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Cetın Z, Ozen B. Investigating spiritual care perceptions and religious coping methods among the relatives of terminally ill patients during the COVID-19 pandemic: the case of Turkey. BMC Palliat Care 2024; 23:131. [PMID: 38778311 PMCID: PMC11112817 DOI: 10.1186/s12904-024-01463-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 05/16/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic in Turkey and around the world has had a profound impact on the families of terminally ill patients. In this challenging period, investigating the spiritual care perceptions and religious coping methods of patients' relatives is an essential step towards understanding the experiences in this process with the additional challenges brought by the pandemic and developing appropriate support services. This study aims to determine the spiritual care perceptions and the use of religious coping methods among the relatives of terminally ill patients in Turkey during the COVID-19 pandemic. METHODS The sample of this descriptive and correlational study consisted of the relatives of terminally ill patients (n = 147) who were receiving treatment in the Anesthesiology and Reanimation Intensive Care Unit of a state hospital in Turkey. Spirituality and Spiritual Care Rating Scale and the Religious Coping Scale to them using face-to-face interviews. Mann-Whitney U test, Kruskal-Wallis test, and Spearman's correlation analysis were used to analyze the data. RESULTS The mean age of the participants was 38.84 ± 11.19 years. Also, 63.3% of them were employed. The participant's total score on the Spirituality and Spiritual Care Rating Scale was 57.16 ± 6.41, and it was determined that the participants' level of perception of spirituality and spiritual care concepts was close to good. When the Religious Coping Scale scores of the participants were examined, it was found that both Positive Religious Coping levels (23.11 ± 2.34) and Negative Religious Coping levels (9.48 ± 1.47) were close to high. There was no correlation between the scores of RCOPE and SSCRS (p > 0.05). CONCLUSION As a result, it was determined that the level of perception of spirituality and spiritual care concepts of the relatives of terminally ill patients during the COVID-19 pandemic was close to sound, and their Positive Religious Coping levels were high. Epidemics are a reality of the world, and it is essential to learn lessons from this process and take precautions for the future. We offer a perspective to realize the coping power of religion and spirituality, which are integral parts of life. The needs of terminally ill patients' relatives, a sensitive group, become visible.
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Affiliation(s)
- Zuhal Cetın
- Health Sciences Institute, Erciyes University, 38033, Kayseri, Turkey
| | - Betul Ozen
- Faculty of Health Sciences, Erciyes University, 38033, Kayseri, Turkey.
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Thomas R, Pesut B, Siden H, Treschow M, Puurveen G. Developing competencies for volunteer navigators to support caregivers of children living with medical complexity: a mixed-method e-Delphi study. Palliat Care Soc Pract 2023; 17:26323524231209060. [PMID: 37954463 PMCID: PMC10634257 DOI: 10.1177/26323524231209060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/04/2023] [Indexed: 11/14/2023] Open
Abstract
Background Providing specially trained volunteer navigators is one promising strategy for supporting the increasing number of family caregivers who are caring for children living with medical complexity. Objective The objective of this study was to develop consensus on the role and competencies required for volunteer navigators who support caregivers of children living with medical complexity. Design This was a mixed-method study using modified e-Delphi and focus group methods. In phase 1, a modified e-Delphi survey with 20 family caregivers and a focus group with 4 family caregivers were conducted to develop consensus on their unmet needs and the potential roles of a volunteer to meet those needs. In phase 2, a modified e-Delphi survey was conducted with experts to develop consensus on the volunteer competencies required to meet the roles identified by family caregivers in phase 1. Results Findings from phase 1 resulted in 36 need-related items over 8 domains: communication, daily life and chores, emotional support, information and knowledge, respite, support with decision-making, and sharing the caregiving experience. Concerns about the volunteer role included the potential lack of commitment in the absence of remuneration, the complexity of the child's condition that was beyond the role of a volunteer, and a preference for support from individuals they knew. Findings from the phase 2 Delphi survey with professionals resulted in 22 competencies, derived from the roles identified in phase 1, that would be required of volunteers who wished to support these family caregivers. Conclusion This study provides insight into a role for volunteers in meeting the needs of family caregivers of children living with medical complexity. A volunteer with lived experience and adequate preparation can assist with meeting some of these important needs. Further research is required to better understand the feasibility and acceptability of such a role.
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Affiliation(s)
- Robyn Thomas
- The University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Barbara Pesut
- The University of British Columbia Okanagan, 1147 Research Way, Kelowna, BC V1V 1V7, Canada
| | - Hal Siden
- The University of British Columbia, Canuck Place Children’s Hospice and BC Children’s Hospital, Vancouver, BC, Canada
| | - Michael Treschow
- The University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Gloria Puurveen
- The University of British Columbia Okanagan, Kelowna, BC, Canada
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Wu B, Zhu P, Wang T, Tan JYB, Cao Z, Wan J, Wu S, Zhang L, Xing Y. Experiences of Chinese advanced cancer patients after attending a "four-stage" death education programme: A qualitative study. Eur J Oncol Nurs 2023; 66:102361. [PMID: 37499403 DOI: 10.1016/j.ejon.2023.102361] [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: 02/11/2023] [Revised: 05/14/2023] [Accepted: 06/05/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE This study aimed to explore the experiences of cancer patients who participated in and completed a "four-stage" death education programme based on knowledge-attitude-practice theory. METHODS This study employed a qualitative descriptive design. Semistructured interviews with an interview guide were used to collect data. Fifteen cancer patients who participated in and completed the "four-stage" death education programme (from November 10, 2021, to December 29, 2021) were recruited via purposive sampling. The "four-stage" death education programme model was developed based on knowledge-attitude-practice theory and included eight death education modules. Each interview was audio-recorded and transcribed verbatim. Generic analysis was used to conduct data analysis by coding, classifying, and extracting themes. RESULTS Five themes were identified: the gradual shift of death cognition towards objective reality, a decrease in death anxiety, patients' early thoughts concerning issues related to death and preparation ahead of death, patients' improved ability to respond to death incidents, and patients' increased focus on cherishing the remainder of their lives and living in the moment. CONCLUSIONS Cancer patients accept and respond effectively to the implementation of a "four-stage" death education programme based on knowledge-attitude-practice theory. These findings can help cancer patients improve their reasonable perception of death and reduce their doubts and confusion concerning death.
