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Health care staff's opinions about existential issues among patients with cancer

Published online by Cambridge University Press:  18 February 2010

Maria Browall ,
Christina Melin-Johansson ,
Susann Strang ,
Ella Danielson  and
Ingela Henoch
Maria Browall*
Affiliation:
Sahlgrenska University Hospital, Department of Oncology, Clinical Trial Unit, Gothenburg, Sweden
Christina Melin-Johansson
Affiliation:
Mid Sweden University, Department of Health Sciences, Östersund, Sweden
Susann Strang
Affiliation:
The Sahlgrenska Academy, University of Gothenburg, Department of Clinical Neuroscience and Rehabilitation and Sahlgrenska University Hospital, Gothenburg, Sweden
Ella Danielson
Affiliation:
Mid Sweden University, Department of Health Sciences, Östersund, Sweden The Sahlgrenska Academy, University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden
Ingela Henoch
Affiliation:
Bräcke Diakoni Foundation, Research Unit, Gothenburg, Sweden Karolinska Institutet, Institution of Learning, Informatics, Management and Ethics, Medical Management Centre, Stockholm, Sweden
*
Address correspondence and reprint requests to: Maria Browall, Sahlgrenska University Hospital, Department of Oncology, Clinical Trial Unit, SE 413 45 SE, Gothenburg, Sweden. E-mail: [email protected]
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Abstract

Objective:

The objective of this study was to explore health care staff's opinions about what existential issues are important to patients with cancer and staff's responsibility when existential issues are raised by patients.

Method:

Four focus group interviews were conducted with health care staff (N = 23) at an in-patient hospice, on an oncology ward, on a surgical ward, and with a palliative home health care team. The focus group interviews focused on two questions, first, about health care staff's opinions about patients' important existential questions and, second, about health care staff's responsibility when existential issues are raised by the patient. The interviews were taperecorded, transcribed verbatim, and analyzed by qualitative content analysis into subcategories and categories.

Results:

Four categories and 11 subcategories emerged from the first question. The first category, “life and death,” was based on joy of living and thoughts of dying. The second category “meaning,” consisted of acceptance, reevaluation, hope, and faith. The third category, “freedom of choice,” consisted of responsibility and integrity, and the fourth and last category, “relationships and solitude,” consisted of alleviation, dependency, and loss. One category emerged from the second question about the health care staff's responsibility, “to achieve an encounter,” which was based on the subcategories time and space, attitudes, and invitation and confirmation.

Significance of results:

One strength of this study was that the findings were fairly congruent in different settings and in different geographical areas. Health care staff were aware of the importance of existential issues to patients. The existential issues, mentioned by health care staff, are similar to findings from studies conducted among patients, which is another strength of the present study. Health care staff are also confident about how to act when these issues are raised by the patients. The challenge for the future is to implement the findings from this study among health care staff in different settings.

Keywords

Content analysisExistentialFocus groupsHealth care professionalsPalliative care
Type
Original Articles
Information
Palliative & Supportive Care , Volume 8 , Issue 1 , March 2010 , pp. 59 - 68
Copyright
Copyright © Cambridge University Press 2010

