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Gärtner HS, Blix BH, Raunkiær M, Timm H. "The Most Fantastic Thing is Coming Here as an Individual and Going to Bed as Part of a Group": Participants' Experiences From a Residential Course, for People With Advanced Cancer. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241264876. [PMID: 39046069 DOI: 10.1177/00302228241264876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
People who suffer from advanced cancer may experience a loss of ability to participate in everyday life and meaningful activities, challenging their sense of identity and social relations. Social support in patient-to-patient interactions and the sharing of experiences with people in similar situations may help alleviate distress. This article is based on an ethnographic field study carried out in relation to three residential narrative courses, which included 36 persons with advanced cancer. In this study, we aimed to explore whether the courses were perceived as significant by the participants and, if so, in what ways. The field work included 185 hr of observations, six focus group interviews and nine individual interviews. The data were analyzed using an abductive thematic approach. Our findings indicate that the residential courses were generally experienced as meaningful and that in particular the setting, the community, and gaining hope were experienced as significant.
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Affiliation(s)
| | - Bodil H Blix
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Bergen, Norway
| | - Mette Raunkiær
- Head of Research, REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Copenhagen, Denmark
| | - Helle Timm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- UCSF - Center for Health Research, Copenhagen University Hospital, Copenhagen, Denmark
- Centre for Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
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Chen P, Ding M, Li C, Long Y, Pan D, Ma L, Liu T, Yi C. Distinct experiences and care needs of advanced cancer patients with good ECOG performance status: a qualitative phenomenological study. BMC Palliat Care 2024; 23:102. [PMID: 38627698 PMCID: PMC11022448 DOI: 10.1186/s12904-024-01425-3] [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: 05/08/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Advanced cancer patients with good Eastern Cooperative Oncology Group (ECOG) performance status (score 0-1) are underrepresented in current qualitative reports compared with their dying counterparts. AIM To explore the experiences and care needs of advanced cancer patients with good ECOG. DESIGN A qualitative phenomenological approach using semi-structured interview was employed. Data was analyzed using the Colaizzi's method. SETTING/PARTICIPANTS Purposive sample of terminal solid cancer patients on palliative care aged 18-70 years with a 0-1 ECOG score were recruited from a tertiary general hospital. RESULTS Sixteen participants were interviewed. Seven themes were generated from the transcripts, including experiencing no or mild symptoms; independence in self-care, decision-making, and financial capacity; prioritization of cancer growth suppression over symptom management; financial concerns; hope for prognosis and life; reluctance to discuss death and after-death arrangements; and use of complementary and alternative medicine (CAM) and religious coping. CONCLUSIONS Advanced cancer patients with good ECOG have distinct experiences and care needs from their dying counterparts. They tend to experience no or mild symptoms, demonstrate a strong sense of independence, and prioritize cancer suppression over symptom management. Financial concerns were common and impact their care-related decision-making. Though being hopeful for their prognosis and life, many are reluctant to discuss death and after-death arrangements. Many Chinese patients use herbal medicine as a CAM modality but need improved awareness of and accessibility to treatment options. Healthcare professionals and policy-makers should recognize their unique experiences and needs when tailoring care strategies and policies.
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Affiliation(s)
- Ping Chen
- Abdominal Oncology Ward, Division of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, 610041, Sichuan Province, China
- Department of Oncology, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), No. 1 Shi'er Zhong Street, Wuhou District, Chengdu, 610041, Sichuan Province, China
| | - Mingfu Ding
- Rehabilitation Medicine Department, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, 610041, Sichuan Province, China
| | - Changlin Li
- Department of Oncology, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), No. 1 Shi'er Zhong Street, Wuhou District, Chengdu, 610041, Sichuan Province, China
| | - Yujuan Long
- Department of Intensive Care Unit, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), No. 1 Shi'er Zhong Street, Wuhou District, Chengdu, 610041, Sichuan Province, China
| | - Deng Pan
- Department of Medical Oncology, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530016, Guangxi, China
| | - Li Ma
- Department of Oncology, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), No. 1 Shi'er Zhong Street, Wuhou District, Chengdu, 610041, Sichuan Province, China
| | - Taiguo Liu
- Department of Oncology, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), No. 1 Shi'er Zhong Street, Wuhou District, Chengdu, 610041, Sichuan Province, China.
| | - Cheng Yi
- Abdominal Oncology Ward, Division of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu, 610041, Sichuan Province, China.
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Berntzen H, Rustøen T, Kynø NM. "Hope at a crossroads" - Experiences of hope in intensive care patients: A qualitative study. Aust Crit Care 2024; 37:120-126. [PMID: 37709659 DOI: 10.1016/j.aucc.2023.07.037] [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: 05/10/2023] [Revised: 07/13/2023] [Accepted: 07/17/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Hope is closely connected to experiences of health and illness. In critical illness, the future may be uncertain regarding survival, recovery, and daily functioning. More knowledge is needed on how to support hope in patients in intensive care units and during the following rehabilitation period. OBJECTIVES The aim of this study was to explore hope and its impacting factors among critically ill patients in the intensive care unit. METHODS This was an exploratory study using semistructured interviews for data collection. Thirteen patients discharged from intensive care were interviewed while still in hospital. Data were analysed using thematic analysis. The consolidated criteria for reporting qualitative research were used for reporting this study. FINDINGS Three themes, consisting of 8 subthemes, were generated through the analysis. The first theme presented, 'Hope at the point of uncertainty', describes the perception of hope as a phenomenon in critical illness, while the last two, 'Nourishment for hope' and 'Barriers to hope', comprise possible promoting and constraining factors affecting hope during intensive care The overarching theme 'Hope at a crossroads' reflects the overall patient experience of hope in critical illness. CONCLUSION To maintain or regain hope, healthcare personnel working with critically ill patients should be aware of the importance of encouraging and acknowledging physical progress even when small. Furthermore, they should attend to patients' relational needs and facilitate their ability to interact as the persons they are, not only as patients.
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Affiliation(s)
- Helene Berntzen
- Department of Postoperative and Intensive Care Nursing, Division of Emergencies and Critical Care, Oslo University Hospital, Norway.
| | - Tone Rustøen
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Norway; Department of Public Health Science, Institute of Health and Society, Faculty of Medicine, University of Oslo Norway, Norway
| | - Nina M Kynø
- Oslo Metropolitan University, Faculty of Health Sciences, Department of Nursing and Health Promotion, Acute and Critical Illness, Oslo, Norway; Department of Pediatric and Adolescent Medicine, Division of Neonatal Intensive Care, Oslo University Hospital, Norway
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Velić S, Qama E, Diviani N, Rubinelli S. Patients' perception of hope in palliative care: A systematic review and narrative synthesis. PATIENT EDUCATION AND COUNSELING 2023; 115:107879. [PMID: 37413808 DOI: 10.1016/j.pec.2023.107879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE The aim of this study was to systematically review and synthesize the literature on patients' perceptions of hope in palliative care. METHODS PubMed, Scopus, SocINDEX, Cochrane, and Web of Science were screened against the eligibility criteria. After familiarization with the data and conduction of the coding process, studies were thematically analyzed using Braun and Clarke's methodology. The research question guiding our analysis was: what is said about hope from patients in PC? RESULTS The database searches yielded 24 eligible studies. Three main themes emerged from the studies: Hope beliefs (encompassing patients' understanding of hope and characteristics assigned to it), Hope functions (including the role that hope plays for patients) and Hope work (highlighting aspects that in patients' perspective cultivate hope). CONCLUSION This review emphasizes the importance of acknowledging patients' understanding of hope, its role, and the efforts required to sustain it. In particular, it suggests that hope serves as a valuable strategy, fostering meaningful personal relationships towards end of life. PRACTICE IMPLICATIONS In order to address communication challenges in clinical practice, a potential fruitful strategy for nurturing hope could involve engaging family and friends in hope interventions facilitated by healthcare professionals.
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Affiliation(s)
- Sanda Velić
- Swiss Paraplegic Research, Person-centered Healthcare & Health Communication Group, Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland; Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Luzern, Switzerland
| | - Enxhi Qama
- Swiss Paraplegic Research, Person-centered Healthcare & Health Communication Group, Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland; Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Luzern, Switzerland
| | - Nicola Diviani
- Swiss Paraplegic Research, Person-centered Healthcare & Health Communication Group, Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland; Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Luzern, Switzerland
| | - Sara Rubinelli
- Swiss Paraplegic Research, Person-centered Healthcare & Health Communication Group, Guido A. Zäch Strasse 4, 6207 Nottwil, Switzerland; Faculty of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Luzern, Switzerland.
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Wahyuni S, Gautama MSN, Simamora TY. A Literature Review of Nurses Challenges and Barriers in Assisting Patients and Families Facing Breaking Bad News. Indian J Palliat Care 2023; 29:243-249. [PMID: 37700890 PMCID: PMC10493690 DOI: 10.25259/ijpc_128_2023] [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: 05/21/2023] [Accepted: 07/22/2023] [Indexed: 09/14/2023] Open
Abstract
Objectives Breaking bad news (BBN) is a challenging task for healthcare professionals, including nurses. The manner in which bad news is delivered can have a significant impact on patients and their families, either positive or negative. Understanding the roles, methods, obstacles, and challenges that nurses face in the process of delivering bad news is crucial for improving the quality of the delivery process. Material and Methods This narrative review synthesises related studies. The search was conducted through PubMed, Scopus, ScienceDirect and Sage, with no restriction on publication year. The main keywords were 'nurse's challenge', 'nurse's barrier', 'bad news', 'breaking bad news', and 'communicating bad news.' A total of 12 articles were selected from 1075 articles. Results Nurses play a key role in BBN before, during and after the process. Their activities include preparing patients to receive bad news, supporting patients and families when doctors deliver bad news and clarifying information obtained by patients and families regarding the prognosis of their illness. Nurses should possess skills such as building interpersonal relationships, therapeutic communication and providing emotional care for patients and their families. The main challenges and barriers for nurses in implementing BBN are due to a lack of skills and unpreparedness for patient and family reactions. After BBN, the most reported roles of nurses were supporting patients and families and helping them understand the information received from doctors. It is essential for nurses to have the necessary skills and preparedness to effectively deliver bad news to patients and their families. Conclusion Nurses play a crucial role in delivering bad news to patients and their families. They should be equipped with the necessary skills to effectively communicate with patients and their families during this difficult time. Further training for nurses in therapeutic communication, emotional care for patients and their families, and building interpersonal relationships could help to improve the quality of the delivery process.
