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Li H, Ng MSN, Jin X, Wong CL. 'Life became slow down': A descriptive qualitative study of the experiences of cancer-related fatigue amongst people with advanced lung cancer. Palliat Med 2023; 37:1168-1182. [PMID: 37395316 DOI: 10.1177/02692163231184926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
BACKGROUND Cancer-related fatigue is a complex multidimensional concept. However, little is known about the experience of cancer-related fatigue in people with advanced lung cancer. How they emotionally react to and cope with the experience of cancer-related fatigue according to cultural influences has not been extensively explored. AIM To explore the experience of cancer-related fatigue, its impacts and emotional reactions to and coping strategies for cancer-related fatigue amongst people with advanced lung cancer in China. DESIGN This was a cross-sectional, descriptive qualitative study with face-to-face semi-structured interviews. Data were analysed using content analysis. SETTING/PARTICIPANTS Twenty-one people with advanced lung cancer who experienced cancer-related fatigue were recruited in a hospital setting. RESULTS Four themes were identified: multifaceted experiences of cancer-related fatigue, impacts of cancer-related fatigue, negative perceptions of cancer-related fatigue and avoiding cancer-related fatigue. The multifaceted experience of cancer-related fatigue had physical, psychological and social impacts along the cancer trajectory. Informants regarded it as a sign of a 'bad ending', searched for root causes and had negative attitudes towards role changes. Avoiding coping strategies included not discussing cancer-related fatigue, refusing encouragement and support, hiding feelings, withdrawing from social life and attempting to control cancer-related fatigue. CONCLUSION The findings provide insights into the lack of flexibility of people with advanced lung cancer to adapt to the multidimensional experience of cancer-related fatigue. The reactions and coping towards cancer-related fatigue are profoundly influenced by Chinese culture. Developing psychological interventions based on the cultural background are highly recommended to cultivate the ability to cope flexibly with stressful events and live a meaningful cancer life.
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Affiliation(s)
- Huiyuan Li
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Marques Shek Nam Ng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiaohuan Jin
- The School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Cho Lee Wong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Lim GH, Breen LJ, Keesing S, Buchanan A. Understanding Occupations of Terminally Ill Chinese Adults and Their Caregivers: A Scoping Review. Occup Ther Health Care 2023; 37:75-100. [PMID: 34505796 DOI: 10.1080/07380577.2021.1972379] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
This scoping review explored the occupations of terminally ill Chinese adults and their caregivers. Seven databases were searched for peer-reviewed journal articles published in English or Chinese before June 2020. Of the 16 studies that met the selection criteria, only one directly used the term "occupations" while the other 15 studies contained descriptions of occupations. Eight themes were extracted and compared with existing literature. The top two reported themes were occupations surrounding life roles and tasks and those surrounding food and eating. More study is required about the occupational engagement of this client group.
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Affiliation(s)
- Geck Hoon Lim
- Health & Social Sciences, Singapore Institute of Technology, Singapore.,Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Lauren J Breen
- Curtin School of Population Health, Curtin University, Perth, Australia.,Curtin enAble Institute, Curtin University, Perth, Australia
| | - Sharon Keesing
- Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Angus Buchanan
- Curtin School of Allied Health, Curtin University, Perth, Australia
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Niu Y, McSherry W, Partridge M. Exploring the Meaning of Spirituality and Spiritual Care in Chinese Contexts: A Scoping Review. JOURNAL OF RELIGION AND HEALTH 2022; 61:2643-2662. [PMID: 33624216 DOI: 10.1007/s10943-021-01199-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/29/2021] [Indexed: 06/12/2023]
Abstract
Spirituality is recognised as a fundamental aspect of health and nursing care. Yet, there are few studies exploring how this concept may be understood outside of Western culture. This scoping review seeks to address this omission by focusing specifically on research conducted with Chinese populations. This is important because people from Chinese backgrounds (PBC) are now residing all over the world, and their spirituality and spiritual needs should be considered when providing healthcare. Adopting a purely generalist understanding and application of spirituality may not capture the cultural difference that exists between the East and West. This scoping review adopted Arksey and O'Malley's method to focus on spirituality and spiritual care among PBC in health and nursing. The systematic strategy was adopted and used to search the main databases in health and nursing. Eighteen (n = 18) empirical studies were included in the review: 11 qualitative studies and seven quantitative involving 1870 participants. The scoping review revealed that in the Chinese understanding of spirituality is an abstract and personal concept which can refer to an internal vital force, experiences of suffering, and traditional Chinese cultural and religious values. As the multidimensional understanding of spirituality and spiritual care may cause confusion, these findings may provide a direction for the researchers emphasising the need for cultural and religious sensitivity when understanding of spirituality.
