Finding meaning in life: an exploration on the experiences with dependence on care of patients with advanced cancer and nurses caring for them

  • Maria Luigia Candela
  • Michela PireddaEmail author
  • Anna Marchetti
  • Gabriella Facchinetti
  • Laura Iacorossi
  • Maria Teresa Capuzzo
  • Daniela Mecugni
  • Laura Rasero
  • Maria Matarese
  • Maria Grazia De Marinis
Original Article



Patients with advanced cancer are likely to face increasing levels of care dependence. Adult patients who become care dependent on others can experience this condition as one of suffering and humiliation. The nurse-patient relationship plays a key role in the experience of dependence. Understanding patients’ and nurses’ perceptions of care dependence is crucial to addressing the impact it has on the lives of both. The aim of this study is to explore the experiences of patients with cancer and nurses caring for them.


A multicentre qualitative study was conducted in Italy using semi-structured interviews with patients with advanced cancer admitted to 3 hospitals, and 9 focus groups with nurses working in oncology wards of 2 hospitals. Data were analysed with inductive content analysis.


Thirty-two patients and 44 nurses participated in the study. Three common themes were identified: within dependence, the relationship is a lifeline; dependence is influenced by internal and external factors and dependence generates changes. Dependence impacts on patients’ and nurses’ lives and implies a process of personal maturing for both. Patients learn the humility to ask for help by exposing their vulnerability. Nurses become aware that a trusting relationship helps patients to accept dependence, and they learn to self-transcend in order to build it.


Striving to build positive relationships implies a change in nurses’ and patients’ lives. In this way, they come to understand important aspects of life and find meaning in difficult situations. Further studies should explore also homecare settings and patients’ families.


Care dependence Focus groups Interview Neoplasms Nurses Qualitative research 



We thank the patients and the nurses who participated in this study by sharing their experiences.

Author contributions

All authors: Maria Luigia Candela (MLC), Michela Piredda (MP), Anna Marchetti (AM), Gabriella Facchinetti (GF), Laura Iacorossi (LI), Maria Teresa Capuzzo (MTC), Daniela Mecugni (DM), Laura Rasero (LR), Maria Matarese (MM) and Maria Grazia De Marinis (MGDM) contributed substantially to study conception and design. MP, LI, MTC, DM and LR contributed also to retrieval, analysis and interpretation of data. MLC and MP drafted the article, and all authors critically reviewed it and approved the version to be published.

All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Funding information

This research was funded by a grant by the Center of Excellence for Nursing Culture and Research (CECRI), Rome, Italy.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2020

Authors and Affiliations

  1. 1.Department of Biomedicine and PreventionTor Vergata UniversityRomeItaly
  2. 2.Research Unit Nursing ScienceCampus Bio-Medico di Roma UniversityRomeItaly
  3. 3.Istituto Superiore di SanitàRomeItaly
  4. 4.Department of Surgery, Medicine, Dentistry and Morphological SciencesUniversity of Modena and Reggio EmiliaReggio EmiliaItaly
  5. 5.Department of Health SciencesUniversity of FlorenceFlorenceItaly

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