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Affiliation(s)
- Surya Wahyuni
- Master of Nursing Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Made Satya Nugraha Gautama
- Master of Nursing Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Tiur Yulianta Simamora
- Master of Nursing Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Hammer K, Højgaard HS, Á Steig B, Wang AG, Bergenholtz HM, Rosted EE. Hope pictured in drawings by patients newly diagnosed with advanced cancer. J Clin Nurs 2023; 32:1262-1275. [PMID: 35277902 DOI: 10.1111/jocn.16274] [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: 12/20/2021] [Revised: 02/15/2022] [Accepted: 02/22/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hope is an integral part of a dying person's needs and an important phenomenon that has not been satisfactorily explored. The tension between hope for a cure and the reality of being terminally ill is a paradox, which in the context of palliative cancer care, nurses and health care professionals must take into consideration. OBJECTIVE The purpose of this study was to elucidate the phenomenon of hope and to investigate the lived experiences of hope among newly diagnosed patients with advanced cancer. METHOD The study used a phenomenological-visual method where drawings and post-drawing interviews were used. The participants were six patients who recently had been offered specialised palliative care treatment. They were five women and one man with different cancer diagnoses and between 30 and 82 years of age (median 65 years). The data consisted of six drawings and individual post-drawing interviews with the participants. The study was reported using the COREQ checklist. RESULTS The study revealed one main concern 'Being in hope' and hope appeared in four different dimensions; internal, external, relational and transcendental. Hopelessness was present at all times. CONCLUSION Hope pictured in drawings was expressed through colour, shape, lines, symbols and metaphors, and hope incorporated internal, external, relational and transcendental aspects. Hope was constantly fighting against hopelessness and hope integrated with past, present and future. RELEVANCE TO CLINICAL PRACTICE Drawings, as well as other visual representations, are suitable tools when trying to understand an ineffable phenomenon such as hope experienced by people newly diagnosed with cancer.
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Affiliation(s)
- Kristianna Hammer
- Department of Palliative Care, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | | | - Bjarni Á Steig
- Department of Hematology and Palliative Care, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands
| | - August G Wang
- Faculty of Health, University of Faroe Islands, Tórshavn, Faroe Islands.,Centre of Psychiatry, Copenhagen University Hospital Amager, Copenhagen S, Denmark
| | - Heidi M Bergenholtz
- Department of Surgery, Holbaek Hospital, Holbaek, Denmark.,REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Nyborg, UK
| | - Elizabeth E Rosted
- Department of Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark.,University of Southern Denmark, Odense, Denmark
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Kodba‐Čeh H, Lunder U, Bulli F, Caswell G, van Delden JJM, Kars MC, Korfage IJ, Miccinesi G, Rietjens JAC, Seymour J, Toccafondi A, Zwakman M, Pollock K. How can advance care planning support hope in patients with advanced cancer and their families: A qualitative study as part of the international ACTION trial. Eur J Cancer Care (Engl) 2022; 31:e13719. [PMID: 36168108 PMCID: PMC9787960 DOI: 10.1111/ecc.13719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Clinicians' fears of taking away patients' hope is one of the barriers to advance care planning (ACP). Research on how ACP supports hope is scarce. We have taken up the challenge to specify ways in which ACP conversations may potentially support hope. METHODS In an international qualitative study, we explored ACP experiences of patients with advanced cancer and their personal representatives (PRs) within the cluster-randomised control ACTION trial. Using deductive analysis of data obtained in interviews following the ACP conversations, this substudy reports on a theme of hope. A latent thematic analysis was performed on segments of text relevant to answer the research question. RESULTS Twenty patients with advanced cancer and 17 PRs from Italy, the Netherlands, Slovenia, and the United Kingdom were participating in post-ACP interviews. Three themes reflecting elements that provide grounds for hope were constructed. ACP potentially supports hope by being (I) a meaningful activity that embraces uncertainties and difficulties; (II) an action towards an aware and empowered position; (III) an act of mutual care anchored in commitments. CONCLUSION Our findings on various potentially hope supporting elements of ACP conversations provide a constructive way of thinking about hope in relation to ACP that could inform practice.
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Affiliation(s)
- Hana Kodba‐Čeh
- University Clinic of Respiratory and Allergic Diseases GolnikGolnikSlovenia
- Faculty of Arts, Department of PsychologyUniversity of LjubljanaLjubljanaSlovenia
| | - Urška Lunder
- University Clinic of Respiratory and Allergic Diseases GolnikGolnikSlovenia
| | - Francesco Bulli
- Clinical Epidemiology UnitOncological network research and prevention Institute‐ISPROSienaItaly
| | - Glenys Caswell
- School of Health SciencesUniversity of NottinghamNottinghamUK
| | - Johannes J. M. van Delden
- Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Marijke C. Kars
- Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Ida J. Korfage
- Department of Public HealthErasmus MC, Erasmus University Medical CenterRotterdamThe Netherlands
| | - Guido Miccinesi
- Clinical Epidemiology UnitOncological network research and prevention Institute‐ISPROSienaItaly
| | - Judith A. C. Rietjens
- Department of Public HealthErasmus MC, Erasmus University Medical CenterRotterdamThe Netherlands
| | - Jane Seymour
- Division of Nursing and Midwifery, Health Sciences SchoolUniversity of SheffieldSheffieldUK
| | - Alessandro Toccafondi
- Clinical Epidemiology UnitOncological network research and prevention Institute‐ISPROSienaItaly
| | - Marieke Zwakman
- Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrechtThe Netherlands
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Fhoula B, Hadid M, Elomri A, Kerbache L, Hamad A, Al Thani MHJ, Al-Zoubi RM, Al-Ansari A, Aboumarzouk OM, El Omri A. Home Cancer Care Research: A Bibliometric and Visualization Analysis (1990-2021). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13116. [PMID: 36293702 PMCID: PMC9603182 DOI: 10.3390/ijerph192013116] [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: 08/09/2022] [Revised: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
Home cancer care research (HCCR) has accelerated, as considerable attention has been placed on reducing cancer-related health costs and enhancing cancer patients' quality of life. Understanding the current status of HCCR can help guide future research and support informed decision-making about new home cancer care (HCC) programs. However, most current studies mainly detail the research status of certain components, while failing to explore the knowledge domain of this research field as a whole, thereby limiting the overall understanding of home cancer care. We carried out bibliometric and visualization analyses of Scopus-indexed papers related to home cancer care published between 1990-2021, and used VOSviewer scientometric software to investigate the status and provide a structural overview of the knowledge domain of HCCR (social, intellectual, and conceptual structures). Our findings demonstrate that over the last three decades, the research on home cancer care has been increasing, with a constantly expanding stream of new papers built on a solid knowledge base and applied to a wide range of research themes.
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Affiliation(s)
- Boutheina Fhoula
- Division of Engineering Management and Decision Sciences, College of Science and Engineering, Hamad Bin Khalifa University, Doha 34110, Qatar
| | - Majed Hadid
- Division of Engineering Management and Decision Sciences, College of Science and Engineering, Hamad Bin Khalifa University, Doha 34110, Qatar
| | - Adel Elomri
- Division of Engineering Management and Decision Sciences, College of Science and Engineering, Hamad Bin Khalifa University, Doha 34110, Qatar
| | - Laoucine Kerbache
- Division of Engineering Management and Decision Sciences, College of Science and Engineering, Hamad Bin Khalifa University, Doha 34110, Qatar
| | - Anas Hamad
- Pharmacy Department, National Center for Cancer Care & Research, Hamad Medical Corporation, Doha 3050, Qatar
| | | | - Raed M. Al-Zoubi
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha 3050, Qatar
- Department of Biomedical Sciences, College of Health Sciences, QU-Health, Qatar University, Doha 2713, Qatar
- Department of Chemistry, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Abdulla Al-Ansari
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha 3050, Qatar
| | - Omar M. Aboumarzouk
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha 3050, Qatar
- College of Medicine, QU-Health, Qatar University, Doha 2713, Qatar
- School of Medicine, Dentistry and Nursing, The University of Glasgow, Glasgow G12 8QQ, UK
| | - Abdelfatteh El Omri
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha 3050, Qatar
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Zhang X, Ju B, Tu J, Wang B, Liu X, Wang Z, Cheng Y, Zhang C, He Y. The possibility of impossibility: The hope for a cure among terminally ill cancer patients in China. Eur J Cancer Care (Engl) 2022; 31:e13724. [PMID: 36193852 DOI: 10.1111/ecc.13724] [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: 09/29/2021] [Revised: 08/31/2022] [Accepted: 09/14/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Although the medical potential of the hope for a cure has been fiercely debated within academia, few researchers have approached this topic from the perspective of terminally ill cancer patients themselves. As such, this article aims to help bridge the gap by exploring how terminally ill cancer patients in China construct the hope for a cure. METHODS Seventeen terminally ill cancer patients were recruited from the department of oncology at a tertiary hospital, where data were collected through individual interviews and participatory observation from April to December 2020 and analysed via thematic analysis. RESULTS The respondents experienced a dynamic swing between construction and denial of the hope for a cure. Furthermore, the patients negotiated between three forms of hope, including the hope for a cure, the hope for prolonged life expectancy and the hope of living in the moment. Meanwhile, family-oriented hope was centred on intergenerational relationships, which further shaped the construction of the hope for a cure. CONCLUSION Medical staff needs to be sensitive to terminally ill cancer patients' dynamic swing, negotiation and motivation during the process of constructing the hope for a cure.
