How older people with incurable cancer experience daily living: A qualitative study from Norway

2014 ◽  
Vol 13 (4) ◽  
pp. 1037-1048 ◽  
Author(s):  
Sigrid Helene Kjørven Haug ◽  
Lars J. Danbolt ◽  
Kari Kvigne ◽  
Valerie Demarinis
Keyword(s):  
Palliative Care ◽  
Older People ◽  
Daily Living ◽  
Meaning Making ◽  
Phenomenological Approach ◽  
Incurable Cancer ◽  
Existential Meaning ◽  
Strongly Connected ◽  
Sociocultural Resources ◽  
Cancer Experience

AbstractObjective:An increasing number of older people are living with incurable cancer as a chronic disease, requiring palliative care from specialized healthcare for shorter or longer periods of time. The aim of our study was to describe how they experience daily living while receiving palliative care in specialized healthcare contexts.Method:We conducted a qualitative research study with a phenomenological approach called “systematic text condensation.” A total of 21 participants, 12 men and 9 women, aged 70–88, took part in semistructured interviews. They were recruited from two somatic hospitals in southeastern Norway.Results:The participants experienced a strong link to life in terms of four subthemes: to acknowledge the need for close relationships; to maintain activities of normal daily life; to provide space for existential meaning-making and to name and handle decline and loss. In addition, they reported that specialized healthcare contexts strengthened the link to life by prioritizing and providing person-centered palliative care.Significance of results:Older people with incurable cancer are still strongly connected to life in their daily living. The knowledge that the potential for resilience remains despite aging and serious decline in health is considered a source of comfort for older people living with this disease. Insights into the processes of existential meaning-making and resilience are seen as useful in order to increase our understanding of how older people adapt to adversity, and how their responses may help to protect them from some of the difficulties inherent to aging. Healthcare professionals can make use of this information in treatment planning and for identification of psychosocial and sociocultural resources to support older people and to strengthen patients' life resources.

Older people with incurable cancer: Existential meaning-making from a life-span perspective

2015 ◽  
Vol 14 (1) ◽  
pp. 20-32 ◽  
Author(s):  
Sigrid Helene Kjørven Haug ◽  
Lars J. Danbolt ◽  
Kari Kvigne ◽  
Valerie DeMarinis
Keyword(s):  
Palliative Care ◽  
Older People ◽  
Life Span ◽  
Daily Living ◽  
Developmental Psychology ◽  
Meaning Making ◽  
Adaptive Strategies ◽  
Growth Potential ◽  
Incurable Cancer ◽  
Existential Meaning

ABSTRACTObjective:An increasing number of older people in Western countries are living with incurable cancer, receiving palliative care from specialized healthcare contexts. The aim of our article was to understand how they experience the existential meaning-making function in daily living from a life-span perspective.Method:Some 21 participants (12 men and 9 women), aged 70–88, were interviewed in a semistructured framework. They were recruited from somatic hospitals in southeastern Norway. We applied the model of selective optimization with compensation (SOC) from life-span developmental psychology in a deductive manner to explore the participants' life-oriented adaptive strategies. A meaning component was added to the SOC model.Results:The participants experienced the existential meaning-making function on two levels. On a superordinate level, it was an important component for interpreting and coordinating the adaptive strategies of SOC for reaching the most important goals in daily living. The existential meaning-making framework provided for a comprehensive understanding of resilience, allowing for both restoration and growth components to be identified. The second level was related to strategy, in that the existential meaning-making function was involved in a complex interaction with behavioral resources and resilience, leading to continuation of goals and more realistic goal adjustments. A few experienced existential meaning-making dysfunction.Significance of results:The modified SOC model was seen as applicable for palliative care in specialized healthcare contexts. Employing the existential meaning-making framework with its complementary understanding of resilience as growth potential to the SOC model's restoration potential can help older people to identify how they make meaning and how this influences their adaptation process to being incurably sick.

scholarly journals Don’t become a burden and don’t complain: a case study of older persons suffering from incurable cancer and living alone in rural areas

2011 ◽  
Vol 1 (1) ◽  
pp. 3 ◽  
Author(s):  
Guri Bitnes Wiik ◽  
Siri Devik ◽  
Ove Hellzen
Keyword(s):  
Palliative Care ◽  
Older People ◽  
Rural Areas ◽  
Urban Areas ◽  
Older Persons ◽  
Healthcare Services ◽  
Hospital Treatment ◽  
Incurable Cancer ◽  
Gain Access

