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Patients' perspectives on information from physicians during palliative chemotherapy: A qualitative study

Published online by Cambridge University Press:  14 December 2015

Lisa Martinsson ,
Bertil Axelsson  and
Christina Melin-Johansson
Lisa Martinsson*
Affiliation:
Department of Radiation Sciences, Umeå University, Umeå, Sweden
Bertil Axelsson
Affiliation:
Department of Radiation Sciences, Unit of Clinical Research Centre–Östersund, Umeå University, Umeå, Sweden, and Swedish Register of Palliative Care, Kalmar, Sweden
Christina Melin-Johansson
Affiliation:
Department of Nursing, Mid Sweden University, Östersund, Sweden, and Institute of Health and Care Sciences, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
*
Address correspondence and reprint requests to: Lisa Martinsson, Department of Radiation Sciences, Umeå University, SE-901 87 Umeå, Sweden. E-mail: [email protected].
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Abstract

Objective:

During the course of their disease, patients with cancer receiving palliative chemotherapy receive extensive amounts of information from physicians. The objective of our study was to describe patients' perspectives on the information they received from physicians during palliative chemotherapy with regard to their cancer diagnosis, treatments, prognosis, and future planning.

Method:

A total of 15 semistructured face-to-face interviews with patients who had incurable cancer were conducted, transcribed verbatim, and analyzed with qualitative content analysis.

Results:

Three categories were defined during the analytical process: “having a chronic disease,” “depending on chemotherapy,” and “living with an unpredictable future.”

Significance of results:

Our study demonstrated that patients undergoing palliative chemotherapy perceived that their disease was incurable and chronic, that they were dependent on chemotherapy, and that their future was uncertain. Compared with other studies, the patients in our study seemed to be more aware of their prognosis and the goals of care.

Keywords

CancerChemotherapyCommunicationDisclosurePalliative care
Type
Original Articles
Information
Palliative & Supportive Care , Volume 14 , Issue 5 , October 2016 , pp. 495 - 502
Copyright
Copyright © Cambridge University Press 2015 