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Affiliation(s)
- Yanping Niu
- Department of Nursing, Changzhi Medical College, No.161 Jiefang Dong Street, Changzhi City, 046000, Shanxi Province, China.
- Department of Nursing, School of Health and Social Care, Staffordshire University, Stoke-on-Trent, UK.
| | - Wilfred McSherry
- Department of Nursing, School of Health and Social Care, Staffordshire University, Stoke-on-Trent, UK
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
- VID University College, Berge/Oslo, Norway
| | - Martin Partridge
- Department of Social Care, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
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Increasing our understanding of nonphysical suffering within palliative care: A scoping review. Palliat Support Care 2021; 20:417-432. [DOI: 10.1017/s1478951521001127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Objective
Nonphysical suffering is emotional, psychological, existential, spiritual, and/or social in nature. While palliative care is a discipline dedicated to the prevention and relief of suffering — both physical and nonphysical — little is known about existing research specific to nonphysical suffering within the context of palliative care. This scoping review helps to fill this gap.
Method
Three hundred and twenty-eight unique records were identified through a systematic search of three databases (MEDLINE, CINAHL, and PsycINFO). The following keywords were used: (suffering) AND (palliative OR “end of life” OR “end-of-life” OR hospice OR dying OR terminal* ill*). Thirty studies published between 1998 and 2019 met the inclusion criteria.
Results
Losses, worries, and fears comprise patients’ primary sources of nonphysical suffering. Patients face numerous barriers in expressing their nonphysical suffering to healthcare providers. The idea that patients can choose how they perceive their circumstances, thereby minimizing their nonphysical suffering, is pervasive in the research. The nature of nonphysical suffering experienced by family caregivers and palliative care clinicians is revealed in the review. The unique and sensitive interplay between nonphysical suffering and both palliative sedation and requests for hastened death is also evident. Overall, seven themes can be identified: (i) patients’ experiences of nonphysical suffering; (ii) patient coping mechanisms; (iii) efforts to measure nonphysical suffering; (iv) palliative sedation; (v) requests for hastened death; (vi) family suffering; and (vii) clinician suffering.
Significance of results
This is the first scoping review to map palliative care's research specific to suffering that is social, emotional, spiritual, psychological, and/or existential in nature. Its findings expand our understanding of the nature of nonphysical suffering experienced by patients, families, and palliative care clinicians. The review's findings have significant implications for front-line practice and future research.
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Chung H, Harding R, Guo P. Palliative Care in the Greater China Region: A Systematic Review of Needs, Models, and Outcomes. J Pain Symptom Manage 2021; 61:585-612. [PMID: 32916261 DOI: 10.1016/j.jpainsymman.2020.08.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/19/2020] [Accepted: 08/24/2020] [Indexed: 12/14/2022]
Abstract
CONTEXT There is rapidly increasing need for palliative care in Greater China because of rapidly aging populations. OBJECTIVES This study aimed to systematically review and appraise evidence for palliative care needs, models of care, interventions, and outcomes in Greater China. METHODS Four databases (MEDLINE, EMBASE, CINAHL, and PsycINFO) were searched, with hand searching of local journals and databases. Narrative synthesis was applied to the qualitative and quantitative evidence. RESULTS Nineteen qualitative studies and 47 quantitative studies were retained. With respect to care needs, nine themes were synthesized: pain control, reduced aggressive end-of-life care, truth telling, physical, emotional, and spiritual supports, and achieving preferred place of care/death. Informal caregivers expressed their needs for education and burden reduction. Health care professionals called for training and national policy support. Twenty-four studies evaluated interventions, mostly among patients with advanced cancer. Positive effects were suggested for improvements in quality of life, pain, anxiety and depression, readmission rate, and costs. Models of care evaluated were mostly specialist palliative care delivered in various settings (hospitals, residential care, and home). Outcome measures used were grouped into six categories of construct: quality of life, pain, physical assessment, psychospiritual assessment, quality of care, and implementation assessment. Limited rigorous randomized controlled trials are available to document intervention outcomes, and some problems (such as high attrition rates) reduced the strength of the evidence. CONCLUSION Palliative care services within Greater China should pay more attention to management of nonmalignant disease and to integration into primary services. Policy support is key to establishing culturally appropriate person-centered services.