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Affiliation(s)
- Xin Zhang
- Digestive Diseases Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Bei Ju
- Macau University of Science and Technology, Macau, China
| | - Jiong Tu
- Department of Sociology, School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Bo Wang
- Department of Oncology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Xuan Liu
- Department of Oncology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Zhechen Wang
- Department of Psychology, School of Social Development and Public Policy, Fudan University, Shanghai, China
| | - Yu Cheng
- Department of Medical Humanities, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.,Department of Anthropology, School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Changhua Zhang
- Digestive Diseases Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Yulong He
- Digestive Diseases Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
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Wajid M, Rajkumar E, Romate J. Exploring the End-of-Life Experiences of Advanced Cancer Patients from India. Health Psychol Res 2022. [DOI: 10.52965/001c.36272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective Paying attention to the socio-cultural characteristics of advanced cancer patients as they pass through the final stages of life can help healthcare professionals and mental health professionals assess the end-of-life experiences of terminally ill patients better. A comprehensive study of this population in the Indian context is helpful to devise individualized end-of-life care that aligns with their preferences and focuses on their comfort. Method The dataset comprised information-rich cases of 10 advanced cancer patients from Bangalore, India, selected using the purposive sampling method. The semi-structured interviews with the participants were audio-recorded, transcribed, and translated. Identification of patterns and commonalities in the dataset helped generate codes. The codes were used to narrow down to overarching themes. Results The standout themes were outlook on life, unfulfilled goals, end-of-life expectations, and death anxieties and attitudes to impending death. Significance of Results The study highlights the psychosocial and cultural needs of the patients in end-of-life care. How advanced cancer patients long for psychological care from mental health professionals and empathy from their loved ones. This study argues for renewed attention on the socio-cultural characteristics of terminally ill patients to enhance individualized care through culturally-competent interventions.
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Salimi H, Zadeh Fakhar HB, Hadizadeh M, Akbari M, Izadi N, MohamadiRad R, Akbari H, Hoseini R. Hope therapy in cancer patients: a systematic review. Support Care Cancer 2022; 30:4675-4685. [PMID: 35079905 DOI: 10.1007/s00520-022-06831-y] [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] [Received: 10/16/2021] [Accepted: 01/11/2022] [Indexed: 12/24/2022]
Abstract
AIM To identify the associated factors of hope therapy during treatment in cancer patients. BACKGROUND Hope is very important to cancer patients at all stages of the disease process. Several and different factors are associated with hope. DESIGN A systematic literature review of quantitative empirical studies on hope and quality of life in cancer patients. DATA SOURCES Search in MEDLINE, Psychinfo, and Cochrane (January 2010-December 2020). REVIEW METHODS A coherent search strategy was designed where MESH terms were combined with "free text" terms: hope (e.g., hope therapy, Herth Hope Index, quality of life) and cancer (e.g. neoplasm, tumor). Two authors independently screened all the studies and assessed their quality. RESULTS Twenty studies were included. The overall score of Herth Hope Index in cancer patients was 36.93, and the overall score of quality of life in cancer patients were 47.52. Also, the trend of quality of life and Herth Hope Index in cancer patients has been decreasing, from 2010 to 2020. CONCLUSIONS This systematic literature review of associated factors of hope in cancer patients receiving treatment shows that hope seems to be positively related mainly by intrinsic factors, such as perceived health, quality of life, and social support.
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Affiliation(s)
- Hamed Salimi
- Department of DBA, Oxford University, London, UK
| | | | - Mohammad Hadizadeh
- Cancer Research Centre (CRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - MohammadEsmaeil Akbari
- Cancer Research Centre (CRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Neda Izadi
- Cancer Research Center, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Hosna Akbari
- Cancer Research Centre (CRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Croker A, Fisher K, Hungerford P, Gourlay J, May J, Lees S, Chapman J. Developing a meta-understanding of 'human aspects' of providing palliative care. Palliat Care Soc Pract 2022; 16:26323524221083679. [PMID: 35281714 PMCID: PMC8915236 DOI: 10.1177/26323524221083679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 02/01/2022] [Indexed: 01/03/2023] Open
Abstract
Objectives: Our intention was to develop a meta-understanding of the ‘human aspects’ of providing palliative care. Integral to developing this meta-understanding was recognising the individuality of people, their varied involvements, situations, understandings, and responses, and the difficulty in stepping back to get a whole view of this while being in the midst of providing palliative care. We intended for this meta-understanding to inform reflections and sense-making conversations related to people’s changing situations and diverse needs. Methods: Using collaborative inquiry, this qualitative research was undertaken ‘with’ clinicians rather than ‘on’ them. Our team (n = 7) was composed of palliative care clinicians and researchers from a co-located rural health service and university. We explored our personal perceptions and experiences through a series of 12 meetings over 8 months. In addition, through five focus groups, we acccessed perceptions and experiences of 13 purposively sampled participants with a range of roles as carers and/or healthcare providers. Data were dialogically and iteratively interpreted. Findings: Our meta-understanding of ‘human aspects’ of providing palliative care, represented diagrammatically in a model, is composed of ATTRIBUTES OF HUMANITY and ACTIONS OF CARING. ATTRIBUTES OF HUMANITY are death’s inevitability, suffering’s variability, compassion’s dynamic nature, and hope’s precariousness. ACTIONS OF CARING include recognising and responding, aligning expectations, valuing relationships, and using resources wisely. The meta-understanding is a framework to keep multiple complex concepts ‘in view’ as they interrelate with each other. Significance of findings: Our meta-understanding, highlighting ‘human aspects’ of providing palliative care, has scope to embrace complexity, uncertainty, and the interrelatedness of people in the midst of resourcing, requiring, and engaging in palliative care. Questions are posed for this purpose. The non-linear diagrammatic representation of ATTRIBUTES OF HUMANITY and ACTIONS OF CARING facilitates multiple ways of engaging and revisiting palliative care situations or navigating changes within and across them.
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Affiliation(s)
- Anne Croker
- Department of Rural Health (UONDRH), The University of Newcastle, 114 - 148 Johnston Street, Tamworth, NSW 2340, Australia
| | - Karin Fisher
- Department of Rural Health (UONDRH), The University of Newcastle, Tamworth, NSW, Australia
| | | | - Jonathan Gourlay
- Hunter New England Local Health District, Tamworth, NSW, Australia
| | - Jennifer May
- Department of Rural Health (UONDRH), The University of Newcastle, Tamworth, NSW, Australia
| | - Shannon Lees
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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Kirby E, Broom A, MacArtney J, Lewis S, Good P. Hopeful dying? The meanings and practice of hope in palliative care family meetings. Soc Sci Med 2021; 291:114471. [PMID: 34663540 DOI: 10.1016/j.socscimed.2021.114471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/24/2021] [Accepted: 10/07/2021] [Indexed: 11/16/2022]
Abstract
Hope can carry considerable allure for people facing imminent mortality and for those who care for them. Yet, how hope is variously and relationally (re)produced within end-of-life care settings, remains under-researched. In this study, we aimed to better understand hope as it circulates within palliative care, drawing on video recorded family meetings and pre- and post-meeting qualitative interviews, within two hospitals in Queensland, Australia. Our findings highlight family meetings as an important site for articulations of hope and hopefulness. The results illustrate how hope is recalibrated within the transition to and through palliative care, the tensions between hope and futility, and the work of hope in discussions of goals and expectations. Through our analysis we argue that hopefulness within family meetings, and in palliative care more broadly, is collectively produced and opens up discourses of hope to the lived experience of terminality. Attending to the nuances of hope, including moving beyond the determinative (hope for more life/hope for a quick death), can elucidate the possibilities and problems of the collective negotiation of hope at the end of life, including how hope can be drawn on to express support and solidarity.
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Affiliation(s)
- Emma Kirby
- Centre for Social Research in Health, University of New South Wales, Australia; Warwick Medical School, University of Warwick, UK.
| | - Alex Broom
- Sydney Centre for Healthy Societies & School of Social and Political Sciences, University of Sydney, Australia
| | | | - Sophie Lewis
- Sydney School of Health Sciences, University of Sydney, Australia
| | - Phillip Good
- Department of Palliative Care, St Vincent's Private Hospital, Brisbane, Australia; Department of Palliative and Supportive Care Mater Health Services, Brisbane, Australia; Mater Research Institute - University of Queensland, Brisbane, Australia
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14
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Sandén U, Harrysson L, Thulesius H, Nilsson F. Breaking the patientification process - through co-creation of care, using old arctic survival knowledge. Int J Qual Stud Health Well-being 2021; 16:1926052. [PMID: 33974518 PMCID: PMC8118398 DOI: 10.1080/17482631.2021.1926052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Purpose: Cancer research and connected innovation processes often lack a major component; patient participation. We revisit three studies (a-c) in order to explore how Momentary contentment theory may be used to improve patient participation and psychosocial health. Method: We revisited data from the initial (a) classic grounded theory study on Momentary contentment, based on four years of observation and 14 interviews. It explains a way of dealing with life close to death and morbidity. In the imminence of danger the studied culture resembles the context of cancer patients. The two following studies used focus group interviews with (b) 19 cancer patients and (c) 17 relatives of cancer patients in southern Sweden. Results: We suggest a process where cancer patients are taught to be submissive and that the support they receive from health providers may be counterproductive to contentment; a patientification process. We present alternative ways for people to handle issues such as hope, waiting, knowledge gaps and healthcare navigation while living with cancer. We introduce an alternative to patientification and passive patients where active patients create their own safety and truly participates in their care.Conclusions: We propose clinical studies to introduce such a shift from patentification to co-creation of care.