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Affiliation(s)
- Bing Wu
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Ping Zhu
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Tao Wang
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Jing-Yu Benjamin Tan
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Zhenglan Cao
- Department of Oncology Surgery, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Wan
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Suya Wu
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Liuliu Zhang
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China.
| | - Yihui Xing
- Department of Internal Medicine-Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.
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Kyota A, Kanda K, Senuma M, Tsukagoshi N, Futawatari T, Kondo Y. The perception of life and death in patients with end-of-life stage cancer: A systematic review of qualitative research. Eur J Oncol Nurs 2023; 66:102354. [PMID: 37586291 DOI: 10.1016/j.ejon.2023.102354] [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: 04/19/2021] [Revised: 05/08/2023] [Accepted: 05/31/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE This study aims to clarify the perceptions on life and death among patients with the end-of-life stage cancer through a systematic review. METHODS The search strategy combined MeSH terminology with free text searches, and was applied to the PubMed, CINAHL, Embase, and ICHUSHI (Japan Medical Abstracts Society) databases covering from 2010 to 5/2022. To ensure the quality of the research included, the Critical Appraisal Skills Program Qualitative Studies Checklist was used. Data relating to the perceptions of life and death of patients with the end-of-life stage cancer was extracted and analyzed with reference to qualitative meta-synthesis methods. RESULTS Ultimately, 50 studies were included. Five themes were derived based on the perceptions of life and death of patients with the end-of-life stage cancer: despair, making sense of death, how to live the rest of life, special feelings for loved ones, and fluctuation. By making sense of death in their own way, and reconciling it with their current situation, patients with the end-of-life stage cancer, even in despair over their impending death, look ahead into the future and their surroundings and consider how they would live the remaining time they have. During this time, the special feelings they have for their loved ones make an impact. CONCLUSIONS An important new finding from this study lies in the fact that the patients' desire to live as ordinary people who were not patients were expressed as a face that they hid from their families. Further research is needed in low-income countries/regions.
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Affiliation(s)
- Ayumi Kyota
- Department of Nursing, Gunma University Graduate School of Health Sciences, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8514, Japan.
| | - Kiyoko Kanda
- Niigata College of Nursing, 240 Shinnan-cho, Joetsu, Niigata, 943-0147, Japan.
| | - Maiko Senuma
- Department of Nursing, Gunma University Graduate School of Health Sciences, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8514, Japan.
| | - Noriko Tsukagoshi
- Department of Nursing, Gunma University Graduate School of Health Sciences, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8514, Japan.
| | - Tamae Futawatari
- Department of Nursing, Gunma University Graduate School of Health Sciences, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8514, Japan.
| | - Yuka Kondo
- Department of Nursing, Gunma University Graduate School of Health Sciences, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8514, Japan.
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Erami E, Taghadosi M. Factors Contributing to Grief Experience Among Oncology Nurses: A Qualitative Study. Semin Oncol Nurs 2023; 39:151472. [PMID: 37507268 DOI: 10.1016/j.soncn.2023.151472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 06/08/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVES Care provision to patients with cancer can cause varying levels of grief for oncology nurses. Grief in turn significantly affects nurses' personal and professional life. However, there is limited information about the contributing factors to grief experience among oncology nurses. The aim of this study was to explore the contributing factors to grief experience among oncology nurses. DATA SOURCES This qualitative study was conducted in Iran from May 2020 to October 2021. Participants were 18 oncology nurses purposively selected from several hospitals in Iran. Data were gathered via in-depth semistructured interviews and analyzed via the conventional content analysis method proposed by Graneheim and Lundman. Lincoln and Guba's criteria were used to ensure trustworthiness. CONCLUSION The four categories of the contributing factors to oncology nurses' grief experience were exposure to patients' painful death, depressing work atmosphere, knowing the heavy financial burden of cancer for patients, and patients' helplessness in the healthcare system. Oncology nurses experience deep grief due to a wide range of personal, professional, environmental, and sociocultural factors. IMPLICATIONS FOR NURSING PRACTICE The findings of this study can be used to better understand the contributing factors to grief experience among oncology nurses, determine their needs, and develop strategies to strongly support them.
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Affiliation(s)
- Elahe Erami
- PhD Candidate in Nursing, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohsen Taghadosi
- Associate Professor of Nursing Education, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran.
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Wong AK, Wang D, Marco D, Le B, Philip J. Prevalence, Severity, and Predictors of Insomnia in Advanced Colorectal Cancer. J Pain Symptom Manage 2023; 66:e335-e342. [PMID: 37295563 DOI: 10.1016/j.jpainsymman.2023.05.020] [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] [Received: 02/15/2023] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023]
Abstract
CONTEXT Insomnia is an under-recognized and undertreated symptom in palliative care and advanced cancer cohorts. Insomnia in an advanced colorectal cancer cohort is yet to be investigated despite colorectal cancer being the third commonest cancer worldwide and one with a high symptom burden. OBJECTIVES To examine the prevalence of insomnia and its associations in a large advanced colorectal cancer cohort. METHODS A consecutive cohort study of 18,302 patients with colorectal cancer seen by palliative care services across various settings (inpatient, outpatient, and ambulatory) was conducted from an Australia-wide database (2013-2019). The Symptom Assessment Score (SAS) was used to assess the severity of insomnia. Clinically significant insomnia was defined as SAS score ≥3/10, and used to compare associations with other symptoms and functional scores from validated questionnaires. RESULTS The prevalence of any insomnia was 50.5%, and clinically significant insomnia 35.6%, particularly affecting people who were younger (<45-years-old), more mobile (AKPS score ≥70), or physically capable (RUG-ADL score ≤5). Outpatients and patients living at home had higher prevalence of insomnia. Nausea, anorexia and psychological distress were the commonest concurrent symptoms in patients with clinically significant insomnia. CONCLUSIONS To our knowledge, this study was the first to investigate the prevalence and associations of insomnia in an advanced colorectal cancer cohort. Our findings demonstrate several groups at greater risk of suffering from insomnia (younger, greater physical capacity, living at home, and those with greater psychological distress). This may guide earlier recognition and management of insomnia to improve overall quality of life in this population.
