Skip to main content
Erschienen in: Supportive Care in Cancer 8/2012

01.08.2012 | Original Article

Self-care and end of life care—patients’ and carers’ experience a qualitative study utilising serial triangulated interviews

verfasst von: Bridget Margaret Johnston, Stuart Milligan, Claire Foster, Nora Kearney

Erschienen in: Supportive Care in Cancer | Ausgabe 8/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

This study aimed to understand patient and carer experiences of end of life care and to explore how patients care for themselves at the end of life in Scotland. Research questions: (1) From the perspectives of patients and carers, what are their experience of advanced cancer and end of life care? (2) What self-care strategies enable patient and carers to cope with their end of life care?

Methods

This paper reports a qualitative study using in-depth, unstructured serial interviews involving collaboration with and participation of people affected by advanced cancer. The study was a 2-year, three-phase study with multiple methods of data collection. The study was conducted in the Highlands and West of Scotland including rural, remote and socially deprived areas. Patient experience data were collected from 20 patients as well as their main carer and the health professional who they perceived had given them the most support. Triangulating data in this way allowed the totality of the patient experience to be captured. A total of 71 interviews were conducted. Data were analysed both within and across cases using framework analysis with the aid of QSR NVIVO 7.

Results

Maintaining normality and preparing for death were the two most important areas, for the patients in the study, as far as their self-care was concerned. Patients wished support that enabled them to maintain their independence and remain at home. People managed their illness both physically and emotionally; managing and adjusting to their lack of independence and keeping control were keys to most participants.