The majority of older people wish to continue to live at home for as long as possible. As a consequence, the healthcare system, including cancer care, is located in urban areas and people living in rural areas must commute to gain access to the services offered. The aim of this study was to investigate how older people, who live on their own, experience living with incurable cancer and commuting for palliative care in rural Norway. A case study was designed and informants were recruited not because they were typical but because they were deemed to have the potential to contribute to knowledge about the phenomenon of being an older person who has been diagnosed with incurable cancer and lives alone in a rural area. Three major categories were identified: &ldquo;<em>Hovering between hope and fear</em>, <em>Stressful commuting to palliative care</em>, and <em>Being exhausted</em>. The findings indicated that older people who have been stricken with incurable cancer and who live alone in rural areas have to<em> walk the palliative path alone</em>. A common feature of all the informants is that they do not speak out and they do not complain. Even though the trend in healthcare is towards centralized treatment, shorter and more effective stays in hospital, and policlinic (policlinic services are a place where healthcare services can be accessed without the need for an overnight stay in hospital, usually such clinics are located close to a hospital) treatment and care, not all older persons manage to take care of themselves. The findings suggest that nurses should pay more attention to these patients&rsquo; needs for care at different levels of the healthcare service.

scholarly journals ‘Food for Life and Palliation (FLiP)’: a qualitative study for understanding and empowering dignity and identity for terminally ill patients in Asia

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e038914
Author(s):  
Paul Victor Patinadan ◽  
Geraldine Tan-Ho ◽  
Ping Ying Choo ◽  
Casuarine Xinyi Low ◽  
Andy Hau Yan Ho
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Meaning Making ◽  
A Priori ◽  
Terminally Ill ◽  
Phenomenological Approach ◽  
Clinical Implications ◽  
Framework Analysis ◽  
Terminally Ill Patients ◽  
Palliative Care Setting

ObjectivesWith ‘eating’ posited as Singapore’s domestic pastime, food experiences for Singaporeans constitute national, social, ethnic and personal identities. However, though they form significant parts of Singaporean existence across the lifespan, studies and observations about food experiences for individuals at the end of life remain noticeably absent. Extant literature continues to focus on nutritional practice during illness and the active dying process, forgoing the rich lived experiences of food in the lives of patients and their families. The current work sought to qualitatively extricate through a constructivist phenomenological approach, the ‘food voices’ of Singaporean palliative care patients and their families. It also simultaneously aimed to assess the role of food in bolstering their subjective feelings of dignity and identity, while also considering resultant clinical implications.SettingHomes of patients within the Singaporean palliative care setting.ParticipantsA subset of qualitative data (n=25) in the form of dyadic interviews with terminally ill patients and a family caregiver was generated from a larger family dignity intervention study that explored the experience of living and dying among Asian palliative care patients and their families.ResultsFramework analysis with both inductive and deductive approaches informed by the a priori domain of food resulted in the generation of four major themes, each with three subthemes. These were organised into the Food for Life and Palliation model. They include: (1) feeding identity and familial bonds, (2) liminal subsistence in illness transition, (3) food becoming lineage, and (4) compassionate nourishment.ConclusionsClinical implications are considered; including food-focused interventions that enhance dignity, promote meaning-making and facilitate legacy construction. Developmental suggestions are also directed at industry partners producing end-of-life nutrition products.

Patients experience major changes in life and significant others struggle with caregiving during the course of incurable cancer: a systematic review and meta-synthesis

2018 ◽  
Vol 6 (1) ◽  
pp. 88 ◽  
Author(s):  
Rikke Madsen ◽  
Regner Birkelund ◽  
Lisbeth Uhrenfeldt
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Effect Size ◽  
Cancer Care ◽  
Healthcare Professionals ◽  
Significant Others ◽  
Evidence Based ◽  
Incurable Cancer ◽  
Cancer Experience ◽  
Patients Experience

Aim: The aim of this review was to explore experiences of patients and significant others concerning  existential, psychosocial and organisational transitions during the course of incurable cancer.Methods: The search was based on 5 databases (PubMed, CINAHL, Scopus, PsycInfo and Embase) and 50 studies were finally included and critically appraised. The review was inspired by the methods of Joanna Briggs Institute, Kvale and Brinkmann and illustrated with effect size, inspired by Sandelowski and Barroso.Results: Based on experiences from 496 patients and 320 significant others, 3 main themes with  3 subthemes each were identified and, from these, a meta-synthesis was developed. Patients experience major changes in life and significant others struggle with caregiving during the course of incurable cancer. Main themes: 1. Patients living with incurable cancer experience major changes in life; 2. Patients’ experiences of both living and dying; 3. Significant others living and loosing. Relating findings to the theory of Irvin D. Yalom revealed that patients and significant others experience transitioning into living most of life in an ontological mode of existence.Conclusion: This review underlines the complexity within planning individualised palliative care and contributes with evidence-based knowledge relevant to healthcare professionals in palliative cancer care.