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Affiliation(s)
- Aaron K Wong
- Parkville Integrated Palliative Care Service (A.K.W., D.W., B.L., J.P.), The Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Medicine, Eastern Hill Campus, (A.K.W., D.M., J.P.), University of Melbourne, Fitzroy, Victoria, Australia.
| | - Dorothy Wang
- Parkville Integrated Palliative Care Service (A.K.W., D.W., B.L., J.P.), The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - David Marco
- Department of Medicine, Eastern Hill Campus, (A.K.W., D.M., J.P.), University of Melbourne, Fitzroy, Victoria, Australia; Centre for Palliative Care, St Vincent's Hospital Melbourne (D.M.), Fitzroy, Victoria, Australia
| | - Brian Le
- Parkville Integrated Palliative Care Service (A.K.W., D.W., B.L., J.P.), The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Jennifer Philip
- Parkville Integrated Palliative Care Service (A.K.W., D.W., B.L., J.P.), The Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Medicine, Eastern Hill Campus, (A.K.W., D.M., J.P.), University of Melbourne, Fitzroy, Victoria, Australia; Palliative Care Service (J.P.), St Vincent's Hospital, Fitzroy, Victoria, Australia
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Öcalan S, Üzar-Özçetin YS. "I am in a Fight with My Brain": A Qualitative Study on Cancer-Related Ruminations of Individuals with Cancer. Semin Oncol Nurs 2023; 39:151450. [PMID: 37210226 DOI: 10.1016/j.soncn.2023.151450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/30/2023] [Accepted: 04/19/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVE This study aimed to determine the cancer-related ruminations from the subjective perspectives of individuals with cancer. DATA SOURCES The study adopted a qualitative design, and participants (N = 16) were individuals with cancer. The analysis and interpretation of data were carried out according to the phenomenological-hermeneutical method. CONCLUSION The following four themes emerged as a result of the analysis of qualitative data revealing the experiences of individuals with cancer: (1) attributed meanings to cancer-related ruminations, (2) perceived ruminations toward an uncertain future, (3) losing against intrusive ruminations, and (4) fighting with ruminations. The results underline the negative impact of ruminative thoughts on the disease process and social life of individuals with cancer. Individuals with cancer struggle with intense thoughts about the cause, treatment, and future of the disease from the moment they are diagnosed with cancer. In order to stop ruminative thoughts, individuals with cancer have tried solutions such as distracting activities and avoiding thoughts. IMPLICATIONS FOR NURSING PRACTICE Nurses have an important role in catching verbal and nonverbal cues for rumination, as they are constantly together with individuals with cancer and make observations. Therefore, nurses can raise awareness about their ruminative thoughts and teach coping skills to individuals with cancer.
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Affiliation(s)
- Sinem Öcalan
- MSc, PhD Candidate, RN, Research Assistant, Psychiatric Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey.
| | - Yeter Sinem Üzar-Özçetin
- PhD, RN, Associate Professor, School of Nursing, Midwifery, and Health Systems, UCD Health Sciences Centre, University College Dublin, Dublin, Ireland
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Tak YW, Han JH, Park YJ, Kim DH, Oh JS, Lee Y. Examining Final-Administered Medication as a Measure of Data Quality: A Comparative Analysis of Death Data with the Central Cancer Registry in Republic of Korea. Cancers (Basel) 2023; 15:3371. [PMID: 37444480 DOI: 10.3390/cancers15133371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/21/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Death is a crucial outcome in retrospective cohort studies, serving as a criterion for analyzing mortality in a database. This study aimed to assess the quality of extracted death data and investigate the potential of the final-administered medication as a variable to quantify accuracy for the validation dataset. Electronic health records from both an in-hospital and the Korean Central Cancer Registry were used for this study. The gold standard was established by examining the differences between the dates of in-hospital deaths and cancer-registered deaths. Cosine similarity was employed to quantify the final-administered medication similarities between the gold standard and other cohorts. The gold standard was determined as patients who died in the hospital after 2006 and whose final hospital visit/discharge date and death date differed by 0 or 1 day. For all three criteria-(a) cancer stage, (b) cancer type, and (c) type of final visit-there was a positive correlation between mortality rates and the similarities of the final-administered medication. This study introduces a measure that can provide additional accurate information regarding death and differentiates the reliability of the dataset.
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Affiliation(s)
- Yae Won Tak
- Department of Information Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Jeong Hyun Han
- Department of Information Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Yu Jin Park
- Medical Information-Management Team, Asan Medical Center, Seoul 05505, Republic of Korea
| | - Do-Hoon Kim
- Medical Big Data Research Center, Kyungpook National University Hospital, Daegu 41944, Republic of Korea
| | - Ji Seon Oh
- Department of Information Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Yura Lee
- Department of Information Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
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Ahmad A, Asim M, Malik N, Safdar MR, Sher F, Sohail MM. Between Life and Death: How do Muslim Terminal Patients in Pakistan cope with Hepatitis C utilizing their Beliefs and Social Support? JOURNAL OF RELIGION AND HEALTH 2023:10.1007/s10943-023-01828-1. [PMID: 37166691 DOI: 10.1007/s10943-023-01828-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 05/12/2023]
Abstract
Life-threatening events including terminal illness intensify the search for meaning and incite individuals to get closer to religion. Terminal patients can often find religious practices as helpful as medical therapy for bettering both physical and mental health. The present research aims to explain the interaction between religion, spirituality, and social support in coping with terminal illness among Muslim hepatitis C patients in Pakistan. A semi-structured open-ended interview guide was utilized to collect the data. Participants expressed that the deployment of religious and spiritual beliefs along with socio-emotional support during illness fostered medical therapy. Participants also revealed that belief in God provided them the strength to be steadfast during the terminal stage of the disease. Religious beliefs enabled terminal participants to accept death as an eventual reality and a normal part of their lives. Furthermore, participants put forward their longing for those kinds of religious practices that terminal diseases usually restrained them from receiving. The emotional support stemming from social relationships also improved resilience to cope with the terminal stage of illness. The study concludes that the interplay of religion, spirituality, and social support normalizes the fear of death, lessens pain, and improves resilience among Muslim hepatitis C patients in Pakistan.
