Existential concerns of terminally ill cancer patients receiving specialized palliative care in Japan
- 636 Downloads
Although alleviation of existential distress is important for terminally ill cancer patients, the concept of existential distress has not been fully understood. The aim of this study was to categorize existential concerns of Japanese terminally ill cancer patients and explore care strategies based on the categorizations.
A multicenter cross-sectional study in 88 terminally ill cancer patients receiving specialized inpatient palliative care was performed. The nurses explored patient existential concerns by asking several key questions, and recorded the answers that they considered typically described the patients’ concerns. All statements recorded by the nurses were analyzed using content analysis methods.
A total of 89 statements were subjected to analysis. The categories and their prevalence were: relationship-related concerns (22%; isolation, concerns about family preparation, conflicts in relationship), loss of control (16%; physical control, cognitive control, control over future), burden on others (4.5%), loss of continuity (10%; loss of role, loss of enjoyable activity, loss of being oneself), uncompleted life task (6.8%), hope/hopelessness (17%), and acceptance/preparation (25%).
Existential concerns of Japanese terminally ill cancer patients were categorized as relationship-related concerns, loss of control, burden on others, loss of continuity, uncompleted life task, hope/hopelessness, and acceptance/preparation. These themes seemed to encompass universal human suffering beyond cultural differences, and this conceptualization may contribute to the development of effective therapeutic interventions to alleviate existential distress.
KeywordsExistential distress Spiritual care Palliative care Neoplasms
- 2.Bolmsjo I (2000) Existential issues in palliative care—interviews with cancer patients. J Palliat Care 16:20–24Google Scholar
- 10.Hirai K, Morita T, Kashiwagi T (2003) Professionally perceived effectiveness of psychosocial interventions for existential suffering of terminally ill cancer patients. Palliat Med 17:688–694Google Scholar
- 13.Krippendorff K (1980) Content analysis: an introduction to its methodology, 4th edn. Sage Publications, Newbury Park, CAGoogle Scholar
- 14.McGrath P (2002) Creating a language for ‘spiritual pain’ through research: a beginning. Support Care Cancer 10:634–646Google Scholar
- 17.Morita T, Tei Y, Inoue S, Chihara S (2001) Care for spiritual and existential suffering of terminally ill cancer patients (in Japanese). Integration by systematic review. Jpn J Palliat Med 3:444–456Google Scholar
- 19.Singer PA, Martin DK, Kelner M (1999) Quality end-of-life care. Patients’ perspectives. JAMA 281:163–168Google Scholar
- 22.Takahashi M, Hara M, Shimoinaba K, Tsuneto S (1996) A survey of spiritual pain and care among hospice inpatients (in Japanese). Jpn J Clin Res Death Dying 19:53–56Google Scholar