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Fu Y, Li S, Huang L, Liu D, Wang H, Zuo F, Zhou C, Liu Y, Lin M. The mediating effect of perceived social support between family resilience and meaning in life in breast cancer patients. Support Care Cancer 2024; 32:425. [PMID: 38864918 DOI: 10.1007/s00520-024-08605-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 05/24/2024] [Indexed: 06/13/2024]
Abstract
PURPOSE The beneficial effects of family resilience and meaning in life on patients are established, but limited is known for the effect of perceived social support. We aim to investigate the impact of family resilience on the meaning of life among Chinese patients with breast cancer (BC) and to further detect whether perceived social support mediated this association. METHODS From February to June 2022, we conducted this cross-sectional study with 276 women who were diagnosed with BC in a tertial hospital in Guangdong province, China. The Chinese version of Meaning in Life Scale (C-MiLS) was used to measure the meaning in life. The Chinese version of the family resilience assessment scale (C-FRAS) and the perceived social support scale (PSSS) were adopted to obtain the family resilience and perceived social support, respectively. The mediating effect of perceived spousal support was estimated using the bootstrapped confidence interval (CI) via IBM SPSS AMOS 22.0. RESULTS The mean scores were 60.79 ± 11.63 for meaning in life, 82.08 ± 11.48 for family resilience, and 62.72 ± 12.19 for perceived social support, respectively. Our results indicated the positive correlations of meaning in life with family resilience (β = 0.822, P < 0.05) and perceived social support (β = 0.886, P < 0.05). The perceived social support exerted the mediating effect in the relationship between family resilience and meaning in life (β = 0.368 [95%CI, 0.274, 0.450], P < 0.001), accounting for 54.6% of the variance in meaning in life. CONCLUSIONS Our findings highlight that family resilience and perceived social support should be enhanced for BC patients to improve their meaning in life. In particular, the association between family resilience and meaning in life was positively mediated by perceived social support. Thus, interventions for improving family resilience and perceived social support might be useful in easing psychological distress and improving meaning in life in individuals with BC.
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Affiliation(s)
- Youyuan Fu
- Department of Breast Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China
| | - Siyi Li
- Department of Urology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China
| | - Limei Huang
- Department of Breast Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China
| | - Dan Liu
- Department of Breast Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China
| | - Huixin Wang
- Department of Breast Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China
| | - Fengjiao Zuo
- Department of Breast Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou, 510120, China
| | - Chunjiao Zhou
- Nursing Department, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), No.111, Dade Road, Yuexiu District, Guangzhou, 510120, China
| | - Yangchen Liu
- Nursing Department, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), No.111, Dade Road, Yuexiu District, Guangzhou, 510120, China
| | - Meizhen Lin
- Nursing Department, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), No.111, Dade Road, Yuexiu District, Guangzhou, 510120, China.
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Wæhrens EE, Morgan DD, la Cour K, Lyons KD, Lozano ML, De Carlo MMP, Rezende G, Pilegaard MS. International consensus on occupational therapy interventions for people with palliative care needs: A European Association for Palliative Care Group Concept Mapping study. Palliat Med 2023; 37:1389-1401. [PMID: 37534430 DOI: 10.1177/02692163231188155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
BACKGROUND While evidence shows that occupational therapists can play a key role in the care of people with palliative care needs, more knowledge about effective occupational therapy interventions for this group is needed. AIM To identify, organise and prioritise intervention components considered to be effective within occupational therapy for people with palliative care needs from the perspective of occupational therapy clinicians, managers and researchers. DESIGN Group Concept Mapping utilising a mixed methods participatory approach. Using a focus prompt, participants brainstormed, sorted, labelled and rated generated statements about effective occupational therapy intervention components. Multidimensional scaling analysis and cluster analysis were conducted. SETTING/PARTICIPANTS Snowball recruitment was used to recruit participants. Participants included occupational therapists worldwide who were able to read and write in English and were working as clinicians, managers and/or researchers with occupational therapy interventions for people with palliative care needs. RESULTS Seventy-two occupational therapists from 15 countries participated in the study representing Asia (n = 3, 20%), Europe (n = 8, 53%), Oceania (n = 2, 13%) and North America (n = 2, 13%). A total of 117 statements were identified and organised into five clusters: (1) being client-centred, (2) promoting occupational engagement to optimise quality of life, (3) involving the social and relational environment, (4) enabling occupations and (5) facilitating occupational adaptation. CONCLUSIONS Five clusters of core occupational therapy intervention components were considered to be effective when supporting people with palliative care needs. Research should use this knowledge to inform future occupational therapy interventions for this group of people.