scholarly journals Activities of Daily Living and Categorization Skills of Elderly with Cognitive Deficit: A Preliminary Study

2021 ◽  
Vol 11 (2) ◽  
pp. 213
Author(s):  
Dulce Romero-Ayuso ◽  
Cristian Cuerda ◽  
Carmen Morales ◽  
Ricardo Tesoriero ◽  
José Matías Triviño-Juárez ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Older People ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Deductive Reasoning ◽  
Personal Autonomy ◽  
Assessment Process ◽  
Digital Version ◽  
Routine Tasks

Cognitive dysfunction affects the performance of Activities of Daily Living (ADL) and the quality of life of people with these deficits and their caregivers. To the knowledge of the authors, to date, there are few studies that focus on knowing the relationship between personal autonomy and deductive reasoning and/or categorization skills, which are necessary for the performance of the ADL. The aim of this study was to explore the relationships between ADL and categorization skills in older people. The study included 51 participants: 31 patients with cognitive impairment and 20 without cognitive impairment. Two tests were administered to assess cognitive functions: (1) the Montreal Cognitive Assessment (MoCA); and (2) the digital version of Riska Object Classification test (ROC-d). In addition, the Routine Tasks Inventory-2 (RTI-2) was applied to determine the level of independence in activities of daily living. People with cognitive impairment performed poorly in categorization tasks with unstructured information (p = 0.006). Also, the results found a high correlation between cognitive functioning and the performance of ADLs (Physical ADL: r = 0.798; p < 0.001; Instrumental ADL: r = 0.740; p < 0.001), a moderate correlation between Physical ADLs and categorization skills (unstructured ROC-d: r = 0.547; p < 0.001; structured ROC-d: r = 0.586; p < 0.001) and Instrumental ADLs and categorization skills in older people (unstructured ROC-d: r = 0.510; p < 0.001; structured ROC-d: r = 0.463; p < 0.001). The ROC-d allows the assessment of categorization skills to be quick and easy, facilitating the assessment process by OT, as well as the accuracy of the data obtained.

scholarly journals What Keeps Oncologists From Addressing Palliative Care Early on With Incurable Cancer Patients? An Active Stance Seems Key

2014 ◽  
Vol 20 (1) ◽  
pp. 56-61 ◽  
Author(s):  
Timo A. Pfeil ◽  
Katsiaryna Laryionava ◽  
Stella Reiter‐Theil ◽  
Wolfgang Hiddemann ◽  
Eva C. Winkler
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Incurable Cancer

scholarly journals Qualitative study to explore what patients with heart failure find significant during integrated palliative care sessions in a Danish clinic

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e043955
Author(s):  
Stine Gundtoft Roikjær ◽  
Charlotte Paaske Simonÿ ◽  
Helle Ussing Timm
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Meaning Making ◽  
Interview Study ◽  
Exclusion Criterion ◽  
Semistructured Interview ◽  
Patients With Heart Failure ◽  
New Diagnosis ◽  
Medical Perspective

ObjectiveIn the field of palliative care (PC) as it is integrated into heart failure (HF) treatment, it is essential to explore the patient experience and build on this knowledge for the further development of PC practice and policy. Based on an intervention study, this paper explores what patients with HF find significant in integrated sessions using a narrative S’ approach.DesignWe conducted a semistructured interview study with a qualitative analysis focused on meaning making. The study follows the guidelines of Consolidated Criteria for Reporting Qualitative Research.Participants and settingThe inclusion criteria for the PC intervention were (1) a new diagnosis of HF, (2) follow-up treatment at this local Danish HF clinic and (3) informed consent to participate in the integrated PC intervention. The only exclusion criterion was if the patient was already engaged in a PC programme. 20 patients agreed to participate in the intervention, and 12 of these completed the S’ approach sessions and participated in this interview study.ResultsOverall, the analysis showed that the integrated S’ approach sessions were successful in joining an embodied patient perspective with a medical perspective. The thematic analysis resulted in three themes supporting the overall findings: sessions bring comfort, telling your story provides a sense of meaningfulness, and integrating perspectives of HF into everyday life.ConclusionThe method using the S’ approach in integrated PC and HF sessions was significant in various ways. First, patients experienced a calm and safe atmosphere and perceived that the nurse was truly interested in them. Second, the integrated sessions based on the S’ approach were able to bring comfort to lived physical, psychosocial and existential issues. Last, it allowed patients to combine their embodied understanding of HF with a medical perspective, thereby finding meaning in the sense of how everything is connected.

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