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Research ArticleResearch

Ultimate journey of the terminally ill

Ways and pathways of hope

Serge Daneault, Véronique Lussier, Suzanne Mongeau, Louise Yelle, Andréanne Côté, Claude Sicotte, Pierre Paillé, Dominique Dion and Manon Coulombe
Canadian Family Physician August 2016; 62 (8) 648-656;
Serge Daneault
Palliative care physician, a researcher, and Professor in the Research Centre and Palliative Care Service at the University of Montreal Hospital Centre and in the Faculty of Medicine at the University of Montreal in Quebec.
MD PhD FRCPC
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  • For correspondence: serge.daneault.chum@ssss.gouv.qc.ca
Véronique Lussier
Professor in the Department of Psychology at the University of Quebec at Montreal.
PhD
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Suzanne Mongeau
Professor in the School of Social Work at the University of Quebec at Montreal.
PhD
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Louise Yelle
Clinical Investigator and Associate Clinical Professor in the Research Centre and for the Hematology and Oncology Service at the University of Montreal Hospital Centre and in the Faculty of Medicine at the University of Montreal.
MD MSc FRCPC
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Andréanne Côté
Palliative care physician and Director of the Programme de compétences avancées en soins palliatifs for the Palliative Care Service at the University of Montreal Hospital Centre and in the Faculty of Medicine at the University of Montreal.
MD MA
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Claude Sicotte
Professor in the School of Public Health at the University of Montreal.
PhD
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Pierre Paillé
Professor in the Faculty of Education at the University of Sherbrooke in Quebec.
PhD
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Dominique Dion
Palliative care physician at the Maisonneuve-Rosemont Hospital in Montreal and Assistant Professor at the University of Montreal.
MD MSc
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Manon Coulombe
Nurse at the Maisonneuve-Rosemont Hospital.
MSc
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Abstract

Objective To better understand the role of hope among terminally ill cancer patients.

Design Qualitative analysis.

Setting A tertiary specialized cancer centre in Canada.

Participants Cancer patients in palliative care with an estimated remaining life expectancy of 12 months or less (N = 12) and their loved ones (N = 12) and treating physicians (N = 12).

Methods Each patient underwent up to 3 interviews and identified a loved one who participated in 1 interview. Treating physicians were also interviewed. All interviews were fully transcribed and analyzed by at least 2 investigators. Interviews were collected until saturation occurred.

Main findings Seven attributes describe the experiences of palliative cancer patients and their caregivers: hope as an irrational phenomenon that is a deeply rooted, affect-based response to adversity; initial hope for miraculous healing; hope as a phenomenon that changes over time, evolving in different ways depending on circumstances; hope for prolonged life when there is no further hope for cure; hope for a good quality of life when the possibility of prolonging life becomes limited; a lack of hope for some when treatments are no longer effective in curbing illness progression; and for others hope as enjoying the present moment and preparing for the end of life.

Conclusion Approaches aimed at sustaining hope need to reflect that patients’ reactions might fluctuate between despair and a form of acceptance that leads to a certain serenity. Clinicians need to maintain some degree of hope while remaining as realistic as possible. The findings also raise questions about how hope influences patients’ perceptions and acceptance of their treatments.

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Canadian Family Physician: 62 (8)
Canadian Family Physician
Vol. 62, Issue 8
1 Aug 2016
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Ultimate journey of the terminally ill
Serge Daneault, Véronique Lussier, Suzanne Mongeau, Louise Yelle, Andréanne Côté, Claude Sicotte, Pierre Paillé, Dominique Dion, Manon Coulombe
Canadian Family Physician Aug 2016, 62 (8) 648-656;

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Ultimate journey of the terminally ill
Serge Daneault, Véronique Lussier, Suzanne Mongeau, Louise Yelle, Andréanne Côté, Claude Sicotte, Pierre Paillé, Dominique Dion, Manon Coulombe
Canadian Family Physician Aug 2016, 62 (8) 648-656;
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