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Affiliation(s)
- Eva Ejlersen Wæhrens
- User Perspectives and Community-based Interventions, the Research Group for Occupational Science, Department of Public Health, University of Southern Denmark, Odense C, Denmark
- The ADL Unit, The Parker Institute, Copenhagen University Hospital, Denmark
| | - Deidre D Morgan
- Research Centre for Palliative Care, Death and Dying (RePaDD), Flinders University, Adelaide, SA, Australia
| | - Karen la Cour
- User Perspectives and Community-based Interventions, the Research Group for Occupational Science, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Kathleen Doyle Lyons
- The Department of Occupational Therapy, Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA
| | - Mario Lozano Lozano
- The Department of Physical Therapy, University of Granada, Granada, Andalucía, Spain
- Instituto de Investigación Biosanitaria ibs, GRANADA, Granada, Andalucía, Spain
- The Sport and Health Joint University Institute (IMUDS), Granada, Andalucía, Spain
| | - Marysia Mr Prado De Carlo
- Division of Occupational Therapy, Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
| | - Gabriela Rezende
- Division of Occupational Therapy, Department of Health Sciences, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
| | - Marc Sampedro Pilegaard
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
- Department of Social Medicine and Rehabilitation, Gødstrup Hospital, Denmark
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Silva HLM, Valério PHM, Barreira CRA, Peria FM. Filling gaps in experiences religious understanding of people living with cancer in palliative care: a phenomenological qualitative study. BMC Palliat Care 2023; 22:127. [PMID: 37667276 PMCID: PMC10478484 DOI: 10.1186/s12904-023-01254-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 08/30/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND According to a phenomenology of contemporary religion, the analysis of religious experiences finds that they are part of an individual's search for something powerful that overcomes him seeking not only a need, but the meaning of all existence. The present study aims to contribute to a deeper understanding of the religious experiences of people living with cancer in palliative care (PC) and fill gaps in access to experience, with regard to how it was properly lived. METHODS A qualitative, phenomenological, cross-sectional study was conducted with 14 people living with cancer undergoing PC at two outpatient clinics of a public hospital. The experiences were accessed through in-depth interviews and the results were analysed according to the principles of classical phenomenology. RESULTS The patients confidently surrendered to the divine, attributing to it the power of continuity of life or not, which sustained them and launched them into horizons of hope, directing them to possibilities of achieving meaning in life, which it fed back their faith and to continue living, opening them up to an intense perception of the value of life. CONCLUSIONS The religious positions of confident surrender to the divine, to his will and a belief in his intervention, regardless of the outcome, opened possibilities to patients for the belief in the continuity of life by the power of faith. This position allowed the patients in this study to visualize achievements in the present and in the future, opening a horizon of hope, meaning and value of living. This study showed how this elements are presented and sustained, providing subsidies to health professionals seeking to provide more holistic care.
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Affiliation(s)
- Hellen Luiza Meireles Silva
- Department of Medical Images, Hematology and Clinical Oncology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
- Rua Amadeu Amaral, 340, ap 112, Vila Seixas, Ribeirão Preto, SP, Brazil.