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Affiliation(s)
- Huei Chung
- Department of Pharmacy, Zhongxiao Branch, Taipei City Hospital, Taipei, Taiwan
| | - Richard Harding
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Ping Guo
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK; School of Nursing, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
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Female Suffering After Blunt Trauma and the Need to be Cared for and Cared About. J Trauma Nurs 2019; 26:247-256. [PMID: 31503198 DOI: 10.1097/jtn.0000000000000463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Using a phenomenological design, the researcher repeated a previous study of males, this time exploring the question of what is the experience of suffering voiced by female patients 6-12 months after hospitalization for blunt trauma. Eleven female volunteers were interviewed and asked questions about how they suffered, what made their suffering more or less bearable, and how they were transformed through their suffering. Like the males, female participants experienced changes in patterns resulting in perceptions of suffering. Participants reported mostly experiencing physical, emotional, and social forms of suffering, whereas fewer participants experienced economic and spiritual suffering. Experiences of suffering resulted from the threat to their sense of wholeness because of their injuries. Intrinsic and extrinsic factors made participants' suffering more or less bearable as they regained or revised their shattered wholeness. Positive attitude and motivation were significant intrinsic factors, whereas quality supportive care was the most significant extrinsic factor. Feeling cared about emotionally was as important as feeling cared for physically in helping participants better bear their suffering. Poor quality care was a significant negative extrinsic factor resulting in suffering being made more unbearable. Through their experiences of suffering and finding meaning in that suffering, participants were transformed, amending their previous state and resulting in a new state of wholeness. Knowledge gained through this phenomenological study may help nurses understand suffering and guide their care and caring to alleviate it or make it more bearable.
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Maiko S, Johns SA, Helft PR, Slaven JE, Cottingham AH, Torke AM. Spiritual Experiences of Adults With Advanced Cancer in Outpatient Clinical Settings. J Pain Symptom Manage 2019; 57:576-586.e1. [PMID: 30528539 PMCID: PMC6382574 DOI: 10.1016/j.jpainsymman.2018.11.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/27/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2022]
Abstract
CONTEXT Adults who have advanced cancer experience distress, and many use religion and spirituality to cope. Research on the spiritual experiences of patients with advanced cancer will help guide the provision of high-quality spiritual care. OBJECTIVES To qualitatively describe advanced cancer patients' spiritual experiences of illness. METHODS We conducted semistructured qualitative interviews at a single cancer center with 21 patients with stage IV solid malignancies who had a prognosis of less than 12 months, as estimated by each patient's medical oncologist. Five investigators conducted a thematic analysis of the transcribed interviews. RESULTS We found 31 patients who were eligible for enrollment, and 21 (67.7%) participated in interviews to thematic saturation. Using a thematic-analysis approach, five major themes emerged. Relationships with family and friends was the most important theme among all 21 patients irrespective of their religious or spiritual identity. Relationship with God and faith community was frequently identified by those who considered themselves spiritually religious. Cancer often led to reflection about the meaning of life and the nature of existential suffering. Patients addressed the extent to which identity was changed or maintained through the cancer experience, and some expressed acceptance as a way of coping with illness. CONCLUSIONS Spiritual care for dying cancer patients should always include the exploration of relationships with family and friends, as well as God and faith community for some patients. Relationships with family, friends, and God can be a source of strength for many. Making meaning, addressing identity concerns, supporting acceptance as a resource for coping with illness, and acknowledging existential suffering will often arise for these patients.
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Affiliation(s)
- Saneta Maiko
- Indiana University Health, The Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, Indianapolis, Indiana, USA; The John Templeton Transforming Chaplaincy Research Fellow and Affiliate Research Scientist, Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, Indiana, USA.
