Prioritising, downplaying and self-preservation: Processes significant to coping in advanced cancer patients

To date there has been little research that describes the relation between the individual and their envi-ronment as the foundation for the coping process in advanced cancer patients. The aim of the study was to identify and describe, from a patient perspective, processes that are significant to coping with advanced cancer. We used the method Grounded Theory as described by Strauss and Corbin. Data were gener-ated through qualitative interviews. A total of 18 in-terviews were conducted. The central theme was “The struggle to be a participant in one’s own life”. This theme involved three processes: prioritising, downplaying and self-preservation, each of which in different ways endeavours to either maintain or re-establish the feeling of being a participant. The aware-ness of the processes complement existing knowledge about coping in advanced cancer patients, by showing how patients make use of meaning-based coping ef-forts to increase their experience of being a partici-pant in their own lives

Testing the feasibility of the Dignity Therapy interview: adaptation for the Danish culture

<p>Abstract</p> <p>Background</p> <p><b>'</b>Dignity Therapy' (DT) is a brief, flexible intervention, which allows patients to complete an interview and create a document regarding their life, identity and what they want to leave in writing for their loved ones. DT is based on the DT Question Protocol. Developed and tested in English speaking settings, DT has proven to be a feasible and effective way to enhance patient dignity, while diminishing suffering and depression. The aim of this study was to test the acceptability and feasibility of the DT Question Protocol among Danish health professionals and cancer patients, and to obtain preliminary estimates of patient uptake for DT. These results will be used to inform a larger evaluation study.</p> <p>Method</p> <p>Ten professionals were interviewed about their perception of DT and the Question Protocol. It was then tested with 20 patients at two palliative care sites and one gynecologic oncology department. Data was analyzed using content analysis techniques to evaluate the protocol for relevance, acceptability and comprehension. The interest and relevance of the intervention was also determined by examining the preliminary participation rate.</p> <p>Results</p> <p>Overall, DT was perceived to be comprehensible and relevant. Professionals highlighted six concerns that might warrant modification. These issues were examined using patient data. Some of their concerns overlapped with those raised by the professionals (e.g. <it>'unacceptable self-praise' </it>and '<it>interference with the lives of others'</it>). Tailoring DT to Danish culture required easily accommodated adjustments to the procedures and the DT Question Protocol. Some concerns expressed by health professionals may have reflected protectiveness toward the patients. While the intervention was relevant and manageable for patients admitted to palliative care, DT was less easily implemented at the gynecologic oncology department.</p> <p>Conclusion</p> <p>Based on patients' and professionals' reaction to the DT Question Protocol, and based on the preliminary proportion of participants accepting DT, the DT question protocol - with minor adaptations - appears to be a manageable, acceptable and relevant intervention for Danish patients admitted to palliative care.</p

Existential Loneliness and end-of-life care: A Systematic Review

Contains fulltext : 88662.pdf (publisher's version ) (Closed access)Patients with a life-threatening illness can be confronted with various types of loneliness, one of which is existential loneliness (EL). Since the experience of EL is extremely disruptive, the issue of EL is relevant for the practice of end-of-life care. Still, the literature on EL has generated little discussion and empirical substantiation and has never been systematically reviewed. In order to systematically review the literature, we (1) identified the existential loneliness literature; (2) established an organising framework for the review; (3) conducted a conceptual analysis of existential loneliness; and (4) discussed its relevance for end-of-life care. We found that the EL concept is profoundly unclear. Distinguishing between three dimensions of EL-as a condition, as an experience, and as a process of inner growth-leads to some conceptual clarification. Analysis of these dimensions on the basis of their respective key notions-everpresent, feeling, defence; death, awareness, difficult communication; and inner growth, giving meaning, authenticity-further clarifies the concept. Although none of the key notions are unambiguous, they may function as a starting point for the development of care strategies on EL at the end of life.1 april 201

Lidelsens udtryksformer og vilkår - som beskrevet af uhelbredeligt kræftsyge patienter

Alvorligt kr&aelig;ftsygepatienter f&oslash;ler sig ofte svigtede af de professionelle og har uanset social baggrund vanskeligt ved at h&aring;ndtere deres lidelse. Selvom &raquo;Lidelse&laquo; er et centralt begreb i WHO&rsquo;s definition af palliative care, s&aring; eksisterer der kun begr&aelig;nset viden om hvordan patienterne udtrykker deres lidelse, samt hvordan sygeplejersker erkender og responderer p&aring; den.Form&aring;let med denne unders&oslash;gelse er at beskrive hvad der karakteriserer lidelsens udtryksform og vilk&aring;r for alvorligt kr&aelig;ftsyge patienter. Peirce&acute;s f&aelig;nomenologisk groundede tegnteori anvendes til identifikation af hvilke potentielle og reelle tegn p&aring; lidelsens v&aelig;ren og vilk&aring;r der viser sig under deltagerobservation og interview. Giorgi&rsquo;s f&aelig;nomenologiske analysemetode er anvendt til identifikation af lidelsens karakteristika. Resultaterne indikerer at det prim&aelig;rt er sygeplejerskerne, der definerer konteksten og dermed hvilke handlin- ger og oplevelser, der erkendes og responderes p&aring;. Patienternes muligheder for at beskrive deres lidelse synes at drukne i sygeplejerskernes bestr&aelig;belser p&aring; at prioritere, organisere og udf&oslash;re den krops og symptomorienterede pleje, hvilket indeb&aelig;rer, at patienternes lidelse ofte dekontekstualiseres ind i en krops-, symptom- og behandlingsorienteret forst&aring;else og praksis