| | | | | | - Fernanda Maris Peria
- Department of Medical Images, Hematology and Clinical Oncology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Buwana C, Dwijayanti F, Nurhidayah N, Ito Y, Bontje P. The Meaning of Occupation for Adults With Advanced Cancer: A Scoping Review. Am J Occup Ther 2023; 77:7705205130. [PMID: 37851589 DOI: 10.5014/ajot.2023.050072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023] Open
Abstract
IMPORTANCE In this scoping review, we explore the meaning of occupation for people with advanced cancer to develop and improve occupation-based services in oncology. OBJECTIVE To identify the meaning(s) of occupation for adults with advanced cancer through relevant peer-reviewed literature. DATA SOURCES Scopus, CINAHL, Medline, and PubMed were used to identify peer-reviewed articles published between 2011 and 2021. STUDY SELECTION AND DATA COLLECTION Inclusion criteria comprised research studies in English and on meaningful occupations as well as participants age 19 yr or older and diagnosed with advanced cancer. Exclusion criteria comprised non-English publications, studies with participants in an early stage of cancer, and gray literature or nonreviewed articles. FINDINGS Thirteen articles matched the inclusion criteria: 9 qualitative studies, 1 mixed-methods study, 1 case study, 1 pilot study (pretest-posttest design), and 1 retrospective study (review of clinical data). Four themes emerged from the thematic analysis: occupation benefits important relationships and connections with others, occupation as a source of physical or psychological comfort, managing one's identity through occupation, and occupation as a religious expression. CONCLUSIONS AND RELEVANCE This scoping review highlights the value of participating in an occupation for people with advanced cancer. It also shows the importance of meaningful occupations to the quality of life and well-being of adults with advanced cancer. What This Article Adds: This scoping review identifies meanings of occupation linked to the health and well-being of adults with advanced cancer to develop and improve occupation-based services in oncology.
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Affiliation(s)
- Cahya Buwana
- Cahya Buwana, PhD, MSOT, is Researcher, Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Arakawa-ku, Tokyo, Japan, and Occupational Therapist Supervisor, Department of Rehabilitation, Dharmais National Cancer Hospital, Jakarta, Indonesia;
| | - Fifi Dwijayanti
- Fifi Dwijayanti, MKM, SKM, is Researcher, Department of Research and Development, Dharmais National Cancer Hospital, Jakarta, Indonesia
| | - Ninik Nurhidayah
- Ninik Nurhidayah, Dr, MKes, SPd, SST, is Senior Lecturer, Occupational Therapy, Polytechnic of Health Kemenkes Surakarta, Surakarta, Indonesia
| | - Yuko Ito
- Yuko Ito, PhD, is Professor, Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Arakawa-ku, Tokyo, Japan
| | - Peter Bontje
- Peter Bontje, PhD, is Professor, Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Arakawa-ku, Tokyo, Japan
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Brose JM, Willis E, Morgan DD. The intentional pursuit of everyday life while dying: A longitudinal qualitative study of working-aged adults living with advanced cancer. Palliat Med 2023; 37:1210-1221. [PMID: 37310026 PMCID: PMC10503259 DOI: 10.1177/02692163231180911] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND People living with advanced cancer experience functional decline and increasing difficulty participating in activities of daily living over their final year of life, consequently reducing quality of life. Palliative rehabilitation may serve to mitigate some of these challenges by optimising function. However, limited research and theory explore the rehabilitative process of adaptation amid increasing dependency, often experienced by people living with advanced cancer. AIM To explore the lived experience of everyday life for working-aged adults living with advanced cancer, and how this changes over time. DESIGN A longitudinal hermeneutic phenomenological approach was employed, using in-depth semi-structured interviews. Data was analysed using inductive thematic analysis, and findings mapped against the Model of Human Occupation and illness experience literature. SETTING/PARTICIPANTS Purposively sampled working-aged adults (40-64 years) with advanced cancer were recruited by a rural home care team in Western Canada. RESULTS Thirty-three in-depth interviews were conducted over 19 months with eight adults living with advanced cancer. Advanced cancer and other losses have a disruptive impact on daily life. Despite experiencing progressive functional decline, these adults intentionally sought to participate in valued everyday activities. Adaptation to ongoing deterioration occurred through engagement in daily life. CONCLUSIONS Despite experiencing disruption to routines and daily life, people living with advanced cancer seek to continue doing what is important to them, albeit in a modified form. Adaptation to functional decline is an active, ongoing process and occurs through continued engagement in activities. Palliative rehabilitation can facilitate participation in everyday life.