Conclusions

Self-care is important to this group of people. People receiving end of life care want to and are able to engage in research. The findings are timely and relevant to current changes in palliative care policy and practice.
Literatur
1.
Zurück zum Zitat Murray S et al (2004) Developing primary palliative care. Br Med J 329(7474):1056CrossRef Murray S et al (2004) Developing primary palliative care. Br Med J 329(7474):1056CrossRef
2.
Zurück zum Zitat Davies E, Higginson I (2004) The solid facts: palliative care. World Health Organisation, Copenhagen, p 32 Davies E, Higginson I (2004) The solid facts: palliative care. World Health Organisation, Copenhagen, p 32
3.
Zurück zum Zitat Scottish Government (2005) Building a health service fit for the future: Edinburgh Scottish Government (2005) Building a health service fit for the future: Edinburgh
4.
Zurück zum Zitat Teno JM et al (2001) Patient-focused, family-centered end-of-life medical care: views of the guidelines and bereaved family members. J Pain Symptom Manage 22(3):738–751PubMedCrossRef Teno JM et al (2001) Patient-focused, family-centered end-of-life medical care: views of the guidelines and bereaved family members. J Pain Symptom Manage 22(3):738–751PubMedCrossRef
5.
Zurück zum Zitat Dougherty D, Conway PH (2008) The “3T’s” road map to transform US health care. J Am Med Assoc 299(19):2319CrossRef Dougherty D, Conway PH (2008) The “3T’s” road map to transform US health care. J Am Med Assoc 299(19):2319CrossRef
6.
Zurück zum Zitat Sepúlveda C et al (2002) Palliative care—the World Health Organization’s global perspective. J Pain Symptom Manage 24(2):91–96PubMedCrossRef Sepúlveda C et al (2002) Palliative care—the World Health Organization’s global perspective. J Pain Symptom Manage 24(2):91–96PubMedCrossRef
7.
Zurück zum Zitat Levin L, Katz A, Holst E (1977) Self-care: lay initiatives in health. Taylor & Francis, Boca Raton Levin L, Katz A, Holst E (1977) Self-care: lay initiatives in health. Taylor & Francis, Boca Raton
8.
Zurück zum Zitat Hatch S, Kickbusch I (1983) Self-help and health in Europe. New approaches in health care. World Health Organization Publications Centre USA, New York, 12210 Hatch S, Kickbusch I (1983) Self-help and health in Europe. New approaches in health care. World Health Organization Publications Centre USA, New York, 12210
9.
10.
Zurück zum Zitat Curtin R et al (2005) Self-management in patients with end stage renal disease: exploring domains and dimensions. Nephrol Nurs J 32(4):389PubMed Curtin R et al (2005) Self-management in patients with end stage renal disease: exploring domains and dimensions. Nephrol Nurs J 32(4):389PubMed
11.
Zurück zum Zitat Richardson A (1992) Studies exploring self-care for the person coping with cancer treatment: a review. Int J Nurs Stud 29(2):191–204PubMedCrossRef Richardson A (1992) Studies exploring self-care for the person coping with cancer treatment: a review. Int J Nurs Stud 29(2):191–204PubMedCrossRef
12.
Zurück zum Zitat Corner J (2002) Self management in palliative care. Int J Palliat Nurs 8(11):516PubMed Corner J (2002) Self management in palliative care. Int J Palliat Nurs 8(11):516PubMed
13.
Zurück zum Zitat Corner J (2001) Between you and me: closing the gap between people and health care. The Nuffield Trust Stationery Office, London Corner J (2001) Between you and me: closing the gap between people and health care. The Nuffield Trust Stationery Office, London
14.
Zurück zum Zitat Johnston B, Smith L (2006) Nurses’ and patients’ perceptions of expert palliative nursing care. J Adv Nurs 54(6):700–709PubMedCrossRef Johnston B, Smith L (2006) Nurses’ and patients’ perceptions of expert palliative nursing care. J Adv Nurs 54(6):700–709PubMedCrossRef
15.
Zurück zum Zitat Dodd M, Miaskowski C (2000) The PRO-SELF program: a self-care intervention program for patients receiving cancer treatment. Elsevier, Amsterdam Dodd M, Miaskowski C (2000) The PRO-SELF program: a self-care intervention program for patients receiving cancer treatment. Elsevier, Amsterdam
16.
Zurück zum Zitat Bourbeau J et al (2003) Reduction of hospital utilization in patients with chronic obstructive pulmonary disease: a disease-specific self-management intervention. Arch Intern Med 163(5):585PubMedCrossRef Bourbeau J et al (2003) Reduction of hospital utilization in patients with chronic obstructive pulmonary disease: a disease-specific self-management intervention. Arch Intern Med 163(5):585PubMedCrossRef
17.
Zurück zum Zitat Aiken L et al (2006) Outcome evaluation of a randomized trial of the PhoenixCare intervention: program of case management and coordinated care for the seriously chronically ill. J Palliat Med 9(1):111–126PubMedCrossRef Aiken L et al (2006) Outcome evaluation of a randomized trial of the PhoenixCare intervention: program of case management and coordinated care for the seriously chronically ill. J Palliat Med 9(1):111–126PubMedCrossRef
18.