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Affiliation(s)
- Akhlaq Ahmad
- Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
| | - Muhammad Asim
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
- Population Research Center, University of Texas at Austin, Austin, USA.
| | - Nazia Malik
- Department of Sociology, Government College University Faisalabad, Faisalabad, Pakistan
| | | | - Falak Sher
- Department of Sociology, Government College University Faisalabad, Faisalabad, Pakistan
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Living experiences of people living with HIV-AIDS from the client's perspective in nurse-client interaction in Indonesia: A qualitative study. PLoS One 2023; 18:e0282049. [PMID: 36812224 PMCID: PMC9946244 DOI: 10.1371/journal.pone.0282049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Nurse-client interaction when providing nursing services is limited to optimizing treatment and self-care, with limited focus on the psychological problems of people living with HIV-AIDS. However, psychological problems manifest more often than the health risks of the disease itself. This study aimed to determine the emotional response of people living with HIV-AIDS who received limited attention from nurses from the perspective of nurse-client relationship. PATIENTS AND METHODS A phenomenological qualitative design was used through in-depth face-to-face interviews in a semi-structured manner, in an effort to obtain complete data. This research used purposive sampling with Participatory Interpretative Phenomenology analysis, involving 22 participants (14 males and 8 females). RESULTS This research produces several themes, with six subcategories: 1) Difficulty of social access, 2) Forcing to accept their situation and suppressing their will, 3) Wanting to be recognized like other people in general, 4) Social stigma and self-stigmatization affecting surroundings, 5) Lacking enthusiasm for life expectancy, 6) Always lingering under the shadow "when death picks up." CONCLUSION The results showed that mental stress was experienced more than physical problems by people living with HIV-AIDS, thus prompting new changes to nursing services for HIV-AIDS patients that emphasize psychosocial aspects, in addition to clinical features, facilitated by satisfying relationships between nurses and clients to provide quality services.
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Effendy C, Kristanti MS. Open and structured assessment in addressing hospitalized cancer-related problems: The perception of patients and nurses in Indonesia. PROGRESS IN PALLIATIVE CARE 2022. [DOI: 10.1080/09699260.2022.2148196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Christantie Effendy
- Department of Medical-Surgical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Lotus Care, Wound and Palliative Homecare Center, Private Clinic, Yogyakarta, Indonesia
| | - Martina Sinta Kristanti
- Department of Basic and Emergency Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Muacevic A, Adler JR. Self-Inflicted Total Amputation of the External Genitalia as a Psychological Repercussion of the COVID-19 Pandemic: A Case Report. Cureus 2022; 14:e32725. [PMID: 36686088 PMCID: PMC9850316 DOI: 10.7759/cureus.32725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 01/24/2023] Open
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, mandatory quarantine has interrupted everyday social life, leaving many individuals feeling confined and lonely, with increased rates of suicide and suicidal behavior. Genital self-mutilation (GSM) is a rare phenomenon that typically occurs in the context of severe mental illness. The following case report describes the first case of total self-inflicted genital amputation in a healthy man who had no prior history of mental or medical conditions. This case poses challenges for psychiatric diagnosis and treatment. We report a case of a 52-year-old male with no significant medical and psychiatric history who was admitted to a tertiary care hospital after attempting suicide by self-inflecting a total amputation of his external genitalia due to fear of COVID-19 infection. The diathesis-stress linked with the tribulations of the current pandemic was highlighted as well as other possible contributory factors and psychopathology behind his clinical presentation.
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Prado E, Marcon S, Kalinke L, da Silva M, Barreto M, Takemoto A, Birolim M, Laranjeira C. Meanings and Experiences of End-of-Life Patients and Their Family Caregivers in Hospital-to-Home Transitions: A Constructivist Grounded Theory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12987. [PMID: 36293568 PMCID: PMC9602127 DOI: 10.3390/ijerph192012987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
This study explored the meanings and experiences of patients with terminal chronic diseases and their caregivers, who face the imminence of death in the home environment after hospital discharge. The qualitative study used constructivist grounded theory. The participants were individuals with a terminal chronic illness, discharged to home, and their family caregivers. Data were gathered from in-depth interviews and field notes, and a comparative analysis was conducted to identify categories and codes, according to Charmaz's theory. The sample consisted of 21 participants. Three inter-related data categories emerged: "Floating between acceptance and resistance: Perceiving the proximity of death", "Analysing the end from other perspectives: it is in the encounter with death that life is understood" and "Accepting the path: between the love of letting go and the love of wanting to stay". The categories translate the reconstruction of those facing end-of-life occurring in the home environment. It is amid the imminence of death that life gains intensity and talking about the finitude of life configures an opportunity to see life from other perspectives. Giving voice to individuals facing the mishaps of a terminal illness fosters the path to a comfortable death. For health professionals, it is an opportunity to provide structured and humanized care with an ethical attitude, in defence of human dignity.
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Affiliation(s)
- Eleandro Prado
- Postgraduate Program in Nursing, Nursing Department, State University of Maringá, Maringá 87020-900, Brazil
| | - Sonia Marcon
- Postgraduate Program in Nursing, Nursing Department, State University of Maringá, Maringá 87020-900, Brazil
| | - Luciana Kalinke
- Nursing Department, Federal University of Paraná, Curitiba 80210-170, Brazil
| | - Marcelle da Silva
- Anna Nery Nursing School, Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil
| | - Mayckel Barreto
- Postgraduate Program in Nursing, Nursing Department, State University of Maringá, Maringá 87020-900, Brazil
| | - Angelica Takemoto
- Nursing Department, Guairacá University Center, Guarapuava 85010-000, Brazil
| | - Marcela Birolim
- Nursing Department, Guairacá University Center, Guarapuava 85010-000, Brazil
| | - Carlos Laranjeira
- School of Health Sciences of Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology, Rua de Santo André 66-68, Campus 5, Polytechnic of Leiria, 2410-541 Leiria, Portugal
- Research in Education and Community Intervention, Piaget Institute, 3515-776 Viseu, Portugal
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14
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Kolsteren EEM, Deuning-Smit E, Chu AK, van der Hoeven YCW, Prins JB, van der Graaf WTA, van Herpen CML, van Oort IM, Lebel S, Thewes B, Kwakkenbos L, Custers JAE. Psychosocial Aspects of Living Long Term with Advanced Cancer and Ongoing Systemic Treatment: A Scoping Review. Cancers (Basel) 2022; 14:cancers14163889. [PMID: 36010883 PMCID: PMC9405683 DOI: 10.3390/cancers14163889] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/01/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Studies examining the psychosocial impact of living long term on systemic treatment in advanced cancer patients are scarce. This scoping review aimed to answer the research question “What has been reported about psychosocial factors among patients living with advanced cancer receiving life-long systemic treatment?”, by synthesizing psychosocial data, and evaluating the terminology used to address these patients; (2) Methods: This scoping review was conducted following the five stages of the framework of Arksey and O’Malley (2005); (3) Results: 141 articles published between 2000 and 2021 (69% after 2015) were included. A large variety of terms referring to the patient group was observed. Synthesizing qualitative studies identified ongoing uncertainty, anxiety and fear of disease progression or death, hope in treatment results and new treatment options, loss in several aspects of life, and worries about the impact of disease on loved ones and changes in social life to be prominent psychosocial themes. Of 82 quantitative studies included in the review, 76% examined quality of life, 46% fear of disease progression or death, 26% distress or depression, and 4% hope, while few studies reported on adaptation or cognitive aspects. No quantitative studies focused on uncertainty, loss, or social impact; (4) Conclusion and clinical implications: Prominent psychosocial themes reported in qualitative studies were not included in quantitative research using specific validated questionnaires. More robust studies using quantitative research designs should be conducted to further understand these psychological constructs. Furthermore, the diversity of terminology found in the literature calls for a uniform definition to better address this specific patient group in research and in practice.