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Affiliation(s)
- Julie M Brose
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute of Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, UK
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
- Research Centre for Palliative Care Death and Dying (RePaDD), Flinders University, Adelaide, SA, Australia
| | - Eileen Willis
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Deidre D Morgan
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
- Research Centre for Palliative Care Death and Dying (RePaDD), Flinders University, Adelaide, SA, Australia
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Launonen M, Vehviläinen-Julkunen K, Mattila L, Savela RM, Kvist T. Older patients' perceptions of the quality of acute cancer care: An integrative review-A mixed-method approach. Int J Older People Nurs 2023; 18:e12503. [PMID: 36168107 DOI: 10.1111/opn.12503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/15/2022] [Accepted: 09/03/2022] [Indexed: 01/15/2023]
Abstract
AIM This integrative review aimed to describe the perceptions of the quality of care of older patients (aged 65 and above) living with cancer in acute-care settings. METHODS We identified relevant research suitable for inclusion criteria through systematic searches of the PubMed®, EBSCOhost Academic Search Premier®, Scopus® and Web of Science® databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework and the Synthesis Without Meta-analysis (SWiM) guidelines were used to conduct the research and report the results. The quality of the studies was evaluated using the modified Critical Skills Appraisal Programme (CASP) checklist. RESULTS A total of 24 studies met the inclusion criteria. The data analysis revealed that care quality could be described through three distinct themes: individuality, a sense of security and respectful encounters. CONCLUSION The perceptions of older people living with cancer regarding the quality of acute care have not been extensively covered in the literature. Health- and age-related challenges, patients' overall life situation, clear, realistic information about care and the future and respect during encounters should be given attention. IMPLICATIONS FOR PRACTICE Patient-centred and tailored care, considering the heterogeneity of the population and support for independence, is needed.
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Affiliation(s)
- Minna Launonen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Katri Vehviläinen-Julkunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.,Kuopio University Hospital, Kuopio, Finland
| | - Laura Mattila
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Roosa-Maria Savela
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Tarja Kvist
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Jespersen E, Minet LR, Nissen N. Symptoms of total pain experienced by older people with advanced gastrointestinal cancer receiving palliative chemotherapy. Eur J Cancer Care (Engl) 2022; 31:e13674. [PMID: 35973729 PMCID: PMC9788272 DOI: 10.1111/ecc.13674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/23/2022] [Accepted: 07/28/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Little is known about concurrent physical, psychological, social and spiritual distress experienced by older patients during early stages of advanced cancer while receiving life-prolonging treatment. Drawing on the concept of total pain, this study explored the multi-faceted symptoms of pain in older patients with advanced gastrointestinal cancer while receiving palliative chemotherapy. METHODS A total of 14 in-depth interviews with seven participants were conducted, one interview at the beginning and one after completion of chemotherapy. Participants were ≥70 years, diagnosed with advanced gastrointestinal cancer and receiving palliative chemotherapy. RESULTS Thematic analysis revealed four themes: variability and inevitability of physical pain, ways of coping with psychological pain, mitigating social pain through contributions to social life and the anticipation of existential pain in old age. Conducting two interviews with each participant foregrounded the changing nature of the participants' experienced symptoms and life perspectives while receiving palliative chemotherapy. Further, old age was experienced as integral to how participants described their situation and indicated an acceptance of old age. CONCLUSION Older adults with advanced cancer are affected by multiple-faceted symptoms resulting from cancer and its treatment. The concept of total pain is suggested to guide interdisciplinary palliative care in earlier stages of advanced cancer.