Zurück zum Zitat Yates P et al (2004) A randomized controlled trial of a nurse-administered educational intervention for improving cancer pain management in ambulatory settings. Patient Educ Couns 53(2):227–237PubMedCrossRef Yates P et al (2004) A randomized controlled trial of a nurse-administered educational intervention for improving cancer pain management in ambulatory settings. Patient Educ Couns 53(2):227–237PubMedCrossRef
19.
Zurück zum Zitat Miaskowski C et al (2004) Randomized clinical trial of the effectiveness of a self-care intervention to improve cancer pain management. J Clin Oncol 22(9):1713PubMedCrossRef Miaskowski C et al (2004) Randomized clinical trial of the effectiveness of a self-care intervention to improve cancer pain management. J Clin Oncol 22(9):1713PubMedCrossRef
20.
Zurück zum Zitat Schumacher K et al (2002) Putting cancer pain management regimens into practice at home. J Pain Symptom Manage 23(5):369–382PubMedCrossRef Schumacher K et al (2002) Putting cancer pain management regimens into practice at home. J Pain Symptom Manage 23(5):369–382PubMedCrossRef
21.
Zurück zum Zitat Lin H, Bauer-Wu S (2003) Psycho-spiritual well-being in patients with advanced cancer: an integrative review of the literature. J Adv Nurs 44(1):69–80PubMedCrossRef Lin H, Bauer-Wu S (2003) Psycho-spiritual well-being in patients with advanced cancer: an integrative review of the literature. J Adv Nurs 44(1):69–80PubMedCrossRef
22.
Zurück zum Zitat Porter L et al (2002) Perceptions of patients’ self-efficacy for managing pain and lung cancer symptoms: correspondence between patients and family caregivers. Pain 98(1–2):169–178PubMedCrossRef Porter L et al (2002) Perceptions of patients’ self-efficacy for managing pain and lung cancer symptoms: correspondence between patients and family caregivers. Pain 98(1–2):169–178PubMedCrossRef
23.
Zurück zum Zitat Fellowes D, Barnes K, Wilkinson S (2004) Aromatherapy and massage for symptom relief in patients with cancer. Cochrane Database of Syst Rev (2):CD002287 Fellowes D, Barnes K, Wilkinson S (2004) Aromatherapy and massage for symptom relief in patients with cancer. Cochrane Database of Syst Rev (2):CD002287
24.
Zurück zum Zitat Gary R (2006) Self-care practices in women with diastolic heart failure. Heart & Lung: J Acute Crit Care 35(1):9–19CrossRef Gary R (2006) Self-care practices in women with diastolic heart failure. Heart & Lung: J Acute Crit Care 35(1):9–19CrossRef
25.
Zurück zum Zitat Kearney N et al (2007) Developing cancer services: patient and carer experiences. Cancer Care Research Centre, University of Stirling, Stirling Kearney N et al (2007) Developing cancer services: patient and carer experiences. Cancer Care Research Centre, University of Stirling, Stirling
26.
Zurück zum Zitat Johnston B et al (2006) Palliative care research in Scotland: a scoping exercise. University of Stirling and NHS Forth Valley, Stirling Johnston B et al (2006) Palliative care research in Scotland: a scoping exercise. University of Stirling and NHS Forth Valley, Stirling
27.
Zurück zum Zitat Department of Health (2004) The NHS cancer plan and the new NHS: providing a patient-centred service. Crown, London Department of Health (2004) The NHS cancer plan and the new NHS: providing a patient-centred service. Crown, London
28.
Zurück zum Zitat Hudson P, Aranda S, McMurray N (2001) Randomized controlled trials in palliative care: overcoming the obstacles. Int J Palliat Nurs 7(9):427PubMed Hudson P, Aranda S, McMurray N (2001) Randomized controlled trials in palliative care: overcoming the obstacles. Int J Palliat Nurs 7(9):427PubMed
29.
Zurück zum Zitat Grande G et al (2004) Caregiver bereavement outcome: relationship with hospice at home, satisfaction with care, and home death. J Palliat Care 20(2):69PubMed Grande G et al (2004) Caregiver bereavement outcome: relationship with hospice at home, satisfaction with care, and home death. J Palliat Care 20(2):69PubMed
30.
Zurück zum Zitat Matulonis U (2004) End of life issues in older patients. Elsevier, Amsterdam Matulonis U (2004) End of life issues in older patients. Elsevier, Amsterdam
31.
Zurück zum Zitat Johnston B et al (2009) Self care and end of life care in advanced cancer: literature review. Eur J Oncol Nurs 13(5):386–398PubMedCrossRef Johnston B et al (2009) Self care and end of life care in advanced cancer: literature review. Eur J Oncol Nurs 13(5):386–398PubMedCrossRef
32.
Zurück zum Zitat Johnston B, Forbat L, Hubbard G (2008) Involving and engaging patients in cancer and palliative care research: workshop presentation. Int J Palliat Nurs 14(11):554PubMed Johnston B, Forbat L, Hubbard G (2008) Involving and engaging patients in cancer and palliative care research: workshop presentation. Int J Palliat Nurs 14(11):554PubMed
33.
Zurück zum Zitat Bowling A (2002) Research methods in health. Open University Press, Buckingham Bowling A (2002) Research methods in health. Open University Press, Buckingham
34.
Zurück zum Zitat Ruspini E (2000) Longitudinal research in the social sciences. Social research update. University of Surrey, Guildford Ruspini E (2000) Longitudinal research in the social sciences. Social research update. University of Surrey, Guildford
35.