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References

REFERENCES

Audrey, S., Abel, J., Blazeby, J.M., et al. (2008). What oncologists tell patients about survival benefits of palliative chemotherapy and implications for informed consent: Qualitative study. BMJ, 337, a752.Google Scholar
Back, A.L., Trinidad, S.B., Hopley, E.K., et al. (2014). Reframing the goals of care conversation: “We're in a different place.” Journal of Palliative Medicine, 17(9), 1019–1024.Google Scholar
Barclay, J.S., Blackhall, L.J. & Tulsky, J.A. (2007). Communication strategies and cultural issues in the delivery of bad news. Journal of Palliative Medicine, 10(4), 958–977.Google Scholar
Buiting, H.M., Terpstra, W., Dalhuisen, F., et al. (2013). The facilitating role of chemotherapy in the palliative phase of cancer: Qualitative interviews with advanced cancer patients. PLoS One, 8(11), 1–9.Google Scholar
Burns, C.M., Broom, D.H., Smith, W.T., et al. (2007). Fluctuating awareness of treatment goals among patients and their caregivers: A longitudinal study of a dynamic process. Supportive Care in Cancer, 15(2), 187–196.Google Scholar
Chen, A.B., Cronin, A., Weeks, J.C., et al. (2013). Expectations about the effectiveness of radiation therapy among patients with incurable lung cancer. Journal of Clinical Oncology, 31(21), 2730–2735.Google Scholar
Chow, E., Andersson, L., Wong, R., et al. (2001). Patients with advanced cancer: A survey of the understanding of their illness and expectations from palliative radiotherapy for symptomatic metastases. Clinical Oncology, 13(3), 204–208.Google Scholar
El-Jawahri, A., Traeger, L., Park, E.R., et al. (2014). Associations among prognostic understanding, quality of life, and mood in patients with advanced cancer. Cancer, 120(2), 278–285.Google Scholar
Elkin, E.B., Kim, S.H., Casper, E.S., et al. (2007). Desire for information and involvement in treatment decisions: Elderly cancer patients' preferences and their physicians' perceptions. Journal of Clinical Oncology, 25(33), 5275–5280.Google Scholar
Friedrichsen, M., Lindholm, A. & Milberg, A. (2011). Experiences of truth disclosure in terminally ill cancer patients in palliative home care. Palliative & Supportive Care, 9(2), 173–180.Google Scholar
Graneheim, U.H. & Lundman, B. (2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24(2), 105–112.Google Scholar
Graugaard, P.K., Rogg, L., Eide, H., et al. (2011). Ways of providing the patient with a prognosis: A terminology of employed strategies based on qualitative data. Patient Education and Counseling, 83(1), 80–86.Google Scholar
Grunfeld, E.A., Maher, E.J., Browne, S., et al. (2006). Advanced breast cancer patients' perceptions of decision making for palliative chemotherapy. Journal of Clinical Oncology, 24(7), 1090–1098.Google Scholar
Guest, G., Bunce, A. & Johnson, L. (2006). How many interviews are enough? An experiment with data saturation and variability. Field Methods, 18(1), 59–82.Google Scholar
Hancock, K., Clayton, J.M., Parker, S.M., et al. (2007). Truth-telling in discussing prognosis in advanced life-limiting illnesses: A systematic review. Palliative Medicine, 21(6), 507–517.Google Scholar
Innes, S. & Payne, S. (2009). Advanced cancer patients' prognostic information preferences: A review. Palliative Medicine, 23(1), 29–39.Google Scholar
Jacobsen, J., Thomas, J.D. & Jackson, V.A. (2013). Misunderstandings about prognosis: An approach for palliative care consultants when the patient does not seem to understand what was said. Journal of Palliative Medicine, 16(1), 91–95.Google Scholar
Kutner, J.S., Steiner, J.F., Corbett, K.K., et al. (1999). Information needs in terminal illness. Social Science & Medicine, 48(10), 1341–1352.Google Scholar
Lennes, I.T., Temel, J.S., Hoedt, C., et al. (2013). Predictors of newly diagnosed cancer patients' understanding of the goals of their care at initiation of chemotherapy. Cancer, 119(3), 691–699.Google Scholar
Lundquist, G., Rasmussen, B.H. & Axelsson, B. (2011). Information of imminent death or not: Does it make a difference? Journal of Clinical Oncology, 29(29), 3927–3931.Google Scholar
Lux, M.P., Bayer, C.M., Loehberg, C.R., et al. (2013). Shared decision-making in metastatic breast cancer: Discrepancy between the expected prolongation of life and treatment efficacy between patients and physicians, and influencing factors. Breast Cancer Research and Treatment, 139(2), 429–440.Google Scholar
Markman, M. (2011). Commentary: Implications of cancer managed as a “chronic illness.” Current Oncology Reports, 13(2), 90–91.Google Scholar
Mende, M., Trautmann, K., Rentsch, A., et al. (2013). Patients' perspectives on palliative chemotherapy of colorectal and non-colorectal cancer: A prospective study in a chemotherapy-experienced population. BMC Cancer, 13, 66.Google Scholar
Mitera, G., Zhang, L., Sahgal, A., et al. (2012). A survey of expectations and understanding of palliative radiotherapy from patients with advanced cancer. Clinical Oncology, 24(2), 134–138.Google Scholar
Morse, J.M. (2008). Confusing categories and themes. Qualitative Health Research, 18(6), 727–728.Google Scholar
Näppä, U., Lindqvist, O., Rasmussen, B.H., et al. (2011). Palliative chemotherapy during the last month of life. Annals of Oncology, 22(11), 2375–2380.Google Scholar
Salander, P. (2003). Den kreativa illusionen [The creative illusion] . Lund, Sweden: Studentlitteratur.Google Scholar
Schildmann, J., Ritter, P., Salloch, S., et al. (2013). “One also needs a bit of trust in the doctor …”: A qualitative interview study with pancreatic cancer patients about their perceptions and views on information and treatment decision-making. Annals of Oncology, 24(9), 2444–2449.Google Scholar
Socialdepartementet [Ministry of Health and Social Affairs] (2014). Svensk författningssamling: Patientlag (2014:821) [Swedish regulatory codes: Patient law (2014:821)]. Stockholm: Socialdepartementet.Google Scholar
Sørensen, J., Klee, M., Palshof, T., et al. (1993). Performance status assessment in cancer patients: An inter-observer variability study. British Journal of Cancer, 67(4), 773.Google Scholar
The, A.M., Hak, T., Koeter, G., et al. (2001). Collusion in doctor–patient communication about imminent death: An ethnographic study. The Western Journal of Medicine, 174(4), 247–253.Google Scholar
Weeks, J.C., Catalano, P.J., Cronin, A., et al. (2012). Patients' expectations about the effects of chemotherapy for advanced cancer. The New England Journal of Medicine, 367(17), 1616–1625.Google Scholar