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Affiliation(s)
- Ulrika Sandén
- Department of Design Sciences, Lund University, Lund, Sweden
| | | | - Hans Thulesius
- Department of Medicine and Optometry, Linnaeus University, Växjö, Sweden
| | - Fredrik Nilsson
- Department of Design Sciences, Lund University, Lund, Sweden
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15
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Toft BS, Hörberg U, Rasmussen B. The ups and downs of lifestyle modification: An existential journey among persons with severe obesity. Scand J Caring Sci 2021; 36:265-274. [PMID: 33942904 PMCID: PMC9292916 DOI: 10.1111/scs.12985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/08/2021] [Accepted: 03/14/2021] [Indexed: 12/14/2022]
Abstract
Background Maintaining a healthy living after the end of a lifestyle intervention is a challenge for persons with severe obesity. Measurable outcomes are often emphasised, but there is a need for understanding the process of lifestyle change and the long‐term perspectives among persons with severe obesity. Aim and objective To describe and deepen the understanding of how persons with severe obesity experience making and maintaining lifestyle changes in everyday life three years after lifestyle intervention. Methodology and methods The study used a hermeneutic phenomenological approach. A purposive sample of seven adults with BMI ≥ 40 was recruited from a lifestyle intervention programme. Data were generated through individual follow‐up interviews. The analysis was based on theoretical framework on dwelling and mobility. Ethical approvals were received from the Danish Data Protection Agency and the ethical principles of the Declaration of Helsinki were followed. Results One overarching theme emerged: ‘The journey of ups and downs’. Three sub‐themes were: ‘Living with and tackling the demands of life's hassles’, ‘Deliberating the fight for weight loss’ and ‘Needing a trusted person to feel met as a human being’. Conclusions Everyday life among persons with severe obesity is experienced as a dynamic process of shifting experiences of dwelling and mobility. Sustained lifestyle changes require ongoing adjustments of action, which healthcare providers can influence in ways that either support or obstruct. Collaboration and a humanised approach across disciplines and sectors are suggested to promote sustained healthy living.
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Affiliation(s)
- Bente Skovsby Toft
- Department of Lifestyle Rehabilitation, Horsens Regional Hospital, Braedstrup, Denmark
| | - Ulrica Hörberg
- Faculty of Health and Life Sciences, Department of Health and Caring Sciences P G Vejdes väg, Linnaeus University, Växjö, Sweden
| | - Birgit Rasmussen
- Department of Physio and Occupational Therapy, Horsens Regional Hospital, Horsens, Denmark
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16
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Österlind J, Henoch I. The 6S-model for person-centred palliative care: A theoretical framework. Nurs Philos 2021; 22:e12334. [PMID: 33089912 PMCID: PMC8243997 DOI: 10.1111/nup.12334] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 09/29/2020] [Accepted: 10/01/2020] [Indexed: 12/14/2022]
Abstract
Palliative care is provided at a certain timepoint, both in a person's life and in a societal context. What is considered to be a good death can therefore vary over time depending on prevailing social values and norms, and the person's own view and interpretation of life. This means that there are many interpretations of what a good death can actually mean for an individual. On a more general level, research in palliative care shows that individuals have basic common needs, for example physical, mental, social and spiritual well-being. Therefore, in today's pluralistic Western society, it becomes important that palliative care is person centred to enable individuals to receive, as far as can be achieved, care that promotes as good a life as possible based on the person's own needs and preferences, and in accordance with evidence and current laws. For many years a research group, consisting nurse researchers together with nurses working in palliative care, has developed a model for person-centred palliative care, the 6S-model. The model's central concept is Self-image, where the starting point is the patient as a person and their own experience of the situation. The other concepts: Self-determination, Symptom relief, Social relationships, Synthesis and Strategies are all related to the patient's self-image, and often to each other. The model's development, value base and starting assumptions are reported here, as are examples of how the model is applied in palliative care in Sweden. The model has been, and still is, constantly evolving in a collaboration between researchers and clinically active nurses, and in recent years also with patients and close relatives.
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Affiliation(s)
- Jane Österlind
- Department of Health Care SciencesPalliative Research CentreErsta Sköndal Bräcke University CollegeStockholmSweden
| | - Ingela Henoch
- The Sahlgrenska AcademyInstitute of Health and Care SciencesUniversity of GothenburgGothenburgSweden
- Angered Local HospitalGothenburgSweden
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17
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Levine DR, Cuviello A, Nelson C, Lu Z, Mandrell BN, Baker JN. Hope-Colored Glasses: Perceptions of Prognosis Among Pediatric Oncology Patients and Their Parents. JCO Oncol Pract 2021; 17:e730-e739. [PMID: 33661701 DOI: 10.1200/op.20.00762] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Cancer patients' belief about prognosis can heavily influence medical decision making and goals of care. It is known that parents of children with cancer tend to be optimistic regarding their child's prognosis; however, little is known about pediatric patients' prognostic beliefs, how physicians' prognostic communication is perceived, and how these perceptions are compared with actual prognoses. PATIENTS AND METHODS An original survey was administered to 100 pediatric oncology patients, age 10-18 years, and their parents from 2013 to 2015, at St Jude Children's Research Hospital. Patients were eligible for inclusion if they had an oncologic diagnosis, were between 1 month and 1 year from diagnosis, and were English speaking. Survey responses regarding perceived prognosis were compared with actual prognoses as determined from the medical record review and published literature. Analysis included descriptive statistics and association tests. RESULTS Nearly half of participants (patients = 48.9%, parents = 50.5%) displayed prognostic optimism as compared with the determined objective estimate of curative potential. The majority of both patients (78%) and parents (85%) reported belief in a very high chance of cure, although fewer reported that their physician communicated a very high chance for cure (patients = 57%, parents = 70%), and only 43% were determined to have a very high probability of cure. Significant differences were noted in prognostic optimism by cancer type (P < .0001); patients with solid tumor were more often optimistic (n = 25, 83.3% optimistic; n = 5, 16.7% accurate), and patients with lymphoma were most often accurate (n = 2, 8.7% optimistic; n = 21, 91.3% accurate). CONCLUSION Pediatric oncology patients and parents tend to be optimistic about their chance of cure, as compared to both perceived prognostic communication from physicians and objective estimated prognosis. Understanding the nature of prognostic optimism among patients with cancer and caregivers may empower clinicians to guide realistic decision making while supporting hope.
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Affiliation(s)
- Deena R Levine
- Division of Quality of Life and Palliative Care, Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | - Andrea Cuviello
- Division of Quality of Life and Palliative Care, Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | - Catherine Nelson
- Department of Pediatrics, Our Lady of the Lake Regional Medical Center, Baton Rouge, LA
| | - Zhaohua Lu
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN
| | - Belinda N Mandrell
- Division of Nursing Research, Department of Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN
| | - Justin N Baker
- Division of Quality of Life and Palliative Care, Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
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18
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Lohne V. 'Hope as a lighthouse' A meta-synthesis on hope and hoping in different nursing contexts. Scand J Caring Sci 2021; 36:36-48. [PMID: 33656202 DOI: 10.1111/scs.12961] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/16/2020] [Accepted: 01/04/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hope has a contextual dimension and experiences of hope seem to be an important part of everybody's life irrespective of changing and challenging health conditions. However, less focus has been placed on the similarities and differences in the experiences of hope among patients and family caregivers in different contexts of suffering and health, such as the nursing contexts of acute and critical care, rehabilitation and long-term care and prevention and health promotion. AIM This paper focuses on experiences of hope and hoping in different clinical nursing contexts, based on a meta-synthesis of seventeen empirical studies on hope and hoping. These studies highlight experiences of hope and advance our theoretical and clinical understanding of the phenomenon. METHODOLOGICAL FRAMEWORK This study on hope and hoping from seventeen empirical research studies was based on a meta-synthesis, by clarifying and modifying the essence of hope and hoping, aiming to identify the unique conditions in the different clinical contexts. RESULTS A new understanding of the empirical findings emerged from the text: Hope means transformation and hope is indispensable in the acute and critical nursing context, and hope as an inner flame and hope as a lighthouse related to rehabilitation and long-term care. Hope means pushing limits and expanding hope was experienced in the context of prevention and health promotion. CONCLUSIONS According to the findings, dimensions of hope and hoping were always present but also influenced by contextual suffering and losses. IMPLICATIONS FOR PRACTICE Hope means metaphorically a lighthouse, meaning a bright and shining centre, which must be promoted and protected in patients and their families.
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Affiliation(s)
- Vibeke Lohne
- Department of Nursing and Health Promotion, OsloMet - Oslo Metropolitan University, Postbox 4 St. Olavs plass. 0130, Oslo, N-0783, Norway
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19
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Abstract
Abstract
Objective
Hope promotes oncology patients’ adaptability to their illness, regardless of the stage of cancer. This study aimed to determine the prevalence of hope in a sample of end-of-life patients and to investigate the possible relationships between hope and a set of clinical and psychosocial measures.
Method
Three hundred and fifty end-of-life oncology patients, with a presumed life expectancy of 4 months or less and a Karnofsky Performance Status (KPS) of 50 or lower, were administered the Italian validated versions of a set of rating scales during their first consultation with a psychologist. This included the Herth Hope Index (HHI), Patient Dignity Inventory (PDI), Demoralization Scale (DS), Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy (FACIT-Sp), and the Visual Analogue Scale for pain (VAS).
Results
On average, the sample scored between moderate and high on the HHI and the average level of spirituality was high. However, most patients had clinically relevant anxious and depressive symptomatology and high levels of demoralization. Other than the pain scale, the total HHI score significantly correlated with the total scores of all rating scales and their subscales, as well as with the measure of personal religious practice. The “Meaning” FACIT-Sp subscale was found to be the main predictor of hope.
Significance of results
Since hope represents a core need and a tool for patients dealing with their illness, it is essential to implement stage-specific and realistic hope-facilitating interventions and support patients in their search for meaning, which promotes spiritual well-being and appears relevant in fostering hope.