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Affiliation(s)
- Evie E. M. Kolsteren
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Psychology, 6525 Nijmegen, The Netherlands
- Correspondence:
| | - Esther Deuning-Smit
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Psychology, 6525 Nijmegen, The Netherlands
| | - Alanna K. Chu
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Yvonne C. W. van der Hoeven
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Psychology, 6525 Nijmegen, The Netherlands
| | - Judith B. Prins
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Psychology, 6525 Nijmegen, The Netherlands
| | - Winette T. A. van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute, 1066 Amsterdam, The Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus Medical Center, 3015 Rotterdam, The Netherlands
| | - Carla M. L. van Herpen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Oncology, 6525 Nijmegen, The Netherlands
| | - Inge M. van Oort
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Urology, 6525 Nijmegen, The Netherlands
| | - Sophie Lebel
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Belinda Thewes
- School of Psychology, Sydney University, Camperdown 2050, Australia
| | - Linda Kwakkenbos
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Psychology, 6525 Nijmegen, The Netherlands
- Clinical Psychology, Radboud University, 6525 Nijmegen, The Netherlands
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, 6525 Nijmegen, The Netherlands
- Radboud University Medical Center, Radboudumc Center for Mindfulness, Department of Psychiatry, 6525 Nijmegen, The Netherlands
| | - José A. E. Custers
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Psychology, 6525 Nijmegen, The Netherlands
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15
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Bland KA, Krishnasamy M, Parr EB, Mulder S, Martin P, van Loon LJC, Cormie P, Michael N, Zopf EM. “I want to get myself as fit as I can and not die just yet” – Perceptions of exercise in people with advanced cancer and cachexia: a qualitative study. BMC Palliat Care 2022; 21:75. [PMID: 35578224 PMCID: PMC9110215 DOI: 10.1186/s12904-022-00948-x] [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: 02/22/2022] [Accepted: 04/15/2022] [Indexed: 11/10/2022] Open
Abstract
Cachexia is a prevalent muscle wasting syndrome among people with advanced cancer that profoundly impacts patient quality of life (QoL) and physical function. Exercise can improve QoL, physical function, and overall health in people with cancer and may be an important addition to treatment approaches for cancer cachexia. Greater understanding of patients’ perception of exercise can help elucidate the feasibility of implementing exercise interventions for cancer cachexia and facilitate the design of patient-centered interventions. We aimed to describe the perception of exercise in patients with advanced cancer and cachexia, and capture exercise motivators, barriers, and preferences, to inform the feasibility of exercise interventions. Individual interviews (n = 20) with patients with locally advanced or metastatic cancer with cachexia were conducted and analyzed using reflexive thematic analysis. Main themes from interviews were: 1) Life is disrupted by cancer and cachexia; 2) Exercise offers hope; 3) Exercise barriers are multifaceted; and 4) Exercise access and support are important. Participants reported that their cancer and cachexia had intensely altered their lives, including ability to exercise. Exercise was perceived as important and participants described a hope for exercise to improve their health and wellbeing. Yet, several complex exercise barriers, such as burdensome cancer symptoms and the overwhelming impact of the COVID-19 pandemic, hindered exercise participation and prevented participants from fully realizing the perceived benefits of exercise. Factors believed to improve exercise engagement and overcome exercise barriers included increased exercise support (e.g., professional supervision) and accessibility (e.g., convenient locations). Patient-reported exercise barriers and preferences can inform the design of exercise interventions, particularly within future research studies aiming to establish exercise feasibility and efficacy in people with advanced cancer and cachexia.
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16
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Abbas Q, Arooj N, Baig KB, Khan MU, Khalid M, Shahzadi M. A clinical trial of cognitive behavior therapy for psychiatric comorbidity and quality of life with Cancer Patients during Chemotherapy (CPdC). BMC Psychiatry 2022; 22:222. [PMID: 35351037 PMCID: PMC8966166 DOI: 10.1186/s12888-022-03863-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 03/15/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Cancer is a common worldwide illness; it evokes psychological distress at different stages, during chemotherapy patient perceives a variety of psychiatric symptoms due to various medication side-effects and psychological distress. Studies have shown a significant impact of cognitive behavior therapy (CBT) in the management of psychiatric symptoms during chemotherapy. This study aims to investigate the effectiveness of CBT for depression, anxiety, stress, death anxiety, satisfaction with life, and self-esteem among cancer patients during chemotherapy (CPdC). METHODS Place and duration of the study: Department of Applied Psychology, Government College University Faisalabad in collaboration with Department of Oncology, Allied Hospital Faisalabad from November 20, 2020 and July 31, 2021. A total of 90 cancer patients were enrolled. 70 out of 90 met the eligibility criteria and 60 participants fulfilled all requirements. Participants were randomly allocated to four different groups. The pre-assessment screening was started along with the first trial of chemotherapy. The CBT-based treatment plan was formulated and one session per week was given to each patient for 3 to 4 months. Participants' age range was 18-65 years (M ± SD = 47.51 ± 12.36. Demographic form, Depression Anxiety and Stress Scale (DASS), Death Anxiety Scale (DAS), Satisfaction with Life Scale (SWLS), and Rosenberg Self-Esteem Scale (RSES) were administered. Descriptive, t-test, and repeated measure ANOVA statistics were used to investigate the findings. RESULTS Results indicated significant mean difference on the variable of depression, anxiety and stress across four conditions (i.e. F(2, 56) = 39.55, p < .000, η2 = .679; F(2,56) = 73.32, p < .000, η2 = .797; F(2,56) = 119.77, p < .000, η2 = .865 respectively). On death anxiety significant difference across four conditions was found (F(2,56) = 22.71, p < .000, η2 = .549) with large effect size. Furthermore, findings indicated significant mean difference on the variable of satisfaction with life and self-esteem across four conditions was found (F(2,56) = 22.05, p < .000, η2 = .542; F(2,56) = 36.19, p < .000, η2 = .660) with large effect size. CONCLUSION It is concluded that CBT played a very effective role to reduce depression, anxiety, and stress-related psychiatric symptoms. CBT reduces the level of death anxiety and improving the quality of life and level of self-esteem among CPdC. TRIAL REGISTRATION The study trial was registered in the Thai Clinical Trial Registry-TCTR ( TCTR20201113002 ).