| | - Shelley A Johns
- Indiana University School of Medicine, Regenstrief Institute, Indianapolis, Indiana, USA; Charles Warren Fairbanks Center for Medical Ethics, Indiana University Health, Indianapolis, Indiana, USA; Research in Palliative and End-of-Life Communication and Training (RESPECT) Center, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Paul R Helft
- Indiana University Cancer Center, Charles Warren Fairbanks Center for Medical Ethics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - James E Slaven
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ann H Cottingham
- Regenstrief Institute, Inc, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Alexia M Torke
- The Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, Indiana University Health, Indiana University School of Medicine, Indianapolis, Indiana, USA; Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, Indiana, USA
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Abstract
Cancer affects individuals in all human dimensions. Cancer patients are more susceptible to spiritual distress. Several studies have addressed spiritual distress using quantitative designs; however, a qualitative approach to the experience of spiritual distress could provide a deeper understanding of the phenomenon. This study aims to synthesis the experience of spiritual distress as lived by cancer patients in qualitative primary studies. This is a literature review based on electronic databases search. A total of 4075 citations was identified and 23 studies were included. The most frequent qualitative research method was phenomenology (n = 15), and interviews were the main data collection method (n = 20). Two major themes have been identified related to the experience of spiritual distress: suffering and coping. Spiritual distress is an intimate, deep and suffering experience in life, which requires coping strategies and involves spiritual values and beliefs. Healthcare providers should be aware of this experience and recognize spiritual distress in cancer patients, as it is critical in providing holistic nursing care.
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Al Kalaldeh M, Shosha GA, Saiah N, Salameh O. Dimensions of Phenomenology in Exploring Patient's Suffering in Long-Life Illnesses: Qualitative Evidence Synthesis. J Patient Exp 2018; 5:43-49. [PMID: 29582010 PMCID: PMC5862380 DOI: 10.1177/2374373517723314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Patients' suffering has been increasingly investigated by health-care researchers especially in the chronically ill. Suffering is viewed as a progressive negative consequence that associated with pain, impaired self-esteem, and social alienation. This qualitative evidence synthesis aimed to provide further insights into the application of phenomenology in explaining suffering among patients with chronic illnesses. Methods Studies included in this qualitative evidence synthesis study were retrieved by searching from the following electronic databases: CINAHL, PubMed Central, and EBSCO. Findings Phenomenology is regarded as influential to generate in-depth evidence about suffering that are grounded in chronically ill patients' perspectives. The philosophical constructs of suffering suggested fundamental dimensions such as stress, distress, hopelessness, and depression along with pain. Evidence encompasses the entire manifestation of suffering in which all interrelated meanings are understood and referred to a unique structure. Hermeneutic phenomenology was adopted as an effective strategy to elucidate human experience leading to the discovery of the embedded meanings of life experience. Conclusion The phenomenological approach provides nursing research with the pathway to explore patients' suffering experiences in the chronically ill.
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Affiliation(s)
| | | | - Najah Saiah
- Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Omar Salameh
- Al-Zaytoonah University of Jordan, Amman, Jordan
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10
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The Lived Experience of Suffering of Males After Blunt Trauma: A Phenomenological Study. J Trauma Nurs 2017; 24:193-202. [DOI: 10.1097/jtn.0000000000000289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Philipp R, Mehnert A, Lehmann C, Oechsle K, Bokemeyer C, Krüll A, Vehling S. Detrimental social interactions predict loss of dignity among patients with cancer. Support Care Cancer 2016; 24:2751-8. [DOI: 10.1007/s00520-016-3090-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 01/14/2016] [Indexed: 11/29/2022]
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Eustache C, Jibb E, Grossman M. Exploring hope and healing in patients living with advanced non-small cell lung cancer. Oncol Nurs Forum 2015; 41:497-508. [PMID: 25158655 DOI: 10.1188/14.onf.497-508] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To explore the experience and meaning of hope in relation to the healing process of patients living with stage IIIb or IV non-small cell lung cancer. RESEARCH APPROACH Interpretative qualitative study design. SETTING Peter Brojde Lung Cancer Centre in the Jewish General Hospital in Montreal, Quebec, Canada. PARTICIPANTS 12 English- and French-speaking patients, aged 36-78 years. METHODOLOGIC APPROACH One 60-90-minute semistructured interview per participant was conducted. An inductive approach to data analysis was taken, involving immersion in the data, coding, classifying, and creating linkages. FINDINGS Four main themes emerged: (a) the morass of shattered hope, (b) tentative steps toward a new hope paradigm, (c) reframing hope within the context of a life-threatening illness, and (d) strengthening the link between hope and wellness. CONCLUSIONS Patients described a process where hope was diminished or lost entirely, regained, and reshaped as they learned to live and grow following their diagnosis. INTERPRETATION This study adds to the literature by describing the dynamic nature of hope as well as factors facilitating or hindering the hope process. It demonstrates how finding meaning, a structural component of healing, can be used to envision a new hopeful future. This study suggests hope and healing cannot exist in isolation, and highlights the importance of understanding the fluctuating nature of hope in patients with advanced lung cancer to foster it, therefore promoting healing.