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References

REFERENCES

Blinderman, C.D. & Cherny, N.I. (2005). Existential issues do not necessarily result in existential suffering: Lessons from cancer patients in Israel. Palliative Medicine, 19, 371–380.CrossRefGoogle Scholar
Bolmsjo, I., Hermeren, G., & Ingvar, C. (2002). Meeting existential needs in palliative care: Who, when, and why? Journal of Palliative Care, 18, 185–191.CrossRefGoogle Scholar
Boston, P.H. & Mount, B.M. (2006). The caregiver's perspective on existential and spiritual distress in palliative care. Journal of Pain and Symptom Management, 32, 13–26.CrossRefGoogle ScholarPubMed
Browall, M., Gaston-Johansson, F., & Danielson, E. (2006). Postmenopausal women with breast cancer: Their experience of the chemotherapy treatment period. Cancer Nursing, 29, 34–42.CrossRefGoogle ScholarPubMed
Buckley, J. & Herth, K. (2004). Fostering hope in terminally ill patients. Nursing Standard, 19, 33–41.CrossRefGoogle ScholarPubMed
Chapple, A., Ziebland, S., & McPherson, A. (2004). Stigma, shame, and blame experienced by patients with lung cancer: Qualitative study. British Medical Journal, 328, 1470.CrossRefGoogle ScholarPubMed
Coward, D.D. & Kahn, D.L. (2004). Resolution of spiritual disequilibrium by women newly diagnosed with breast cancer. Oncology Nursing Forum, 31, E24–31.CrossRefGoogle ScholarPubMed
de Vogel-Voogt, E., van der Heide, A., van Leeuwen, A. et al. (2007). Patient evaluation of end-of-life care. Palliative Medicine, 21, 243–348.CrossRefGoogle ScholarPubMed
Flanagan, J. & Holmes, S. (1999). Facing the issue of dependence: Some implications from the literature for the hospice and the hospice nurse. Journal of Advanced Nursing, 29, 592–599.CrossRefGoogle Scholar
Grant, E., Murray, S.A., Kendall, M., et al. (2004). Spiritual issues and needs: Perspectives from patients with advanced cancer and nonmalignant disease. A qualitative study. Palliative & Supportive Care, 2, 371–378.CrossRefGoogle ScholarPubMed
Grumann, M.M. & Spiegel, D. (2003). Living in the face of death: Interviews with 12 terminally ill women on home hospice care. Palliative & Supportive Care, 1, 23–32.CrossRefGoogle ScholarPubMed
Henery, N. (2003). Constructions of spirituality in contemporary nursing theory. Journal of Advanced Nursing, 42, 550–557.CrossRefGoogle ScholarPubMed
Henoch, I. & Danielson, E. (2009). Existential concerns among patients with incurable disease and interventions to meet them: An integrative literature review. Psycho-Oncology, 18, 225–236.CrossRefGoogle Scholar
Hermann, C.P. (2001). Spiritual needs of dying patients: A qualitative study. Oncology Nursing Forum, 28, 67–72.Google ScholarPubMed
Johansson, C.M., Axelsson, B., & Danielson, E. (2006). Living with incurable cancer at the end of life: Patients' perceptions on quality of life. Cancer Nursing, 29, 391–399.CrossRefGoogle ScholarPubMed
Kawa, M., Kayama, M., Maeyama, E., et al. (2003). Distress of inpatients with terminal cancer in Japanese palliative care units: From the viewpoint of spirituality. Supportive Care in Cancer, 11, 481–490.CrossRefGoogle ScholarPubMed
Kreuger, R. & Casey, M. (2000). Focus Groups. A Practical Guide for Applied Research (3rd ed.). London: Sage Publications.Google Scholar
Krippendorff, K. (2004). Content Analysis. An Introduction to Its Methodology. London: Sage Publications.Google Scholar
Kubler-Ross, E. (1969). On Death and Dying. New York: MacMillan.Google Scholar
Landmark, B. T., Strandmark, M., & Wahl, A. K. (2001). Living with newly diagnosed breast incurable disease—The meaning of existential issues: A qualitative study of 10 women with newly diagnosed breast cancer, based on grounded theory. Cancer Nursing, 24, 220–226.CrossRefGoogle Scholar