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Affiliation(s)
- Eva Jespersen
- Department of OncologyAcademy of Geriatric Cancer Research, AgeCare, Odense University HospitalOdenseDenmark,Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Lisbeth Rosenbek Minet
- Geriatric Research Unit, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
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Silva HLM, Valério PHM, Barreira CRA, Peria FM. Personal positioning of oncology patients in palliative care: a mixed-methods study. BMC Palliat Care 2022; 21:34. [PMID: 35277164 PMCID: PMC8917691 DOI: 10.1186/s12904-022-00916-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/08/2022] [Indexed: 12/02/2022] Open
Abstract
Background Advanced oncological disease requires comprehensive health care, although attention is predominantly paid to the physical dimension of care. The consideration of personal positioning encompasses other dimensions of patients’ management of their illness, such as existential management and expanding forms of care. The objective of this study was to understand the personal positioning of cancer patients in palliative care. Methods This was a cross-sectional study using the mixed convergent parallel method. The sample consisted of 71 cancer patients in palliative care, of whom 14 participated in the qualitative and quantitative portions and 57 participated in only the quantitative portion. Phenomenological interviews were performed, and qualitative and quantitative methods were used to collect meaning of life (PIL-Test), quality of life (EORTC QLQ C-30), anxiety and depression (HADS) and sociodemographic data. The interview results were analysed according to the principles of classical phenomenology, and the quantitative data were analysed using the generalized structural equations model. Results The results showed that the patients turned to living, focusing on their possibilities and distancing themselves from the impact of the illness and the factuality of death, which the patients themselves associated with not succumbing to depression, a condition whose signs were exhibited by 21% of the sample. Sustaining this positioning required a tenacious fight, which feeds on sensitivity to life. Linked to this position was the belief in the continuation of life through religious faith, together with the patients’ realization of the meaning of their lives. In this same direction, there was a direct association between awareness of the meaning of life and increased scores on the functional scales (p < 0.01) and decreased scores for symptoms (p < 0.01), anxiety (p = 0.02) and depression (p < 0.01). The last element that emerged and structured this experience was the intense will to live and a sense of the value of life. Conclusions Through the use of mixed methods, the present study recognized the existential positioning of cancer patients in palliative care. This understanding can aid in the realization of more comprehensive and meaningful treatment plans and can contribute to the goal of achieving humanization in this area of treatment. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-00916-5.
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Morgan DD, Taylor RR, Ivy M, George S, Farrow C, Lee V. Contemporary occupational priorities at the end of life mapped against Model of Human Occupation constructs: A scoping review. Aust Occup Ther J 2022; 69:341-373. [PMID: 35199343 DOI: 10.1111/1440-1630.12792] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/21/2021] [Accepted: 01/12/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION People with end-of-life care needs are seen in an increasingly diverse range of health and community settings. Opportunity for continued occupational participation is highly valued by people at the end of life. This scoping review sought to identify the priorities and preferences for participation at the end of life and to map findings using the model of human occupation. METHODS A search strategy informed by the research question was developed in collaboration with a research librarian. Data sources used were Ovid Medline(R), CINAHL, Ovid Emcare, Scopus, Web of Science and PsychInfo. Studies that focused on clinician perspectives, clinical care, grief and loss, did not clearly identify end-stage diseases, <18 years and written in languages other than English were excluded. FINDINGS Forty-four studies were included with a total of 1,070 study participants. Inductively developed themes were mapped against the model of human occupation constructs of volition (personal causation, values, interests), habituation (habits of occupational performance and routine), performance capacity and the lived body within the physical, social and occupational environment. The majority of findings sat within the construct of volition, particularly around sense of personal capacity, self-efficacy and values. At the end of life, people prioritise ongoing engagement in valued occupations even if participation is effortful. As disease progresses, opportunity to exert influence and control over this participation and engagement increases in importance. Personal causation plays an important role in the experience of occupational participation at this time. CONCLUSION This review provides important insights into the occupational priorities of people at the end of life and the importance of supporting agency and volition at this time. The model of human occupation and its client-centred focus offer a framework for a more robust examination of ways to enhance volitional capacity and enable occupational participation for people at the end of life.