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Affiliation(s)
- Qasir Abbas
- Department of Applied Psychology, Government College University Faisalabad, Zakid Block 1st floor, Main Campus, Faisalabad, Punjab, Pakistan.
| | - Nimra Arooj
- grid.411786.d0000 0004 0637 891XDepartment of Applied Psychology, Government College University Faisalabad, Zakid Block 1st floor, Main Campus, Faisalabad, Punjab Pakistan
| | - Khawer Bilal Baig
- Department of Professional Psychology, Bahria University Lahore Campus, Lahore, Pakistan
| | - Muhammad Umar Khan
- grid.411786.d0000 0004 0637 891XDepartment of Applied Psychology, Government College University Faisalabad, Zakid Block 1st floor, Main Campus, Faisalabad, Punjab Pakistan
| | - Muhammad Khalid
- grid.444767.20000 0004 0607 1811Department of Clinical Oncology, Medical University Faisalabad, Faisalabad, Punjab Pakistan
| | - Mafia Shahzadi
- grid.411786.d0000 0004 0637 891XDepartment of Applied Psychology, Government College University Faisalabad, Zakid Block 1st floor, Main Campus, Faisalabad, Punjab Pakistan
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17
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Death anxiety among advanced cancer patients: a cross-sectional survey. Support Care Cancer 2022; 30:3531-3539. [PMID: 35018522 PMCID: PMC8752389 DOI: 10.1007/s00520-022-06795-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 12/31/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE This study aimed to investigate death anxiety in advanced cancer patients and identify associated factors in the context of Chinese culture. METHODS Participants (N = 270) with advanced cancer in a tertiary cancer hospital completed anonymous questionnaire surveys. Measures included the Chinese version of a Likert-type Templer-Death Anxiety Scale, Rosenberg's Self-esteem Scale, Medical Coping Modes Questionnaire, the Social Support Rating Scale, and Connor-Davidson Resilience Scale. Data were analyzed in SPSS using descriptive statistics, Student's t test, Pearson correlation test, and linear regression. RESULTS Respondents returned 252 (93.33%) of the 270 questionnaires. The total CL-TDAS score was 39.56 ± 10.20. The top three items were "I fear dying a painful death" (3.59 ± 1.41), "I often think about how shortly life really is" (3.11 ± 1.33), and "1 am not particularly afraid of getting cancer" (3.09 ± 1.35). Associated factors of death anxiety (R2 = .333, F = 15.756, p < .001) were the medical coping mode (resignation, confronce), self-esteem, the participants' adult children, the patient-primary caregivers' relationship, resilience, and the level of activity of daily living. CONCLUSIONS Our results demonstrate high levels of death anxiety in advanced cancer patients. Generally, patients with adult children, high self-esteem and resilience had low death anxiety. Conversely, patients with low levels of activity of daily living and high coping mode (resignation, confrontation) reported high death anxiety. We determined that associated factors contributed to reduce death anxiety. Social interventions are recommended to improve the end-of-life transition for patients and caregivers.
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18
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Advanced Cancer Patients' Prognostic Awareness and Its Association With Anxiety, Depression and Spiritual Well-Being: A Multi-Country Study in Asia. Clin Oncol (R Coll Radiol) 2021; 34:368-375. [PMID: 34930691 DOI: 10.1016/j.clon.2021.11.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/15/2021] [Accepted: 11/30/2021] [Indexed: 11/23/2022]
Abstract
AIMS The associations between prognostic awareness, acceptance of illness and psychological outcomes (anxiety, depression and spiritual well-being) remain unclear. This study examined the associations between prognostic awareness and various psychological outcomes and how they can be moderated by patient acceptance of illness (cancer). MATERIALS AND METHODS In total, 1184 patients with stage IV solid cancer were recruited at major public hospitals across four Asian countries (China, India, Sri Lanka, Vietnam). Prognostic awareness and acceptance of illness were assessed through self-reported understanding of treatment intent and acceptance of illness, respectively. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale, whereas spiritual well-being was measured using the Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale. Multivariate regressions were used to estimate the associations while controlling for patient characteristics. RESULTS Compared with being unaware of their prognosis (i.e. believing that their cancer is curable), being aware or unsure of their prognosis was associated with higher anxiety and depressive symptoms, and lower spiritual well-being scores. Acceptance of illness moderated these relationships and improved the psychological outcomes. CONCLUSIONS The results suggest that disclosure of prognostic information should be provided in conjunction with psychological interventions that focus on acceptance of illness.
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19
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Iskandar AC, Rochmawati E, Wiechula R. Experiences and perspectives of suffering in cancer: A qualitative systematic review. Eur J Oncol Nurs 2021; 54:102041. [PMID: 34610535 DOI: 10.1016/j.ejon.2021.102041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE Suffering refers to a situation in which a person's illness and condition threaten their integrity. The aim of this systematic review was to synthesize qualitative studies that explored suffering of persons with cancer. METHOD A qualitative systematic review was conducted. Psych Info, PubMed, and CINAHL were searched for relevant studies. Methodological quality was independently assessed using the Critical Appraisal Checklist from Joanna Briggs Institute (JBI). A meta-aggregative approach was utilized to analyze and synthesize the data that focused on how persons with cancer perceive suffering across their illness trajectory. RESULTS Twelve articles reporting the experiences of 230 participants were synthesized. Three synthesized findings were generated from the articles: suffering the loss of normality, suffering in relation to others and existential suffering. Suffering affects the person's normal activities of life and cause the loss of normality. Suffering in relation to others refers patients' suffering also impacts on and is impacted by those around them. The last synthesized finding refers to impact of suffering on patients' whole sense of being. In addition, feelings of hopelessness, and other mental anguish are inevitable responses that lead the patients to think about death. The overall methodological quality resulted in a ConQual rating of moderate for the synthesized findings. CONCLUSION The persons' suffering not only affects themselves but also others, particularly close relatives. The suffering experienced is complex and goes well beyond the immediate impact of physical symptoms and treatment.