Larsson, G., Haglund, K., & Von Essen, L. (2003). Distress, quality of life and strategies to ‘keep a good mood’ in patients with carcinoid tumours: Patient and staff perceptions. European Journal of Cancer Care, 12, 46–57.CrossRefGoogle Scholar
Lowey, S.E. (2008). Letting go before a death: A concept analysis. Journal of Advanced Nursing, 63, 208–215.CrossRefGoogle Scholar
Morita, T., Kawa, M., Honke, Y., et al. (2004). Existential concerns of terminally ill incurable disease patients receiving specialized palliative care in Japan. Supportive Care in Cancer, 12, 137–140.CrossRefGoogle Scholar
Murata, H., Morita, T., & Japanese Task Force. (2006). Conceptualization of psycho-existential suffering by the Japanese task force: The first step of a nationwide project. Palliative & Supportive Care, 4, 279–285.CrossRefGoogle ScholarPubMed
Murray, S.A., Kendall, M., Boyd, K., et al. (2004). Exploring the spiritual needs of people dying of lung cancer or heart failure: A prospective qualitative interview study of patients and their carers. Palliative Medicine, 18, 39–45.CrossRefGoogle ScholarPubMed
O'Baugh, J., Wilkes, L.M., Luke, S., et al. (2003). ‘Being positive’: Perceptions of patients with cancer and their nurses. Journal of Advanced Nursing, 44, 262–270.CrossRefGoogle ScholarPubMed
O'Connor, N. (1993). Paterson and Zderad Humanistic Nursing Theory. London: Sage Publications.Google Scholar
Paterson, J.G. & Zderad, L.T. (1988/1976). Humanistic Nursing. New York: National League for Nursing.Google ScholarPubMed
Polit, D.F. & Beck, C.T. (2008). Nursing Research: Generating and Assessing Evidence for Nursing Practice (8th ed.). London: Lippincott Williams & Wilkins.Google Scholar
Sessanna, L., Finell, D., & Jezewski, M.A. (2007). Spirituality in nursing and health-related literature. A concept analysis. Journal of Holistic Nursing, 25, 252–262.CrossRefGoogle ScholarPubMed
Sprangers, M.A. & Schwartz, C.E. (1999). Integrating response shift into health-related quality of life research: A theoretical model. Social Science & Medicine, 48, 1507–1515.CrossRefGoogle ScholarPubMed
Strang, P. (1997). Existential consequences of unrelieved cancer pain. Palliative Medicine, 11, 299–305.CrossRefGoogle ScholarPubMed
Strang, S., Strang, P., & Ternestedt, B. (2001). Existential support in brain tumour patients and their spouses. Supportive Care in Cancer, 9, 625–633.CrossRefGoogle ScholarPubMed
Tan, H.M., Braunack-Mayer, A., & Beilby, J. (2005). The impact of the hospice environment on patient spiritual expression. Oncology Nursing Forum, 3, 1049–1055.CrossRefGoogle Scholar
Tanyi, R.A. (2002). Towards clarification of the meaning of spirituality. Journal of Advanced Nursing, 39, 500–509.CrossRefGoogle ScholarPubMed
Thomé, B., Dykes, A., Gunnars, B., et al. (2003). The experiences of older people living with cancer. Cancer Nursing, 26, 85–96.CrossRefGoogle ScholarPubMed
Vachon, M., Fillion, L., & Achille, M. (2009). A conceptual analysis of spirituality at the end of life. Journal of Palliative Medicine, 12, 53–59.CrossRefGoogle ScholarPubMed
Van Leeuwen, R., Tiesinga, L.J., Post, D., et al. (2006). Spiritual care: Implications for nurses' professional responsibility. Journal of Clinical Nursing, 15, 875–884.CrossRefGoogle ScholarPubMed
Westman, B., Bergenmar, M., & Andersson, L. (2006). Life, illness and death: Existential reflections of a Swedish sample of patients who have undergone curative treatment for breast or prostatic cancer. European Journal of Oncology Nursing, 10, 169–176.CrossRefGoogle ScholarPubMed
WHO. (2002). National Cancer Control Programmes. Policies and behavioural guidelines. Retrieved March 12, 2009, from http://www.who.int/cancer/media/en/408.pdf.Google Scholar
Wilson, C.T. & Fletcher, P.C. (2002). Dealing with colon cancer: One woman's emotional journey. Clinical Nurse Specialist, 16, 298–305.CrossRefGoogle ScholarPubMed
Yalom, I. (1980). Existential Psychohterapy. New York: Basic Books.Google Scholar