Zurück zum Zitat Murray S, Sheikh A (2006) Serial interviews for patients with progressive diseases. Lancet 368(9539):901–902PubMedCrossRef Murray S, Sheikh A (2006) Serial interviews for patients with progressive diseases. Lancet 368(9539):901–902PubMedCrossRef
36.
Zurück zum Zitat Holland J, Thomson R, Henderson S (2006) Qualitative longitudinal research: a discussion paper. London South Bank University, London Holland J, Thomson R, Henderson S (2006) Qualitative longitudinal research: a discussion paper. London South Bank University, London
37.
Zurück zum Zitat Ritchie J, Lewis J (2003) Qualitative research practice: a guide for social science students and researchers. Sage Publications Ltd, Thousand Oaks Ritchie J, Lewis J (2003) Qualitative research practice: a guide for social science students and researchers. Sage Publications Ltd, Thousand Oaks
39.
Zurück zum Zitat McClement S et al (2004) Dignity-conserving care: application of research findings to practice. Int J Palliat Nurs 10(4):173PubMed McClement S et al (2004) Dignity-conserving care: application of research findings to practice. Int J Palliat Nurs 10(4):173PubMed
40.
Zurück zum Zitat Andershed B (2006) Relatives in end-of-life care–part 1: a systematic review of the literature the five last years, January 1999–February 2004. J Clin Nurs 15(9):1158–1169PubMedCrossRef Andershed B (2006) Relatives in end-of-life care–part 1: a systematic review of the literature the five last years, January 1999–February 2004. J Clin Nurs 15(9):1158–1169PubMedCrossRef
41.
Zurück zum Zitat Ekman I et al (2004) Maintaining normality and support are central issues when receiving chemotherapy for ovarian cancer. Cancer Nurs 27(3):177PubMedCrossRef Ekman I et al (2004) Maintaining normality and support are central issues when receiving chemotherapy for ovarian cancer. Cancer Nurs 27(3):177PubMedCrossRef
42.
Zurück zum Zitat Given B, Given C, Kozachik S (2001) Family support in advanced cancer. CA Cancer J Clin 51(4):213PubMedCrossRef Given B, Given C, Kozachik S (2001) Family support in advanced cancer. CA Cancer J Clin 51(4):213PubMedCrossRef
43.
Zurück zum Zitat Aranda S, Hayman-White K (2001) Home caregivers of the person with advanced cancer: an Australian perspective. Cancer Nurs 24(4):300PubMedCrossRef Aranda S, Hayman-White K (2001) Home caregivers of the person with advanced cancer: an Australian perspective. Cancer Nurs 24(4):300PubMedCrossRef
44.
Zurück zum Zitat Stajduhar K et al (2008) Factors influencing family caregivers’ ability to cope with providing end-of-life cancer care at home. Cancer Nurs 31(1):77PubMedCrossRef Stajduhar K et al (2008) Factors influencing family caregivers’ ability to cope with providing end-of-life cancer care at home. Cancer Nurs 31(1):77PubMedCrossRef
45.
Zurück zum Zitat Ando M, Morita T, O’Connor S (2007) Primary concerns of advanced cancer patients identified through the structured life review process: a qualitative study using a text mining technique. Palliat Support Care 5(03):265–271PubMedCrossRef Ando M, Morita T, O’Connor S (2007) Primary concerns of advanced cancer patients identified through the structured life review process: a qualitative study using a text mining technique. Palliat Support Care 5(03):265–271PubMedCrossRef
46.
Zurück zum Zitat Steinhauser K et al (2001) Preparing for the end of life preferences of patients, families, physicians, and other care providers. J Pain Symptom Manage 22(3):727–737PubMedCrossRef Steinhauser K et al (2001) Preparing for the end of life preferences of patients, families, physicians, and other care providers. J Pain Symptom Manage 22(3):727–737PubMedCrossRef
Metadaten
Titel
Self-care and end of life care—patients’ and carers’ experience a qualitative study utilising serial triangulated interviews
verfasst von
Bridget Margaret Johnston
Stuart Milligan
Claire Foster
Nora Kearney
Publikationsdatum
01.08.2012
Verlag
Springer-Verlag
Erschienen in
Supportive Care in Cancer / Ausgabe 8/2012
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-011-1252-3

Weitere Artikel der Ausgabe 8/2012

Supportive Care in Cancer 8/2012 Zur Ausgabe

Viel pflanzliche Nahrung, seltener Prostata-Ca.-Progression

12.05.2024 Prostatakarzinom Nachrichten

Ein hoher Anteil pflanzlicher Nahrung trägt möglicherweise dazu bei, das Progressionsrisiko von Männern mit Prostatakarzinomen zu senken. In einer US-Studie war das Risiko bei ausgeprägter pflanzlicher Ernährung in etwa halbiert.

Alter verschlechtert Prognose bei Endometriumkarzinom

11.05.2024 Endometriumkarzinom Nachrichten

Ein höheres Alter bei der Diagnose eines Endometriumkarzinoms ist mit aggressiveren Tumorcharakteristika assoziiert, scheint aber auch unabhängig von bekannten Risikofaktoren die Prognose der Erkrankung zu verschlimmern.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Erhöhte Mortalität bei postpartalem Brustkrebs

07.05.2024 Mammakarzinom Nachrichten

Auch für Trägerinnen von BRCA-Varianten gilt: Erkranken sie fünf bis zehn Jahre nach der letzten Schwangerschaft an Brustkrebs, ist das Sterberisiko besonders hoch.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.