Hellen Luiza Meireles Silva
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Pedro Henrique Martins Valério
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Cristiano Roque Antunes Barreira
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Fernanda Maris Peria
Abstract
Background
The condition of advanced oncological disorders demands a complete health care, although attention has been predominant on physical aspects. To consider personal positioning entails other aspects when dealing with patients’ diseases – such as their existential aspects – expanding forms of care. This study aims to comprehend the personal positioning of oncology patients receiving palliative care.
Methods
This is a cross-sectional, convergent parallel mixed-methods study. Seventy-one oncology patients in palliative care cooperated with this study, 14 of whom participated in a qualitative approach and 56 in a quantitative approach only. In the former approach, we conducted a phenomenological interview and, in the latter, we used tools to measure meaning of life (PIL-Test), quality of life (EORTC QLQ C-30), anxiety and depression (HADS), and to collect sociodemographic data. Data obtained through the interview were analyzed according to the principles of Classical Phenomenology, and the quantitative data were analyzed through generalized structural equation models.
Results
Our results showed that patients regained their focus on life, accentuating its possibilities and distancing themselves from the impact of their condition, such as imminent death, which was associated with giving up fighting depression. These signs were observed in 21% of the participants. This demands a tenacious fight that supports a positioning nurtured by sensitivity. Related to such position is the religious belief in life continuation, together with their awareness of the meaning of their own lives. Additionally, we found a direct association between purpose in life and an increase in the scores of functional scales (p < 0.01) and a decrease in scores of symptoms (p < 0.01), anxiety (p = 0.02) and depression (p < 0.01). The last elements to appear and structure the patients’ experience were their intense will to live and the value of life.
Conclusions
Through the complementarity of a mixed-method approach, this study acknowledged the existential positioning of oncology patients in palliative care that may help in more comprehensive and real treatment plans, contributing for humanization in this area.