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Affiliation(s)
- Deidre D Morgan
- Research Centre for Palliative Care, Death and Dying (RePaDD), College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Renée R Taylor
- Director, Model of Human Occupation Clearinghouse, Department of Occupational Therapy, University of Illinois, Chicago, Illinois, USA
| | - Mack Ivy
- Rehabilitation Services, MD Anderson Cancer Center, Manvel, Texas, USA
| | - Stacey George
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Caroline Farrow
- SA Health, Northern Adelaide Palliative Care Service, Adelaide, South Australia, Australia
| | - Vincci Lee
- Eastern Health, Box Hill Hospital, Box Hill, Victoria, Australia
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Lau J, Khoo AMG, Ho AHY, Tan KK. Psychological resilience among palliative patients with advanced cancer: A systematic review of definitions and associated factors. Psychooncology 2021; 30:1029-1040. [PMID: 33728728 DOI: 10.1002/pon.5666] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/16/2021] [Accepted: 02/19/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The palliative journey can be emotionally stressful for both patients with advanced cancer and their families. Psychological resilience is crucial in aiding with patients' adaptation and post-traumatic growth. The aim of this systematic review was to critically examine the definitions of psychological resilience and its associated factors in palliative patients with advanced cancer. METHODS Four databases were systematically searched from inception to August 2020. Both qualitative and quantitative studies that examined factors associated with psychological resilience in a sample of patients with advanced cancer undergoing palliative care were included. RESULTS A total of 15 studies met the criteria, of which 10 were qualitative and five were quantitative. Nine studies included a definition of psychological resilience, from which five common themes of buffering, adaptation, resources, recovery, and growth were derived. The quantitative studies found association between resilience and hope, independence, social support, fatigue, emotional distress, and coping strategies. The qualitative studies reported additional sources of resilience such as spirituality, social support, prior experience dealing with illness and life adversity, meaning-making, reconciling with life's finiteness, acceptance of illness, control, determination, positive attitude, dignity, engagement with palliative care and quality of life being supported by palliative care. CONCLUSIONS More research is needed for developing an overarching definition of psychological resilience in palliative advanced cancer patients that acknowledges and appreciates the contextual sensitivity of this concept among different cultural groups. Further studies are also needed to examine a holistic range of bio-psycho-socio-spiritual factors associated with psychological resilience among these patients and their families.
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Affiliation(s)
- Jerrald Lau
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | - Andy Hau-Yan Ho
- School of Social Sciences, Nanyang Technological University, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Palliative Care Centre for Excellence in Research and Education, Singapore
| | - Ker-Kan Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Lee GL, Ramaswamy A. Physical, psychological, social, and spiritual aspects of end-of-life trajectory among patients with advanced cancer: A phenomenological inquiry. DEATH STUDIES 2018; 44:292-302. [PMID: 30569828 DOI: 10.1080/07481187.2018.1541944] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 10/03/2018] [Accepted: 10/07/2018] [Indexed: 06/09/2023]
Abstract
The study examined and described the perspectives of people living with advanced cancer and the changes over time in their needs and experiences. This paper reports the accounts of 11 terminally-ill people who gave a total of 25 in-depth interviews. Participants were recruited when they began receiving home hospice care service, and they were followed up over time, as their disease progressed. Framework method was used to organize the data and identify themes. The findings highlighted that end-of-life care needs to be holistic, encompassing physical, psychological, social, and spiritual needs, as well as dynamic along the course of disease progression.
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Affiliation(s)
- Geok Ling Lee
- Department of Social Work, National University of Singapore, Singapore, Singapore
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12
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Ribeiro MDS, Borges MDS. Perceptions of aging and falling ill: a study with elderly persons in palliative care. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2018. [DOI: 10.1590/1981-22562018021.180139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: to learn the perceptions of elderly persons in palliative care regarding coping with aging and illness. Method: an exploratory, descriptive, qualitative study was carried out. The study included 11 elderly persons in palliative care because of oncologic disease. Semi-structured interviews were carried out which were analyzed with the aid of the ALCESTE software. Results: two axes were identified from the content analysis. The first, Resist to Survive and Live, has two categories: the first, aging with integrity, portrays the positive perception of the participants regarding the aging process, and coping strategies used to deal with aging and with illness; the other category, resilient development, refers to the life trajectories of the participants and the adversities of the process of development and aging. The second axis, Resist to Die Well, has only one category and refers to the perceptions of the elderly about the stress related to illness. Conclusion: the results show that the perceptions of aging and falling ill involved resilience, as the participants focused on what they had gained rather than their losses. In this context, they used resilient coping strategies: spiritual support, cognitive restructuring, and acceptance.