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20
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Ivzori-Erel A, Bar-Sela G, Cohen M. Introducing the concept sense of place: A mediator between place of care and emotional distress of patients with cancer at the end of life. Psychooncology 2020; 29:1951-1958. [PMID: 32856351 DOI: 10.1002/pon.5530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND A sense of place (SOP) is defined as the emotional bonds, values, meaning, and symbols attached to a place. AIM To assess SOP of patients with cancer during end-of-life care at home (home-hospice service) versus at a hospital in relation to place of care, social support, and emotional distress. METHODS Participants were 150, stage IV, cancer patients with a life expectancy of less than 6 months, as defined by oncological staff, who were not receiving any life-prolonging care. Seventy-five patients received care at home (home-hospice), and the other 75 received care at the oncology department at the hospital, by palliative unit staff. Participants completed the Brief Symptom Inventory anxiety and depression subscales, questionnaires on perceived support and both questionnaires on home SOP and hospital SOP. RESULTS Mean scores of emotional distress were similar for patients in home-hospice and at the hospital. Home SOP among individuals receiving care at home was high, and hospital SOP was high among hospitalized individuals. The structural equation model had good fit indexes, showing that each of the SOP variables mediated the association between place of care and emotional distress. Perceived support was associated with lower distress only in the hospital setting. CONCLUSIONS The SOP concept is relevant to understanding emotional distress in relation to place of care at end of life. Strengthening SOP in relation to place of care should be considered. As newly introduced concept regarding place of care at the EoL, SOP warrants further research.
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Affiliation(s)
- Adi Ivzori-Erel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Department of Family Medicine, Clalit Health Services, Haifa, Israel
| | - Gil Bar-Sela
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Cancer Center, Emek Medical Center, Afula, Israel
| | - Miri Cohen
- School of Social Work, University of Haifa, Haifa, Israel
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21
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Beng TS, Xin CA, Ying YK, Khuen LP, Yee A, Zainuddin SI, Chin LE, Loong LC. Hope in Palliative Care: A Thematic Analysis. J Palliat Care 2020; 37:177-182. [PMID: 32791956 DOI: 10.1177/0825859720948976] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Hope is a positive coping mechanism that is important at all stages of illness, more so for palliative care patients. PURPOSE To explore the experiences of hope of palliative care patients. METHODS A qualitative study was conducted at University of Malaya, Kuala Lumpur, Malaysia. Adult palliative care in-patients were recruited and interviewed with semi structured questions on hope. Transcripts from the interviews were thematically analyzed with qualitative data management software NVIVO. FINDINGS 20 palliative care patients participated in the study. The themes generated from thematic analysis were (1) The notions of hope, (2) The sources and barriers of hope and (3) The contents of hope. CONCLUSION Hope is an ever-present source of energy that gives people strength to carry on even in the most adverse situations. Understanding hope from the palliative care perspective may allow healthcare providers to develop strategies to better foster hope in the terminally ill.
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Affiliation(s)
- Tan Seng Beng
- Department of Medicine, Faculty of Medicine, University of Malaya Medical Centre, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Cheah Ai Xin
- Department of Medicine, Faculty of Medicine, University of Malaya Medical Centre, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Yeoh Kee Ying
- Department of Medicine, Faculty of Medicine, University of Malaya Medical Centre, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Lim Poh Khuen
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya Medical Centre, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Anne Yee
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya Medical Centre, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Sheriza Izwa Zainuddin
- Department of Medicine, Faculty of Medicine, University of Malaya Medical Centre, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Loh Ee Chin
- Department of Medicine, Faculty of Medicine, University of Malaya Medical Centre, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Lam Chee Loong
- Department of Medicine, Faculty of Medicine, University of Malaya Medical Centre, Lembah Pantai, Kuala Lumpur, Malaysia
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22
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Dönmez ÇF, Johnston B. Living in the moment for people approaching the end of life: A concept analysis. Int J Nurs Stud 2020; 108:103584. [PMID: 32450405 DOI: 10.1016/j.ijnurstu.2020.103584] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/26/2020] [Accepted: 03/21/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND 'Living in the moment' is an essential part of dignity-conserving practice in end-of-life care settings. Although living in the moment is important for care at the end of life, from the perspective of both the person and their family, there is no clear conceptual understanding of what it represents. OBJECTIVE To explore the concept of 'living in the moment' in the context of dignity-conserving care at the end of life. DESIGN A concept analysis. DATA SOURCES The databases of Medline, CinAHL, PubMed, Web of Science, PsycINFO, SocINDEX and Cochrane were searched for studies published between 1941 and 2019, and searches of dictionaries and grey literature, as well as hand-searching were conducted, to yield qualitative, mixed methods and systematic reviews published in English, related to the term 'living in the moment'. METHOD The methods of Walker and Avant were used to identify antecedents, attributes and consequences of the concept of 'living in the moment'. RESULTS The literature review generated a total of 37 papers for this concept analysis. The attributes identified were (1) simple pleasure, (2) prioritising relationships, (3) living each day to the fullest, (4) maintaining normality, and (5) not worrying about the future. The antecedents were (1) awareness of dying, (2) living with life-threatening illness, (3) positive individual growth, and (4) living with an uncertain future. The consequences were (1) a good quality of life, (2) preserving dignity, and (3) coping with the uncertainty of life. CONCLUSIONS A universal definition and conceptual model of the main concept, including theoretical relationships between its antecedents, attributes and consequences, was developed. The definition and proposed conceptual model can allow instruments to be developed that measure the effects, existence or attributes of the concept, and identify a theoretical model, and can also lead to new perspectives and strategies for implementation by nurses to improve dignified person-centred care at the end of life.
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Affiliation(s)
- Çiğdem Fulya Dönmez
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland, UK; School of Heath Sciences, Department of Nursing, Istanbul Arel University, Istanbul, Turkey.
| | - Bridget Johnston
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland, UK; Florence Nightingale Foundation Clinical Professor of Nursing, School of Medicine, Dentistry & Nursing, and NHS Greater Glasgow and Clyde, College of Medical, Veterinary & Life Sciences, University of Glasgow, 57-61 Oakfield Avenue, Glasgow G12 8LL, Scotland, UK.
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23
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Sandén U, Nilsson F, Thulesius H, Hägglund M, Harrysson L. Cancer, a relational disease exploring the needs of relatives to cancer patients. Int J Qual Stud Health Well-being 2020; 14:1622354. [PMID: 31122166 PMCID: PMC6534208 DOI: 10.1080/17482631.2019.1622354] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose: In this qualitative interview study we investigated the experiences of family members to cancer patients. Our objective was to explore and to differentiate their needs from the needs of cancer patients. Methods: Five focus groups and six individual narrative interviews with 17 family members to cancer patients in Sweden were conducted and compared with 19 cancer patient interviews. Our analysis was inspired by classic grounded theory. Results: Family members to cancer patients expressed own morbidity connected to high stress levels and difficulties in recognizing own stress due to ongoing comparisons with the cancer patient. Family members were trapped in a momentary terror-like situation where they became their sick relative’s safety net. A percieved inability to improve their loved one’s well being contributed to a feeling of guilt. The longing for it all to end was encumbered with shame since the end included possible death. Conclusions: By recognizing cancer as a disease striking both body and relationships, family members are given precedence over their own struggles, differentiated from the patient’s experiences. We define differences in needs between cancer patients and family members. Family members to cancer patients may be supported in developing balancing strategies towards less stress, increased safety and moments of contentment.
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Affiliation(s)
- Ulrika Sandén
- a Department of Design sciences , Lund University , Lund , Sweden
| | - Fredrik Nilsson
- a Department of Design sciences , Lund University , Lund , Sweden
| | - Hans Thulesius
- b Research and Development Kronoberg and Linnaeus University , Växjö , Sweden
| | - Maria Hägglund
- c Department of Women's and Children's Health , Uppsala University and Uppsala University Hospital , Uppsala , Sweden
| | - Lars Harrysson
- d School of Social Work , Lund University , Helsingborg , Sweden
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24
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Malhotra C, Harding R, Teo I, Ozdemir S, Koh GCH, Neo P, Lee LH, Kanesvaran R, Finkelstein E. Financial difficulties are associated with greater total pain and suffering among patients with advanced cancer: results from the COMPASS study. Support Care Cancer 2019; 28:3781-3789. [PMID: 31832824 DOI: 10.1007/s00520-019-05208-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 11/24/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND The Universal Health Coverage goals call for access to affordable palliative care to reduce inequities in "total pain" and suffering. To achieve this, a patient-centred understanding of these inequities is required. AIM To assess association of total pain and suffering (i.e. physical, psychological, social, and spiritual health outcomes) and perceived health care quality with financial difficulties among stage IV solid malignancy patients. DESIGN Using baseline data from the COMPASS cohort study, we assessed total pain and suffering including physical (physical and functional well-being, pain, symptom burden), psychological (anxiety, depression, emotional well-being), social (social well-being), and spiritual (spiritual well-being, hope) outcomes and perceived health care quality (physician communication, nursing care, and coordination/responsiveness). Financial difficulties were scored by assessing patient perception of the extent to which their resources were meeting expenses for their treatments, daily living, and other obligations. We used multivariable linear/logistic regression to test association between financial difficulties and each patient-reported outcome. SETTING/PARTICIPANTS Six hundred stage IV solid malignancy patients in Singapore. RESULTS Thirty-five percent reported difficulty in meeting expenses. A higher financial difficulties score was associated with worse physical, psychological, social, spiritual outcomes, and lower perceived quality of health care coordination and responsiveness (i.e. greater total pain and suffering) (all p < 0.05). These associations persisted after adjustment for socio-economic indicators. CONCLUSION Results identify advanced cancer patients with financial difficulties to be a vulnerable group with greater reported total pain and suffering. A holistic patient-centred approach to care at end-of-life may help meet goals for Universal Health Coverage.