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Affiliation(s)
| | - Emily Jibb
- Jewish General Hospital, Montreal, Quebec, Canada
| | - Mary Grossman
- Integrative Oncology Nursing, Montreal, Quebec, Canada
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15
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Best M, Aldridge L, Butow P, Olver I, Webster F. Conceptual analysis of suffering in cancer: a systematic review. Psychooncology 2015; 24:977-86. [PMID: 25754062 DOI: 10.1002/pon.3795] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 02/11/2015] [Accepted: 02/11/2015] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Patient suffering is a neglected area of care, partly because of poor definitions. The aim of this study was to distill what is currently known about suffering in the health literature in order to generate a conceptual basis for further research. METHODS A systematic review focusing on suffering across all cancers was undertaken. The search included peer-reviewed English articles published between 1992 and 2012 in MEDLINE, Embase, PsycINFO and the Cochrane Library databases focusing on conceptualisation of suffering in adult cancer patients. Seminal theoretical articles conceptualising suffering more generally were also eligible. To ensure identification of a sufficiently broad range of conceptualisations of suffering in cancer, the search strategy was drafted iteratively. Study findings were subjected to conceptual analysis using the evolutionary method. RESULTS One hundred twenty-eight studies were identified, which discussed definitions or conceptualisations of suffering. In terms of its attributes, suffering is defined as 'an all-encompassing, dynamic, individual phenomenon characterized by the experience of alienation, helplessness, hopelessness and meaninglessness in the sufferer which is difficult for them to articulate. It is multi-dimensional and usually incorporates an undesirable, negative quality.' Surrogate terms, antecedents and consequences of suffering are described. CONCLUSIONS The systematic review revealed that suffering includes holistic suffering, which is multidimensional, oscillating, individual and difficult for individuals to express. Opportunities should be provided for patients to express their suffering. The potential for suffering to be transcended needs to be recognized and facilitated by healthcare staff.
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Affiliation(s)
- Megan Best
- Psycho-Oncology Co-operative Research Group, University of Sydney, Level 6 North, Lifehouse C39Z, New South Wales, 2006, Australia
| | - Lynley Aldridge
- Psycho-Oncology Co-operative Research Group, University of Sydney, Level 6 North, Lifehouse C39Z, New South Wales, 2006, Australia
| | - Phyllis Butow
- Psycho-Oncology Co-operative Research Group, University of Sydney, Level 6 North, Lifehouse C39Z, New South Wales, 2006, Australia
| | - Ian Olver
- Cancer Council Australia, GPO Box 4708, Sydney, New South Wales, 2001, Australia
| | - Fleur Webster
- Cancer Australia, Locked Bag 3, Strawberry Hills, New South Wales, 2012, Australia
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Busolo D, Woodgate R. Palliative care experiences of adult cancer patients from ethnocultural groups: a qualitative systematic review protocol. ACTA ACUST UNITED AC 2015; 13:99-111. [DOI: 10.11124/jbisrir-2015-1809] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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17
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Assessment of spiritual suffering in the cancer context: A systematic literature review. Palliat Support Care 2014; 13:1335-61. [PMID: 25386699 DOI: 10.1017/s1478951514001217] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE An important goal of cancer medicine is relief of patients' suffering. In view of the clinical challenges of identifying suffering patients, we sought to identify valid instruments for assessing the spiritual suffering of people diagnosed with cancer. METHOD A systematic review of the literature was conducted in the Medline, Embase, the Cochrane Library, and PsycINFO databases seeking assessment instruments that measure either suffering or one of its synonyms or symptoms. The psychometric properties of the identified measures were compared. RESULTS A total of 90 articles were identified that supplied information about 58 measures. The constructs examined were: suffering, hopelessness/demoralization, hope, meaning, spiritual well-being, quality of life where a spiritual/existential dimension was included, distress in the palliative care setting and pain, distress or struggle of a spiritual nature. The Pictorial Representation of Illness and Self Measure (PRISM) (patient completed) was the most promising measure identified for measuring the burden of suffering caused by illness due to its ease of use and the inclusion of a subjective component. SIGNIFICANCE OF RESULTS Although the appropriateness of any measure for the assessment of spiritual suffering in cancer patients will depend on the context in which it is intended to be utilized, the PRISM is promising for measuring the burden of suffering due to illness.