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Affiliation(s)
| | - Erna Rochmawati
- School of Nursing, Universitas Muhammadiyah Yogyakarta, Indonesia.
| | - Rick Wiechula
- School of Nursing, Universitas Muhammadiyah Yogyakarta, Indonesia; Adelaide Nursing School, University of Adelaide, Australia; Centre for Evidence-based Practice South Australia: A Joanna Briggs Institute Centre of Excellence, Australia
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20
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Wulandari BT, Arianti A. The Dignity of Middle Adult Palliative Patients at Home in Bantul. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The condition of middle adult patients with palliative disease is prone to experiencing physical weakness and psychological suffering, disrupting dignity. As a caregiver at home, the family plays an essential role in providing support to maintain patient dignity.
AIM: This study aims to determine the image of the dignity of the middle adult patient with palliative care needs by family at home.
METHODS: This research is a qualitative study with a phenomenological approach. Participants were seven people with the purposive sampling method. Data collection methods were conducted using in-depth interviews and semi-structured observation. Research instruments included interview guidelines, field notes, and an observation form. Data validity used reference material, rich and thick description, and peer debriefing. Data analysis included data collection, data reduction, data presentation, and conclusion.
RESULTS: The results showed that the dignity of patients was considered by six themes; self-esteem went up and down, the meaning of illness and death, family response to the patient, sources of decision-making, an image of the quality of life, and future wishes.
CONCLUSION: This study had six themes depicting the dignity of patients that consisted of subthemes. The themes included self-esteem went up and down, the meaning of illness and death, family response to the patient, sources of decision-making, an image of the quality of life, and future wishes.
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21
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O'Sullivan A, Alvariza A, Öhlén J, Larsdotter C. Support received by family members before, at and after an ill person's death. BMC Palliat Care 2021; 20:92. [PMID: 34167530 PMCID: PMC8228910 DOI: 10.1186/s12904-021-00800-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/11/2021] [Indexed: 11/30/2022] Open
Abstract
Background It is widely recognised, that family members are central to care of people with advanced illness, and that support should be provided to all family members in need thereof. The aim of this study was to investigate family members’ experiences of support received during the last three months of life, at the time of death and after the death of a person with advanced illness. Methods A retrospective cross-sectional survey design was employed, using the VOICES(SF) questionnaire and multiple methods for data analyses. The sample consisted of 485 bereaved family members (aged: 20–90 years old, 70% women) of people who died in hospital between August 2016-April 2017. Results Of the family members, 58,8% reported they had received enough help and support during the illness, whereas 30,2% had not. Family members’ comments about support during the illness were mainly related to care the ill person had or had not received, rather than about support they themselves received. Of all family members, 52,8% reported having had enough support at the time of the ill person’s death. Related to support at death, 14,6% reported that the imminence of death was not clear, which was described as having affected their opportunity to be with the dying person at the time of death. Of all, 25,2% had a follow-up conversation after the death, 48% did not and did not want to, and 21% had no follow-up conversation, but would have liked one. A follow-up conversation was described as helpful for the bereavement process, and disappointment was expressed when not receiving support after the death. Conclusions Family members’ experiences of support were partly related to whether the ill person’s care needs were fulfilled. Healthcare staff expressing empathy and respect in the care of dying people and their family members were important for family members’ experiences of support. Family members’ difficulty recognising that death was imminent and the importance of healthcare staff providing them with clear information were expressed in connection with support at death. Follow-up conversations were valued by family members, especially if with a healthcare professional who was present at the time of death.
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Affiliation(s)
- Anna O'Sullivan
- Palliative Research Centre, Department of Healthcare Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Anette Alvariza
- Palliative Research Centre, Department of Healthcare Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden.,Capio Palliative Care, Dalen Hospital, Stockholm, Sweden
| | - Joakim Öhlén
- Centre for Person-Centered Care, University of Gothenburg, Gothenburg, Sweden.,Institute of Health and Care Sciences, Sahlgrenska Academy At the University of Gothenburg, Gothenburg, Sweden.,Palliative Centre, Sahlgrenska University Hospital Västra Götaland Region, Gothenburg, Sweden
| | - Cecilia Larsdotter
- Palliative Research Centre, Department of Healthcare Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden. .,Department of Nursing Science, Sophiahemmet University, P.O. Box 5605, 114 86, Stockholm, Sweden.
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22
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Ruíz-Fernández MD, Fernández-Medina IM, Granero-Molina J, Hernández-Padilla JM, Correa-Casado M, Fernández-Sola C. Social acceptance of death and its implication for end-of-life care. J Adv Nurs 2021; 77:3132-3141. [PMID: 33755231 DOI: 10.1111/jan.14836] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/08/2021] [Accepted: 03/07/2021] [Indexed: 12/15/2022]
Abstract
AIMS To understand how the social patterns about death influence end-of-life care from the perspective of healthcare professionals. DESIGN A qualitative study according to the theory of Glaser and Strauss. METHODS A purposeful sample of 47 participants with different roles (nurses, physicians and clinical psychologists) were involved in four focus groups and 17 interviews in 2017-2019. Responses were audio-recorded, transcribed verbatim and analysed using computer-assisted qualitative data. RESULTS A core category 'the theory of social patterns about death' emerged, which is explained by three categories: the culture of concealment and stubbornness towards death, the effort and internal work to make death a part of existence, and the influence of the social patterns of coping with death on end-of life care and healthcare professionals. Our results suggest that social coping with death is affected by a network of concealment and obstinacy towards death. CONCLUSION Recognizing death as part of life and thinking about death itself are social coping strategies. Although healthcare professionals occupy a privileged place in this process, the culture of concealment of death influences end-of-life care. IMPACT The social process that leads to the loneliness of the dying in our days has been theorized. However, social acceptance of death also influences healthcare professionals' attitudes towards death. Thus, healthcare professionals' own attitudes may affect the end-of-life care given to dying individuals and their families. The social patterns of death may contribute to the healthcare professionals' negative attitudes towards death. The concept of dignified death has been linked to the notion of humanization of healthcare. Death should be approached from a more naturalistic perspective by healthcare professionals, healthcare and academic institutions.