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Affiliation(s)
- Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore. .,Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
| | - Richard Harding
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, King's College London, London, UK
| | - Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.,Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,National Cancer Centre Singapore, Singapore, Singapore
| | - Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.,Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Gerald C H Koh
- Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, Singapore, Singapore
| | - Patricia Neo
- National Cancer Centre Singapore, Singapore, Singapore
| | - Lai Heng Lee
- Department of Haematology, Singapore General Hospital, Singapore, Singapore
| | | | - Eric Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.,Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
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25
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Affiliation(s)
- Justin Harmon
- Department of Community and Therapeutic Recreation, University of North Carolina Greensboro, Greensboro, NC, USA
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26
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Möllerberg ML, Årestedt K, Swahnberg K, Benzein E, Sandgren A. Family sense of coherence and its associations with hope, anxiety and symptoms of depression in persons with cancer in palliative phase and their family members: A cross-sectional study. Palliat Med 2019; 33:1310-1318. [PMID: 31368844 DOI: 10.1177/0269216319866653] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND There is evidence indicating that family sense of coherence predicts quality of family life and promotes family well-being. In families living with the palliative phase of cancer, low hope, anxiety and symptoms of depression are common in both persons with cancer and their family members. AIM To determine whether family sense of coherence was associated with hope, anxiety and symptoms of depression, respectively, in persons with cancer in the palliative phase and their family members. DESIGN An observational, cross-sectional, multicentre study was conducted. Nested linear regression analyses were performed in two blocks to determine whether family sense of coherence was associated with hope, anxiety and symptoms of depression. SETTING/PARTICIPANTS Persons with cancer (n = 179) and their family members (n = 165) were recruited from two oncology clinics and two palliative centres in three regions in Sweden. RESULTS The main findings showed that family sense of coherence was significantly and independently associated with hope, anxiety and symptoms of depression. Stronger family sense of coherence was associated with higher hope and lower anxiety and symptoms of depression levels in both persons with cancer and their family members. CONCLUSION Health care providers should strive to identify families with weak family sense of coherence, because of its associations with hope, anxiety and symptoms of depression, in order to offer them professional support and thereby achieve increased well-being during the palliative phase of cancer. Future studies should expand our knowledge of family sense of coherence and how to identify families at risk of lower levels of well-being.
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Affiliation(s)
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden.,The Research Section, Kalmar County Council, Kalmar, Sweden
| | - Katarina Swahnberg
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden
| | - Eva Benzein
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden.,Center for Collaborative Palliative Care, Linnaeus University, Växjö, Sweden
| | - Anna Sandgren
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden.,Center for Collaborative Palliative Care, Linnaeus University, Växjö, Sweden
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27
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Sijabat M, Dahlia D, Waluyo A. Experiences of palliative care nurses in providing home-based care for patient with advanced cancer. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2019.04.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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28
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Bood ZM, Scherer-Rath M, Sprangers MAG, Timmermans L, van Wolde E, Cristancho SM, Heyning F, Russel S, van Laarhoven HWM, Helmich E. Living with advanced cancer: Rich Pictures as a means for health care providers to explore the experiences of advanced cancer patients. Cancer Med 2019; 8:4957-4966. [PMID: 31278862 PMCID: PMC6718737 DOI: 10.1002/cam4.2342] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/28/2019] [Accepted: 05/30/2019] [Indexed: 11/09/2022] Open
Abstract
Background To provide holistic care to patients with advanced cancer, health care professionals need to gain insight in patients’ experiences across the different domains of health. However, describing such complex experiences verbally may be difficult for patients. The use of a visual tool, such as Rich Pictures (RPs) could be helpful. We explore the use of RPs to gain insight in the experiences of patients with advanced cancer. Methods Eighteen patients with advanced cancer were asked to draw a RP expressing how they experienced living with cancer, followed by a semi‐structured interview. Qualitative content analysis, including the examination of all elements in the drawings and their interrelationships, was used to analyze the RPs, which was further informed by the interviews. Results The RPs clearly showed what was most important to an individual patient and made relations between elements visible at a glance. Themes identified included: medical aspects, the experience of loss, feelings related to loss, support from others and meaningful activities, and integration of cancer in one's life. The added value of RPs lies in the ability to represent these themes in one single snapshot. Conclusions RPs allow for a complementary view on the experiences of advanced cancer patients, as they show and relate different aspects of patients’ lives. A RP can provide health care professionals a visual summary of the experiences of a patient. For patients, telling their story to health care professionals might be facilitated when using RPs.
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Affiliation(s)
- Zarah M Bood
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Michael Scherer-Rath
- Faculty of Philosophy, Theology, and Religious Studies, Radboud University-Nijmegen, Nijmegen, The Netherlands
| | - Mirjam A G Sprangers
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Liesbeth Timmermans
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ellen van Wolde
- Faculty of Philosophy, Theology, and Religious Studies, Radboud University-Nijmegen, Nijmegen, The Netherlands
| | - Sayra M Cristancho
- Centre for Education Research & Innovation and Department of Surgery, Health Sciences Addition, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - Fenna Heyning
- Association of Topclinical Hospitals STZ, Utrecht, the Netherlands
| | - Silvia Russel
- Independent Artist, Researcher, Amsterdam, the Netherlands
| | - Hanneke W M van Laarhoven
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Esther Helmich
- Center for Education Development and Research in Health Professions, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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29
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Hope to hope: Experiences of older people with cancer in diverse settings. Eur J Oncol Nurs 2019; 40:71-77. [PMID: 31229209 DOI: 10.1016/j.ejon.2019.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 01/31/2019] [Accepted: 02/05/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of the study was to explore experiences of older people with cancer in ascertaining the attributes of a person-centred approach in sustaining hope and enabling human flourishing. This was a qualitative study comparing patients and professional experiences and perceptions of care across to ward settings. METHODS Methods involved 10 semi-structured interviews conducted with patients and focus groups (n = 6) and 10 semi-structured interviews with health professionals. Three dissemination focus groups (n = 14) were also carried out with professionals to allow further analysis of the data. RESULTS Two main themes were identified, including 'Emotional adaptations of hope: wants and expectations' and 'Hope through belittling their illness'. Findings highlight the way hope is conveyed and the emphasis' accorded to issues such as societal perceptions, knowledge, expectations of care, life stage, relationships, identity, and emotions. Findings also reinforce the importance of maintaining hope, recognising the different ways hope is used, and enabling patients to flourish. CONCLUSION This study highlights how hope is facilitated through the interaction between patients and professionals and that the relational interactive stance. This current study establishes that hope seemed to be temporal, contextual and dynamic in nature, involving an ongoing process. Helping older people with cancer to understand their illness considering the situation of lives and experiences is essential to address expectations and wants.
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30
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Ozen B, Ceyhan O, Büyükcelik A. Hope and perspective on death in patients with cancer. DEATH STUDIES 2019; 44:412-418. [PMID: 31204898 DOI: 10.1080/07481187.2019.1626942] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study was conducted to determine the relationship between various attitudes and hope levels of cancer patients. The study was conducted in an observational and cross-sectional design with 106 cancer patients who were followed in the oncology clinic of a hospital. In the study, it was found that women had lower hope levels than men, and as age decreased, hope levels increased and as educational level increased, hope levels increased. It was found that the patients who said "I have fear/worry/anxiety and think about my family as they will be left behind" had lower total scores and subscale scores of hope. The results of the study showed that individuals with cancer had relatively higher hope levels. It was determined that the patients' thoughts about death affected their hope both directly and indirectly.
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Affiliation(s)
- Betül Ozen
- Department of Community Health Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Ozlem Ceyhan
- Department of Internal Diseases Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
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31
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Abstract
The aim of this study was to illuminate the way of being a family when one family member is in the midst of living and dying. A family systems frame and a life world perspective were used in interviews with five families. A qualitative analysis inspired by Giorgi revealed dialectic and dynamic processes in constant motion within and between the continua being in affinity-being in loneliness, being in power-being in helplessness, and being in continuity-being in disruption. When families were moving in the direction of being in affinity, power, and continuity, these seemed to be prerequisites for enduring their challenged life situation and for giving them a kind of repose. When the movements were in the opposite direction, existential and emotional suffering were manifested as individual embodied experiences such as depression and anxiety.
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32
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Affiliation(s)
- Victor Cellarius
- Temmy Latner Centre for Palliative Care, Mt. Sinai Hospital; Division of Palliative Care, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
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33
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Kruizinga R, Scherer-Rath M, Schilderman JBAM, Hartog ID, Van Der Loos JPM, Kotzé HP, Westermann AM, Klümpen HJ, Kortekaas F, Grootscholten C, Bossink F, Schrama J, Van De Vrande W, Schrama NAWP, Blokland W, De Vos FYFL, Kuin A, Meijer WG, Van Oijen MGH, Sprangers MAG, Van Laarhoven HWM. An assisted structured reflection on life events and life goals in advanced cancer patients: Outcomes of a randomized controlled trial (Life InSight Application (LISA) study). Palliat Med 2019; 33:221-231. [PMID: 30516096 PMCID: PMC6529670 DOI: 10.1177/0269216318816005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: Diagnosis and treatment of incurable cancer as a life-changing experience evokes difficult existential questions. Aim: A structured reflection could improve patients’ quality of life and spiritual well-being. We developed an interview model on life events and ultimate life goals and performed a randomized controlled trial to evaluate the effect thereof on quality of life and spiritual well-being. Design: The intervention group had two consultations with a spiritual counselor. The control group received care as usual. EORTC QLQ-C15-PAL and the FACIT-sp were administered at baseline and 2 and 4 months after baseline. Linear mixed model analysis was performed to test between-group differences over time. Participants: Adult patients with incurable cancer and a life expectancy ⩾6 months were randomized in a 1:1 ratio to the intervention or control group. Results: A total of 153 patients from six different hospitals were included: 77 in the intervention group and 76 in the control group. Quality of life and spiritual well-being did not significantly change over time between groups. The experience of Meaning/Peace was found to significantly influence quality of life (β = 0.52, adj. R 2 = 0.26) and satisfaction with life (β = 0.61, adj. R 2 = 0.37). Conclusion: Although our newly developed interview model was well perceived by patients, we were not able to demonstrate a significant difference in quality of life and spiritual well-being between groups. Future interventions by spiritual counselors aimed at improving quality of life, and spiritual well-being should focus on the provision of sources of meaning and peace.
