Science. 16(2), 90-94. DOI:

[27] Wilson, C., Stock, J., 2019. The impact of living with long-term conditions in young adulthood on mental health and identity: What can help? Health expectations: an international journal of public participation in health care and health policy. 22(5), 1111-1121. DOI:

[28] Arnett, J.J., 2000. Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist. 55(5), 469-480. DOI:

[29] Charmaz, K., 1983. Loss of self: a fundamental form of suffering in the chronically ill, Sociology of Health and Illness. 5, 168-95. DOI:

[30] Frank, A., 1993. The Rhetoric of Self-Change: Illness Experience as Narrative. The Sociological Quarterly. 34(1), 39-52.

[31] Bury, M., 1991. The sociology of chronic illness: a review of research and prospects. Sociology of Health & Illness. 13(4), 451-468. DOI:

[32] Williams, G.H., 1984. The genesis of chronic illness: narrative reconstruction. Sociology of Health and Illness. 6, 175-200. DOI:

[33] Robinson, C.A., 1993. Managing Life with a Chronic Condition: The Story of Normalization. Qualitative Health Research. 3(1), 6-28. DOI:

[34] Thorne, S.E., 1993. Negotiating Health Care: The Social Context of Chronic Illness. Sage.

[35] Spencer, G., Lewis, S., Reid, M., 2018. Living with a chronic health condition: Students’ health narratives and negotiations of (ill) health at university. Health Education Journal. 77(6), 631-643. DOI:

[36] Smith, J.A., Flowers, P., Larkin, M., 2009. Interpretative phenomenological analysis: theory, method, research. Sage.

[37] Smith., J.A., Eatough, V., 2015. Interpretive Phenomenological Analysis. E. Lyons, & A. Coyle. (Eds.), Analysing Qualitative Data in Psychology. SAGE. pp. 50-67.

[38] Larkin, M., Watts, S., Clifton, E., 2006. Giving voice and making sense in interpretative phenomenological analysis. Qualitative Research in Psychology. 3(2), 102-120. DOI: 1478088706qp062oa

[39] Kralik, D., 2002. The quest for ordinariness: Transition experienced by midlife women living with chronic illness. Journal of Advanced Nursing. 39(2), 146-154. DOI:

[40] Mathieson, C., Stam, H., 1995. Renegotiating identity: cancer narratives. Sociol Health Illness. 17, 283-306.


  • There are currently no refbacks.
Copyright © 2022 Johnston HC WONG, Sunny ZQ LI

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.