RT Journal Article
SR Electronic
T1 Ultimate journey of the terminally ill
JF Canadian Family Physician
JO Can Fam Physician
FD The College of Family Physicians of Canada
SP 648
OP 656
VO 62
IS 8
A1 Daneault, Serge
A1 Lussier, Véronique
A1 Mongeau, Suzanne
A1 Yelle, Louise
A1 Côté, Andréanne
A1 Sicotte, Claude
A1 Paillé, Pierre
A1 Dion, Dominique
A1 Coulombe, Manon
YR 2016
UL http://www.cfp.ca/content/62/8/648.abstract
AB 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.