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Affiliation(s)
- Renske Kruizinga
- Department of Medical Oncology, University of Amsterdam and Academic Medical Center, Amsterdam, The Netherlands
| | - Michael Scherer-Rath
- Faculty of Philosophy, Theology and Religious Studies, Radboud University, Nijmegen, The Netherlands
| | - Johannes BAM Schilderman
- Faculty of Philosophy, Theology and Religious Studies, Radboud University, Nijmegen, The Netherlands
| | - Iris D Hartog
- Department of Medical Psychology, University of Amsterdam and Academic Medical Center, Amsterdam, The Netherlands
| | | | - Hantie P Kotzé
- Department of Pastoral Care, University of Amsterdam and Academic Medical Center, Amsterdam, The Netherlands
| | - Anneke M Westermann
- Department of Medical Oncology, University of Amsterdam and Academic Medical Center, Amsterdam, The Netherlands
| | - Heinz-Josef Klümpen
- Department of Medical Oncology, University of Amsterdam and Academic Medical Center, Amsterdam, The Netherlands
| | - Francesco Kortekaas
- Department of Counselling and Care, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Cecile Grootscholten
- Department of Gastroentero-Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Frans Bossink
- Department of Pastoral Care, Spaarne Gasthuis, Haarlem, The Netherlands
| | - Jolanda Schrama
- Department of Medical Oncology, Spaarne Gasthuis, Haarlem, The Netherlands
| | - Willem Van De Vrande
- Department of Pastoral Care and Ethics, Elkerliek Ziekenhuis, Helmond, The Netherlands
| | | | - Willem Blokland
- UMC Utrecht Cancer Center, Department of Existential Orientation & Spiritual Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Filip YFL De Vos
- UMC Utrecht Cancer Center, Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Annemieke Kuin
- Department of Pastoral Care, Westfriesgasthuis, Hoorn, The Netherlands
| | - Wim G Meijer
- Department of Medical Oncology, Westfriesgasthuis, Hoorn, The Netherlands
| | - Martijn GH Van Oijen
- Department of Medical Oncology, University of Amsterdam and Academic Medical Center, Amsterdam, The Netherlands
| | - Mirjam AG Sprangers
- Department of Medical Psychology, University of Amsterdam and Academic Medical Center, Amsterdam, The Netherlands
| | - Hanneke WM Van Laarhoven
- Department of Medical Oncology, University of Amsterdam and Academic Medical Center, Amsterdam, The Netherlands
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34
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Kim JE, So HS. Experience of Hope in Terminal Cancer Patients: Applying Parse' s Human Becoming Methodology. ASIAN ONCOLOGY NURSING 2019. [DOI: 10.5388/aon.2019.19.2.55] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jung Ee Kim
- Nursing Department, Chunnam Techno University, Gwangju, Korea
| | - Hyang Sook So
- College of Nursing, Chonnam National University, Gwangju, Korea
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35
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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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36
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Guy MP, Higginson IJ, Amesbury BD. The effect of Palliative Daycare on Hope: A comparison of Daycare Patients with Two Control Groups. J Palliat Care 2018. [DOI: 10.1177/082585971102700306] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Despite expansion in palliative daycare services, research has not demonstrated an improvement in patient outcomes. This study aimed to determine the effect of palliative daycare on hope. Methods: This was a prospective cohort study that compared three groups of patients: a daycare group and two control groups, one recruited before daycare opened and a matched comparison group. Patients were interviewed at baseline and at two follow-ups using the Herth Hope Index. Results: In all, 22 daycare patients completed a baseline interview (T1); 12 a second (T2); and 9 a third (T3). Corresponding numbers were: before group (56, 34, 24) and matched group (49, 29, 19). An independent samples t-test confirmed a significant difference between the groups from T1 to T2 (mean difference=3.20, p=0.007), with the daycare group experiencing an increase in hope not seen in the other groups. However, this was not maintained. Conclusion: Daycare may effect an initial improvement in hope. The study suffered from attrition and the sample was small. Further robust evaluation of daycare is needed.
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Affiliation(s)
- Margaret P. Guy
- MP Guy (corresponding author) Phyllis Tuckwell Hospice, Waverley Lane, Farnham, Surrey, UK GU9 8BL
| | - Irene J. Higginson
- King's College London, Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, UK; BDW Amesbury: St. Wilfrid's Hospice, Chichester, Sussex, UK
| | - Brendan D.W. Amesbury
- King's College London, Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, UK; BDW Amesbury: St. Wilfrid's Hospice, Chichester, Sussex, UK
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37
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Chan LS, Macdonald ME, Cohen SR. Moving Culture beyond Ethnicity: Examining Dying in Hospital through a Cultural Lens. J Palliat Care 2018. [DOI: 10.1177/082585970902500207] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Lisa S. Chan
- School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Mary Ellen Macdonald
- School of Nursing and Departments of Pediatrics and Oncology, McGill University, and Montreal Children's Hospital of the McGill University Health Center, Montreal, Quebec, Canada
| | - S. Robin Cohen
- Departments of Oncology and Medicine, McGill University, and Lady Davis Institute for Research, Montreal, Quebec, Canada
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38
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Peck V, Valiani S, Tanuseputro P, Mulpuru S, Kyeremanteng K, Fitzgibbon E, Forster A, Kobewka D. Advance care planning after hospital discharge: qualitative analysis of facilitators and barriers from patient interviews. BMC Palliat Care 2018; 17:127. [PMID: 30518345 PMCID: PMC6282276 DOI: 10.1186/s12904-018-0379-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 11/13/2018] [Indexed: 11/24/2022] Open
Abstract
Background Patients who engage in Advance Care Planning (ACP) are more likely to get care consistent with their values. We sought to determine the barriers and facilitators to ACP engagement after discharge from hospital. Methods Prior to discharge from hospital eligible patients received a standardized conversation about prognosis and ACP. Each patient was given an ACP workbook and asked to complete it over the following four weeks. We included frail elderly patients with a high risk of death admitted to general internal medicine wards at a tertiary care academic teaching hospital. Four weeks after discharge we conducted semi-structured interviews with patients. Interviews were transcribed, coded and analysed with thematic analysis. Themes were categorized according to the theoretical domains framework. Results We performed 17 interviews. All Theoretical Domain Framework components except for Social/Professional Identity and Behavioral Regulation were identified in our data. Poor knowledge about ACP and physician communication skills were barriers partially addressed by our intervention. Some patients found it difficult to discuss ACP during an acute illness. For others acute illness made ACP discussions more relevant. Uncertainty about future health motivated some participants to engage in ACP while others found that ACP discussions prevented them from living in the moment and stripped them of hope that better days were ahead. Conclusions For some patients acute illness resulting in admission to hospital can be an opportunity to engage in ACP conversations but for others ACP discussions are antithetical to the goals of hospital care. Electronic supplementary material The online version of this article (10.1186/s12904-018-0379-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Vanessa Peck
- Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Sabira Valiani
- Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Peter Tanuseputro
- Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Sunita Mulpuru
- Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Kwadwo Kyeremanteng
- Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Edward Fitzgibbon
- Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Alan Forster
- Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Daniel Kobewka
- Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada. .,Ottawa Hospital Research Institute, Ottawa, ON, Canada.
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Rasch analysis of the Herth Hope Index in cancer patients. Health Qual Life Outcomes 2018; 16:196. [PMID: 30285767 PMCID: PMC6171309 DOI: 10.1186/s12955-018-1025-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 09/21/2018] [Indexed: 01/25/2023] Open
Abstract
Background The concept of hope has been measured using the Herth Hope Index (HHI) in different samples, but varying factor structures comprising different items from the HHI have been reported. Therefore, further testing with regard to the dimensionality of the instrument is recommended. Rasch modeling can be used to evaluate validity evidence of an instrument’s underlying structure, to identify items with poor fit to the rest of the scale, and to identify items that perform inconsistently across groups. The aim of this study was to assess the HHI’s psychometric properties in a sample of cancer patients using a Rasch model. Adult oncology outpatients (n = 167) with pain from bone metastasis were included, and medical records were reviewed for disease and treatment information. Patients completed the 12-item HHI, which measures various dimensions of hope using a 4-point Likert scale that ranges from 1 (strongly disagree) to 4 (strongly agree). The internal scale validity, person response validity, unidimensionality, and uniform differential item functioning were evaluated by applying a Rasch rating scale model. Results Five (42%) of the twelve items (#3, #4, #5, #6 and #7) did not meet the criterion set for item goodness-of-fit. After removing these 5 items, the resulting 7-item scale demonstrated acceptable item fit to the model, acceptable unidimensionality (52.6% of the variance explained), acceptable person goodness-of-fit, adequate separation, and no differential item function. Conclusion A 7-item version of the HHI had better psychometric properties than the original 12-item version among patients with cancer-related pain. Trial registration The protocol ID is 158,707/V10 and it was registered on ClinicalTrials.gov as NCT00760305. Registered September 25, 2008.
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40
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Hopeck P. Care Providers' Integration of Family Requests in End-of-life Communication: Understanding What to Do and Why to Do It. HEALTH COMMUNICATION 2018; 33:1277-1283. [PMID: 28820620 DOI: 10.1080/10410236.2017.1351273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
End-of-life situations are fraught with challenges for patients, family members, and individuals working at the patient's bedside. Care workers must address needs of the patient, as well as his or her distressed family members. This article is an inductive investigation of care workers' (nurses, patient advocates, and clergy) experiences with end-of-life discussions when the family asks to "do everything." Participants also noted resistance to hospice in some of these encounters based on pre-existing connotations of hospice held by the family members. The article concludes with a discussion about how identifying end-of-life terms may be transformed to be more accessible for family members.
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Affiliation(s)
- Paula Hopeck
- a Department of Communication Studies , Bloomsburg University of Pennsylvania
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41
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Cesaro Lora CA. Esperanza en Pacientes Oncológicos Paliativos hacia una revisión sistemática. PSICOONCOLOGIA 2018. [DOI: 10.5209/psic.61435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objetivo. Revisión sobre el término esperanza. Método. Estudio sistemático, en el que se han seleccionado 31 artículos con población oncológica adulta, en estadio terminal, de edades entre 20 a 88 años, de ambos géneros. Resultado. La esperanza, es inherente para la vida del ser humano, es una expectativa del futuro, dinámica, cambiante, fluctuante, medible y multifacética; presenta dos connotaciones como verbo y como sustantivo. La esperanza se puede mantener y fomentar mediante estrategias personales del paciente, del entorno social y de los profesionales de la salud; además, existen herramientas, técnicas, programas y psicoterapias que facilitan dichos resultados. Conclusión. La esperanza se puede fomentar, mantener y fortalecer y es fundamental para esta etapa de enfermedad. No existe un protocolo de intervención específico, lo principal es escuchar al paciente.