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Affiliation(s)
| | | | - José Granero-Molina
- Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain.,Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco, Chile
| | - José Manuel Hernández-Padilla
- Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain.,Department of Adult, Child and Midwifery, School of Health and Education, Middlesex University, London, UK
| | - Matías Correa-Casado
- Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain
| | - Cayetano Fernández-Sola
- Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain.,Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco, Chile
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Understanding Existential Anxiety and the Soothing Nature of Nostalgia in Life With Incurable Esophageal Cancer: A Phenomenological Hermeneutical Investigation of Patient Narratives. Cancer Nurs 2021; 45:E291-E298. [PMID: 33443956 DOI: 10.1097/ncc.0000000000000916] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Research has identified how people living with incurable esophageal cancer experience existential concerns. OBJECTIVE The aim of this study was to examine the phenomenon of existential anxiety when living with esophageal cancer in the context of receiving general palliative care in a hospital setting. METHODS This qualitative study is inspired by phenomenological and hermeneutical aspects of the philosophies of Ricoeur and Heidegger. Applying Heidegger's theory of existential anxiety and nostalgia, we interpreted the narratives of 18 patients receiving palliative care due to incurable esophageal cancer. RESULTS The patients experienced existential anxiety at the loss of a future and homeliness when receiving palliative care. Their existence was reduced to the present, with a break in temporal continuity. An anxious mood permeated their entire being-in-the-world in an unhomelike way. Despite this, patients initiated a restoration of home and meaning expressed as a soothing sense of nostalgia that served as an atmospheric, safe space allowing them to inhabit the borderline between past, present, and future. CONCLUSIONS The study suggests an empirical interpretation of the existential anxiety patients experience when receiving palliation for incurable esophageal cancer. It sheds light on how these patients would benefit from healthcare professionals inviting them to narrate significant aspects of their life stories in which the soothing presence of nostalgia can be supported. IMPLICATION FOR PRACTICE Providing care conditions for a life heading toward death, where the patient can live alongside anxiety, involves focusing on "being with" the patient and on incorporating a nostalgic dimension to facilitate soothing restoration of home for patients.
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Bittencourt NCCDM, Santos KA, Mesquita MGDR, Silva VGD, Telles AC, Silva MMD. Sinais e sintomas manifestados por pacientes em cuidados paliativos oncológicos na assistência domiciliar: uma revisão integrativa. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo identificar os principais sinais e sintomas manifestados por pacientes em cuidados paliativos oncológicos na assistência domiciliar. Método revisão integrativa nas bases LILACS, MEDLINE e CINAHL em janeiro de 2020. Perguntou-se: “Quais os principais sinais e sintomas manifestados por pacientes em cuidados paliativos oncológicos destacados nos estudos abrangendo o contexto do domicílio?”. Foram descritores/termos: Sinais e Sintomas/Signs and Symptoms; Assistência Domiciliar/Home Care Services; Cuidados Paliativos/Palliative Care e Neoplasias/Neoplasms. Elencaram-se como critérios de elegibilidade: texto completo; entre 2015 e 2019; em inglês, português ou espanhol e idade adulta. Para o mapeamento dos dados, consideraram-se: título; país; ano; objetivo; método; sinais e sintomas. Os resultados foram categorizados em subgrupos, considerando a classificação conceitual predeterminada (sinal e sintoma). O elemento contagem facilitou a análise e a comparação de dados. Resultados foram selecionados 35 artigos, sendo identificados 25 sinais e 23 sintomas. Os mais frequentes foram: dor, náusea/vômito, dispneia, fadiga, depressão, ansiedade, constipação, perda de apetite, sonolência, bem-estar e insônia. A maioria (39) relacionou-se ao domínio físico. Conclusão a identificação dos principais sinais e sintomas, neste contexto, direciona a prática dos profissionais de saúde para as intervenções mais adequadas e o mais precocemente possível, contribuindo para viabilizar a assistência domiciliar, e alerta para a necessidade de educação permanente sobre este tema.
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25
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Iskandar AC, Rochmawati E, Wiechula R. Patient's experiences of suffering across the cancer trajectory: A qualitative systematic review protocol. J Adv Nurs 2020; 77:1037-1042. [PMID: 33210384 DOI: 10.1111/jan.14628] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/01/2020] [Accepted: 10/16/2020] [Indexed: 11/28/2022]
Abstract
AIM To identify, appraise and synthesize the available evidence from qualitative research exploring the suffering of patients with cancer during their illness trajectories. DESIGN Protocol for a qualitative systematic review. DATA SOURCES The database will include PubMed, CINAHL and Psych Info were searched in May 2020. METHODS The review protocol has been registered in International Prospective Register for Systematic Review (CRD42020165405). This review will systematically search qualitative research studies in databases from 1982-May 2020, with predetermined search terms. Searches are limited to studies in English. Two reviewers will independently appraise the methodological quality of the selected studies using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Disagreements can be settled through discussion which includes a third reviewer, if necessary. This review will use the meta-aggregative approach to analyze and synthesize data. A summary of findings from selected studies will be presented. DISCUSSION Suffering is a complex dimension that included physical psychological, existential and social dimensions. This review will enable nurses to gain an in-depth understanding of suffering that not only worsens at the end of life that can deliver comprehensive care. IMPACT This review is designed to systematically identify and explore the suffering that patients with cancer experience during their illness trajectory. Often suffering is highlighted at the end of life phase. This review will synthesize the evidence of suffering from the beginning of the patient's diagnosis to the end of life. The results of this review provide evidence to support nursing developments in education and clinical practice so that understanding of cancer can be optimized. The findings of the proposed review will contribute as a basis for recommendations for future research regarding suffering.
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Affiliation(s)
| | - Erna Rochmawati
- School of Master in Nursing, Universitas of Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Rick Wiechula
- Adelaide Nursing School, University of Adelaide, Adelaide, SA, Australia.,Centre for Evidence-based Practice South Australia: A Joanna Briggs Institute Centre of Excellence, Adelaide, SA, Australia.,School of Master in Nursing, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
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