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Do cancer patients use the term resilience? A systematic review of qualitative studies. Support Care Cancer 2018; 27:43-56. [PMID: 30209600 DOI: 10.1007/s00520-018-4456-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 08/30/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Resilience is a dynamic process of positive adaptation to adversity, including cancer. While the term is used frequently by researchers, controversy exists over its conceptualisation and little is known if and how cancer patients use the term resilience. We examined qualitative studies exploring cancer patient experiences/perceptions of resilience to understand: (a) definitions of resilience as identified by patients and researchers and (b) the themes relating to attributes of resilience as identified by patients. METHODS Four electronic databases (MEDLINE, PsycINFO, SCOPUS, and CINAHL) were searched from database inception to November 2017, identifying qualitative studies of adult cancer patients/survivors which included resilience and cancer in the title, abstract, or medical subject headings. Articles were excluded if resilience was not a theme or outcome or was discussed primarily in the context of non-individuals. Thematic analysis was used to code studies and generate analytical themes, and a single author identified definitions of resilience within the studies. RESULTS Five hundred and seventy-three non-duplicate citations were screened, resulting in 65 citations screened for full-text review. Of these, 33 were excluded, leaving 32 studies. Four thematic categories emerged; coping strategies, social support, spirituality, and growth, within which 79 individual themes were identified. Eight researcher definitions and no patient definitions of resilience were identified. CONCLUSION This review found no cancer patient definitions of resilience and that cancer patients are seldom quoted using the term resilience directly, instead identifying coping strategies, social support, growth, and spirituality as attributes associated with resilience.
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Lilja A, DeMarinis V, Lehti A, Forssén A. Experiences and explanations of mental ill health in a group of devout Christians from the ethnic majority population in secular Sweden: a qualitative study. BMJ Open 2016; 6:e011647. [PMID: 27797991 PMCID: PMC5093464 DOI: 10.1136/bmjopen-2016-011647] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To explore existential meaning-making in an ethnic-majority subgroup with mental ill health and to increase knowledge about the importance of gaining access to such information in mental healthcare. DESIGN Qualitative study using in-depth interviews and systematic text condensation analysis. PARTICIPANTS 17 devote Christians with an ethnic-Swedish background, 12 women and 5 men, 30-73 years old, from different congregations across Sweden, having sought medical care for mental ill health of any kind. SETTING The secular Swedish society. RESULTS A living, although asymmetric, relationship with God often was seen as the most important relationship, giving hope and support when ill, but creating feelings of abandonment and fear if perceived as threatened. Symptoms were interpreted through an existential framework influenced by their view of God. A perceived judging God increased feelings of guilt, sinfulness and shame. A perceived merciful God soothed symptoms and promoted recovery. Existential consequences, such as being unable to pray or participate in congregational rituals, caused feelings of 'spiritual homelessness'. Participants gave biopsychosocial explanations of their mental ill health, consonant with and sometimes painfully conflicting with existential explanations, such as being attacked by demons. Three different patterns of interaction among biopsychosocial and existential dimensions in their explanatory systems of illness causation were identified: (a) comprehensive thinking and consensus; (b) division and parallel functions and (c) division and competitive functions. CONCLUSIONS Prevailing medical models for understanding mental ill health do not include the individual's existential experiences, which are important for identifying risk and protective factors as well as possible resources for recovery. The various expressions of existential meaning-making identified in this devout religious subgroup illustrate that existential information cannot be generalised, even within a small, seemingly homogenous group. The three identified patterns of interactions formed a typology that may be of use in clinical settings.
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Affiliation(s)
- Aina Lilja
- Department of Public Health and Clinical Medicine, Division of Family Medicine, Umeå University, Umeå, Sweden
| | - Valerie DeMarinis
- Department of Public Health and Clinical Medicine, Division of Family Medicine, Umeå University, Umeå, Sweden
- Department of Theology, Psychology of Religion and Cultural Psychology, Uppsala University, Uppsala, Sweden
- Mental Health Division, Innlandet Hospital Trust, Hamar, Norway
| | - Arja Lehti
- Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Annika Forssén
- Department of Public Health and Clinical Medicine, Division of Family Medicine, Umeå University, Umeå, Sweden
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Recent LiteratureFeature Editor: Paul C. Rousseau. J Palliat Med 2015. [DOI: 10.1089/jpm.2015.0315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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