An early palliative care intervention can be confronting but reassuring: A qualitative study on the experiences of patients with advanced cancer.

Fliedner, Monika; Zambrano, Sofia; Schols, Jos Mga; Bakitas, Marie; Lohrmann, Christa; Halfens, Ruud Jg; Eychmüller, Steffen (2019). An early palliative care intervention can be confronting but reassuring: A qualitative study on the experiences of patients with advanced cancer. Palliative medicine, 33(7), pp. 783-792. Sage 10.1177/0269216319847884

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BACKGROUND Intervention trials confirm that patients with advanced cancer receiving early palliative care experience a better quality of life and show improved knowledge about and use of palliative care services. To involve patients in future health-care decisions, health professionals should understand patients' perspectives. However, little is known about how patients' experience such interventions. AIM To explore advanced cancer patients' experiences with a structured early palliative care intervention, its acceptability and impact on the patients' life including influencing factors. DESIGN Qualitative content analysis of in-depth, semi-structured interviews. SETTING/PARTICIPANTS Patients with various advanced cancer diagnoses were enrolled in a multicenter randomized controlled trial (NCT01983956), which investigated the impact of "Symptoms, End-of-life decisions, Network, Support," a structured early palliative care intervention, on distress. Of these, 20 patients who underwent the intervention participated in this study. RESULTS Participants received the intervention well and gained a better understanding of their personal situation. Patients reported that the intervention can feel "confronting" but with the right timing it can be confirming and facilitate family conversations. Patients' personal background and the intervention timing within their personal disease trajectory influenced their emotional and cognitive experiences; it also impacted their understanding of palliative care and triggered actions toward future care planning. CONCLUSION Early palliative care interventions like "Symptoms, End-of-life decisions, Network, Support" may provoke emotions and feel "confrontational" often because this is the first time when issues about one's end of life are openly discussed; yet, advanced cancer patients found it beneficial and felt it should be incorporated into routine care.

Item Type:

Journal Article (Original Article)

Division/Institute:

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04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Fliedner, Monika; Zambrano Ramos, Sofia Carolina and Eychmüller, Steffen

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1477-030X

Publisher:

Sage

Language:

English

Submitter:

Rebeka Gerber

Date Deposited:

17 Dec 2019 12:42

Last Modified:

20 Apr 2020 14:14

Publisher DOI:

10.1177/0269216319847884

PubMed ID:

31068119

Uncontrolled Keywords:

(Early) palliative care advance care planning neoplasms qualitative research

BORIS DOI:

10.7892/boris.136275

URI:

https://boris.unibe.ch/id/eprint/136275

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