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42
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Nierop-van Baalen C, Grypdonck M, van Hecke A, Verhaeghe S. Health professionals’ dealing with hope in palliative patients with cancer, an explorative qualitative research. Eur J Cancer Care (Engl) 2018; 28:e12889. [DOI: 10.1111/ecc.12889] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 04/12/2018] [Accepted: 06/12/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Corine Nierop-van Baalen
- Haaglanden Medical Centre; The Hague The Netherlands
- Department of Public Health; University Hospital; Ghent University; Ghent Belgium
| | - Mieke Grypdonck
- Department of Public Health; University Hospital; Ghent University; Ghent Belgium
| | - Ann van Hecke
- Department of Public Health; University Hospital; Ghent University; Ghent Belgium
| | - Sofie Verhaeghe
- Department of Public Health; University Hospital; Ghent University; Ghent Belgium
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Communicating terminal prognosis: The provider's role in reframing hope. Palliat Support Care 2018; 16:803-805. [DOI: 10.1017/s1478951518000329] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Ashouri E, Taleghani F, Memarzadeh M, Saburi M, Babashahi F. The perceptions of nurses, patients and family members regarding nurses' empathetic behaviours towards patients suffering from cancer: a descriptive qualitative study. J Res Nurs 2018; 23:428-443. [PMID: 34394455 DOI: 10.1177/1744987118756945] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Although evidence suggests that empathic behaviour is an essential component in nursing care that affects the psychological distress experienced by cancer patients, it remains a neglected issue in nursing in Iran. Methods This study was conducted on 33 participants selected through purposive sampling. Data were collected using in-depth interviews and were then analysed using qualitative content analysis with an inductive approach. Findings Three categories of data thus emerged, comprising: (a) empathetic attention; (b) empathetic presence; and (c) the facilitators of empathetic behaviour. Conclusions The findings can help oncology nurses provide more empathetic care to patients and their family members.
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Affiliation(s)
- Elaheh Ashouri
- Assistant professor, Nursing and Midwifery Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Taleghani
- Professor, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrdad Memarzadeh
- Professor, Pediatric Surgery Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Morteza Saburi
- Matron, Cancer Treatment Center, Isfahan University of Medical Science, Isfahan, Iran
| | - Fatemeh Babashahi
- Supervisor, Cancer Treatment Center, Isfahan University of Medical Science, Isfahan, Iran
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Bibler TM, Shinall MC, Stahl D. Responding to Those Who Hope for a Miracle: Practices for Clinical Bioethicists. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2018; 18:40-51. [PMID: 29697329 DOI: 10.1080/15265161.2018.1431702] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Significant challenges arise for clinical care teams when a patient or surrogate decision-maker hopes a miracle will occur. This article answers the question, "How should clinical bioethicists respond when a medical decision-maker uses the hope for a miracle to orient her medical decisions?" We argue the ethicist must first understand the complexity of the miracle-invocation. To this end, we provide a taxonomy of miracle-invocations that assist the ethicist in analyzing the invocator's conceptions of God, community, and self. After the ethicist appreciates how these concepts influence the invocator's worldview, she can begin responding to this hope with specific practices. We discuss these practices in detail and offer concrete recommendations for a justified response to the hope for a miracle.
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Hilding U, Allvin R, Blomberg K. Striving for a balance between leading and following the patient and family - nurses' strategies to facilitate the transition from life-prolonging care to palliative care: an interview study. BMC Palliat Care 2018; 17:55. [PMID: 29615009 PMCID: PMC5883396 DOI: 10.1186/s12904-018-0311-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 03/22/2018] [Indexed: 11/16/2022] Open
Abstract
Background The transition from life-prolonging to palliative care (PC) can be challenging often characterized by psychical, physiological, social and existential changes. Knowledge of how to support the patient and family in this specific care phase is lacking, and this area needs to be further explored. The aim of this study was to investigate strategies that registered nurses (RNs) use to ease the transition from life-prolonging care to PC for patients with incurable disease. Methods The study has a descriptive design. Fourteen RNs working in a specialized PC unit were interviewed. The data were analysed using content analysis. Results The RNs’ strategies can be described under the categories “Getting to know the patient and creating a relationship”, “Providing support”, “Adapting to individuals’ needs” and “Enabling conversations”. Conclusion The findings show that the RNs in this population used strategies that not only took time but also required knowledge about the transition process and required the ability to identify and meet patients’ and families’ unique needs. Patients’ difficult and exposed situation needs to be addressed through a structured follow-up after informing about the change from life-prolonging care to PC. RNs have a unique role of supporting both the patient and the family in the transition from life-prolonging care to PC for patients with incurable disease.
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Affiliation(s)
| | - Renée Allvin
- Clinical Skills Centre, Örebro University Hospital, Örebro, Sweden.,Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-70182, Örebro, Sweden
| | - Karin Blomberg
- Örebro University Hospital, Örebro, Sweden. .,Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-70182, Örebro, Sweden.
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Collins A, Bhathal D, Field T, Larlee R, Paje R, Young D. Hope Tree: An Interactive Art Installation to Facilitate the Expression of Hope in a Hospice Setting. Am J Hosp Palliat Care 2018; 35:1273-1279. [DOI: 10.1177/1049909118767136] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Individuals confronting a terminal illness can experience intense psychological distress. Previous research has shown that hope can enhance one’s ability to acknowledge, accept, and fight a terminal illness. Patients can continue to have hope or be hopeful, even in the face of a terminal illness. Can participation in a creative writing practice improve the expression of hope in a hospice setting? Methods: In this program evaluation, each expressed hope placed on the “Hope Tree” was independently coded by all research team members utilizing inductive content analysis. Overall themes were derived using a constant comparative approach and arranged into overarching themes based on consensus. Results: Eight major themes emerged from the data: “Peace,” “Dreams,” “Total well-being,” “Acknowledgment of loss,” “Relationships,” “Hospice care,” “Spirituality,” and “Dichotomies.” Conclusion: The Hope Tree is a creative art project that can be used within a hospice environment to promote hope among family members and the health-care professionals who care for patients.
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Affiliation(s)
- Andrew Collins
- Peace Arch Hospice, Peace Arch Hospital, White Rock, British Columbia, Canada
- White Rock-South Surrey Division of Family Practice, White Rock, British Columbia, Canada
- Department of Medicine, Division of Palliative Care, University of British Columbia, Vancouver, British Columbia, Canada
| | - Darpanjot Bhathal
- Peace Arch Hospice, Peace Arch Hospital, White Rock, British Columbia, Canada
| | - Tara Field
- Peace Arch Hospice, Peace Arch Hospital, White Rock, British Columbia, Canada
- Peace Arch Hospice Society, White Rock, British Columbia, Canada
| | - Randene Larlee
- Peace Arch Hospice, Peace Arch Hospital, White Rock, British Columbia, Canada
- Irene Thomas Hospice, Delta, British Columbia, Canada
- Laurel Place Hospice, Surrey, British Columbia, Canada
- Palliative Complex Care Unit, Surrey Memorial Hospital, Surrey, British Columbia, Canada
| | - Rachael Paje
- Peace Arch Hospice, Peace Arch Hospital, White Rock, British Columbia, Canada
| | - Daneen Young
- Peace Arch Hospice, Peace Arch Hospital, White Rock, British Columbia, Canada
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KASAI YOSHIMI, HINO OKIO. Psychological Transition Characteristics of Patients Diagnosed with Asbestos-Related Mesothelioma. JUNTENDO MEDICAL JOURNAL 2018. [DOI: 10.14789/jmj.2018.64.jmj17-oa09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- YOSHIMI KASAI
- Department of Pathology and Oncology, Juntendo University Faculty of Medicine
- Department of Home Care Nursing, Tokyo University of Information Sciences Faculty of Nursing
| | - OKIO HINO
- Department of Pathology and Oncology, Juntendo University Faculty of Medicine
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Zeng Y, Cheng ASK, Liu X, Chan CCH. Title: Cervical cancer survivors' perceived cognitive complaints and supportive care needs in mainland China: a qualitative study. BMJ Open 2017. [PMID: 28645952 PMCID: PMC5577865 DOI: 10.1136/bmjopen-2016-014078] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES This study explores Chinese cervical cancer survivors' perceived cognitive complaints and relevant supportive care needs after primary cancer treatment. DESIGN This study utilised a qualitative research design. A semi-structured interview was used to probe cervical cancer patients' perceived cognitive complaints and supportive care needs. SETTING This study was conducted at a secondary cancer care centre located in South China. PARTICIPANTS 31 women with cervical cancer after primary cancer treatment, aged 18-60 years, were purposively selected using non-random sampling procedures. RESULTS 31 cervical cancer survivors joined this study. Of these, 20 women (64.5%) reported cognitive complaints after cancer treatment. The most common complaint was loss of concentration (n=17, 85.0%). Perceived contributing factors to these cognitive complaints included chemotherapy (n=15, 75.0%) and ageing (n=8, 40.0%). These cognitive problems most commonly impacted daily living (n=20, 100%). Common supportive care needs included symptom management strategies (n=11, 55.0%) and counselling services (n=8, 40.0%). CONCLUSION This study adds new insight into the growing body of research on cognitive complaints by cancer survivors, in particular Chinese cervical cancer survivors. Improved understanding of cognitive complaints could subsequently facilitate the development of relevant therapeutic interventions for prevention as well as the provision of supportive care services, such as educational and counselling services, to reduce cognitive impairment in women with cervical cancer.
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Affiliation(s)
- Yingchun Zeng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute of Gynaecology and Obstetrics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Andy SK Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xiangyu Liu
- Department of Nursing, Hunan Cancer Hospital, Changsha, China
| | - Chetwyn CH Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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