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Abstract
Spirituality is salient to persons nearing the end of life (EOL). Unfortunately, researchers have not been able to agree on a universal definition of spirituality reducing the effectiveness of spiritual research. To advance spiritual knowledge and build an evidence base, researchers must develop creative ways to describe spirituality as it cannot be explicitly defined. A literature review was conducted to determine the common attributes that comprise the essence of spirituality, thereby creating a common ground on which to base spiritual research. Forty original research articles (2002 to 2012) focusing on EOL and including spiritual definitions/descriptions were reviewed. Analysis identified five attributes that most commonly described the essence of spirituality, including meaning, beliefs, connecting, self-transcendence, and value.
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Chen AN, Chen KF, Chang PC, Shih FJ, Chen CR, Shih FJ, Huang CY. Hindering factors and suggestions related to organ donation decisions: perspective of the Taiwan Ali-Shan Tsou aboriginal tribe. Transplant Proc 2014; 46:1041-3. [PMID: 24815122 DOI: 10.1016/j.transproceed.2014.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 12/31/2013] [Accepted: 01/13/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUNDS AND AIMS Ali-San Tsou (AST) is one of leading aboriginal tribes in Taiwan with traditional godly beliefs related to life and death. Lacking related knowledge, health professionals (HPs) often failed to help them reach good dying or organ donation (OD). This study aimed to explore hindering factors and suggestions related to OD for good dying from Taiwan AST's own perspective. METHODS An explorative qualitative design was employed using a purposive sample of the AST tribes from Taiwan. Data were collected with AST residents by face-to-face interviews and analyzed by content analysis. RESULTS Thirty AST residents (16 females and 14 males) with ages ranging from 28 to 78 (mean, 54.5) years completed interviews. Of them, 85% reported various diseases. In this study 73% were Catholics and Christians, 17% held traditional godly believes, and 10% had no religious affiliation. Eight hindering factors were reported: (1) limited information about organs and OD; (2) no qualified organs for donation; (3) worry about lack of forgiveness by ancestors; (4) tribe elders who might not accept concept of OD; (5) intact bodies were required at home during spirit-companion rituals; (6) earth burial with intact bodies was preferred; (7) bodies due to accidental and bad death were impermissible for OD; and (8) worry about possession by the donor's spirit. Seven suggestions were also reported for HPs to enhance AST's OD decisions: (1) starting with friendship and a caring relationship; (2) providing spiritual support from reverent religions; (3) stressing good deeds and honoring tribe folks by OD; (4) avoiding accidental/bad death; (5) providing relevant modern medical knowledge of human organs and OD; (6) introducing OD as part of a good-dying care plan; and (7) demonstrating a respectful discussion mindset about OD. CONCLUSIONS Eight hindering factors and 7 types of suggestions for enhancing AST aboriginal people's OD decisions were first explored in this project. In the future, HPs are encouraged to invite AST to share the concepts of OT and try to clarify the related concerns with respect for their cultural contexts. With mutual respect, the efforts of sharing and integrating OD into good-dying care would be more possible.
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Affiliation(s)
- A N Chen
- Institute of Clinical & Community Health Nursing, National Yang-Ming University, Chayi, Taiwan; National Taiwan University Hospital, Chayi, Taiwan
| | - K F Chen
- Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chayi, Taiwan
| | - P C Chang
- Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chayi, Taiwan
| | - F Jong Shih
- Department of Gerontological Care and Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - C R Chen
- Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chayi, Taiwan
| | - F-Jin Shih
- Institute of Clinical & Community Health Nursing, National Yang-Ming University, Chayi, Taiwan; Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chayi, Taiwan.
| | - C-Y Huang
- Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chayi, Taiwan.
