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Supportive Care in Cancer

, Volume 26, Issue 8, pp 2769–2784 | Cite as

Exploring symptom meaning: perspectives of palliative care physicians

  • Celina F. Estacio
  • Phyllis N. ButowEmail author
  • Melanie R. Lovell
  • Skye T. Dong
  • Josephine M. Clayton
Original Article

Abstract

Context

Understanding patients’ symptom experiences is essential to providing effective clinical care. The discussion between patients and physicians of symptom meaning and its significance, however, is ill understood.

Objectives

To investigate palliative care physicians’ understanding of symptom meaning, and their experiences of and attitudes towards the discussion of symptom meaning with patients.

Methods

Semi-structured interviews were conducted (N = 17) across Sydney, Australia. Transcripts were analysed using framework analysis.

Results

Six key themes were identified: (1) definitions of symptom meaning (causal meanings, functional impact, existential impact, and cascade of meanings); (2) meanings are personal (demographic, culture, spiritual, and family differences); (3) eliciting meanings requires subtlety and trust (following the patient’s cues); discussing meaning can be (4) hard (for the patient and health professional); (5) therapeutic (assuaging fears, feeling listened to and valued, increased sense of control, and reduced symptom distress); and (6) enhances clinicians’ practice and work satisfaction (provision of more tailored care, reassurance through the provision of information, and strengthening of doctor-patient relationship).

Conclusions

Exploring symptom meaning can serve to provide information, alleviate anxiety, and facilitate individualised care, but only when patients present cues or are open to discuss symptom-related concerns. However, various barriers hinder such dialogue in consultations. Greater awareness of symptom meaning and its influence may facilitate physicians exploring symptom meaning more with patients in the future.

Keywords

Symptom meaning Symptom experience Palliative care Advanced cancer Qualitative research Health professionals 

Notes

Compliance with ethical standards

The University of Sydney Human Research Ethics Committee granted approval for this study.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Centre for Medical Psychology and Evidence-based Decision-Making, and Kolling Institute, Northern Clinical SchoolThe University of SydneySydneyAustralia
  2. 2.HammondCare Palliative and Supportive Care ServiceGreenwich HospitalGreenwichAustralia

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