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Suffering indicators in terminally ill children from the parental perspective. Eur J Oncol Nurs 2013; 17:720-5. [DOI: 10.1016/j.ejon.2013.04.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Revised: 02/04/2013] [Accepted: 04/05/2013] [Indexed: 11/20/2022]
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Hong EPW, Margaret O, Leng CY, Kannuasamy P. The lived experience of older Chinese Singaporeans with life-threatening illnesses in a inpatient hospice. PROGRESS IN PALLIATIVE CARE 2013. [DOI: 10.1179/1743291x12y.0000000004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Montoya-Juarez R, Garcia-Caro MP, Campos-Calderon C, Schmidt-RioValle J, Gomez-Chica A, Marti-García C, Cruz-Quintana F. Psychological responses of terminally ill patients who are experiencing suffering: A qualitative study. Int J Nurs Stud 2013; 50:53-62. [DOI: 10.1016/j.ijnurstu.2012.08.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 08/22/2012] [Accepted: 08/25/2012] [Indexed: 10/27/2022]
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Östlund U, Brown H, Johnston B. Dignity conserving care at end-of-life: A narrative review. Eur J Oncol Nurs 2012; 16:353-67. [DOI: 10.1016/j.ejon.2011.07.010] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 06/07/2011] [Accepted: 07/31/2011] [Indexed: 11/26/2022]
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Spiritual Care Experiences of Iranian Nursing Students. J Hosp Palliat Nurs 2012. [DOI: 10.1097/njh.0b013e31824876e3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hsiao SM, Gau ML, Ingleton C, Ryan T, Shih FJ. An exploration of spiritual needs of Taiwanese patients with advanced cancer during the therapeutic processes. J Clin Nurs 2011; 20:950-9. [PMID: 21044187 DOI: 10.1111/j.1365-2702.2010.03278.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIMS AND OBJECTIVES This study explores the spiritual needs of patients with advanced cancer during their therapeutic process in Taiwan and analyses the influence of Chinese culture in addressing their spiritual needs. BACKGROUND Many nurse clinicians have concerns about the difficulties of providing spiritual care for ethnic-Chinese cancer clients within their cultural context, possibly as a result of lack of knowledge and training. There has been little research exploring the potential impact of Chinese cultural values on the spiritual needs of patients with advanced cancer. DESIGN Explorative qualitative enquiry was used. METHODS Data were collected through participant observation and in-depth face-to-face interviews. Transcribed interview data were analysed by using qualitative content analysis. The purposive sample (n = 33) was drawn from a leading medical center (n = 19) with 3000 beds in the capital and a community-based rural teaching hospital (n = 14) with 581 beds in Taiwan. RESULTS Four spiritual needs emerged from the analysis: the need to foster hope for survival and obtain a peaceful mindset, to fulfil the meanings of life and preserve one's dignity, to experience more reciprocal human love and finally, to receive assistance in facing death peacefully. CONCLUSION This research has shown that patients with advanced cancer need caregivers, friends and the help of their religion to meet their spiritual needs during the therapeutic processes. RELEVANCE TO CLINICAL PRACTICE The findings of this study could assist health professionals to detect the unmet spiritual needs of ethnic-Chinese patients with cancer in the context of their cultural or religious background as early as possible.
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Affiliation(s)
- Szu-Mei Hsiao
- Department of Nursing National Yang Ming University, Taipei, Taiwan
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Nilmanat K, Chailungka P, Phungrassami T, Promnoi C, Tulathamkit K, Noo-urai P, Phattaranavig S. Living with suffering as voiced by Thai patients with terminal advanced cancer. Int J Palliat Nurs 2010; 16:393-9. [DOI: 10.12968/ijpn.2010.16.8.393] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kittikorn Nilmanat
- Assistant Professor, Medical Nursing Department, Prince of Songkla University
| | - Pachariya Chailungka
- Assistant Professor and appointed Dean, Faculty of Nursing, Prince of Songkla University
| | - Temsak Phungrassami
- Associate Professor, Radiotherapy Department, Songklanagarind Hospital, Prince of Songkla University
| | - Chantra Promnoi
- Senior Lecturer, Surgical Nursing Department, Prince of Songkla University
| | - Kandawasri Tulathamkit
- Senior Nurses, Radiotherapy Department, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Prachuap Noo-urai
- Senior Nurses, Radiotherapy Department, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Sasiwimon Phattaranavig
- Senior Nurses, Radiotherapy Department, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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Sittisombut S, Inthong S. Surrogate decision-maker for end-of-life care in terminally ill patients at Chiang Mai University Hospital, Thailand. Int J Nurs Pract 2009; 15:119-25. [DOI: 10.1111/j.1440-172x.2009.01730.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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