Health Psychology Research / HPR / Volume 10 / Issue 2 / DOI: 10.52965/​001c.36272
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Exploring the End-of-Life Experiences of Advanced Cancer Patients  from India 

Maria Wajid1 Eslavath Rajkumar1 J Romate1
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1 Department of Psychology, Central University of Karnataka
Submitted: 28 December 2021 | Accepted: 4 April 2022 | Published: 28 June 2022
© 2022 by the Author(s). Licensee Health Psychology Research, USA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC BY-NC 4.0) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

Objective

Paying attention to the socio-cultural characteristics of advanced cancer patients as they pass through the final stages of life can help healthcare professionals and mental health professionals assess the end-of-life experiences of terminally ill patients better. A comprehensive study of this population in the Indian context is helpful to devise individualized end-of-life care that aligns with their preferences and focuses on their comfort.

Method

The dataset comprised information-rich cases of 10 advanced cancer patients from Bangalore, India, selected using the purposive sampling method. The semi-structured interviews with the participants were audio-recorded, transcribed, and translated. Identification of patterns and commonalities in the dataset helped generate codes. The codes were used to narrow down to overarching themes.

Results

The standout themes were outlook on life, unfulfilled goals, end-of-life expectations, and death anxieties and attitudes to impending death.

Significance of Results

The study highlights the psychosocial and cultural needs of the patients in end-of-life care. How advanced cancer patients long for psychological care from mental health professionals and empathy from their loved ones. This study argues for renewed attention on the socio-cultural characteristics of terminally ill patients to enhance individualized care through culturally-competent interventions.

Keywords
End of Life
Terminal Ill Cancer Patients
Dying and Death
India
Better Care
References

1. Latest global cancer data: Cancer burden rises to 19.3 million new cases and 10.0 million cancer deaths in 2020. Published December 15, 2020. Accessed April 11,2022.https://www.iarc.who.int/wp-content/uploads/2020/12/pr292_E.pdf

2. News|UICC.Accessed March 13,2021.https://www.uicc.org/news/globocan-2020-new-global-cancer-data

3. Zanni GR, Browne CL III. Coping with Terminal Illness. Pharmacy Times. https://www.pharmacytimes.com/publications/issue/2010/August2010/CounselingTerminalIllness-0810. Published March 8,2021.

4. Yun YH, Lee CG, Kim SY,et al. The Attitudes of Cancer Patients and Their Families toward the Disclosure of Terminal Illness. J Clin Oncol.2004;22(2):307-314.doi:10.1200/jco.2004.07.053

5. Nair MK, Varghese C, Swaminathan R. Cancer:Current Scenario, Intervention Strategies and Projections for 2015. NCHM Background papers-Burden of Disease in India; 2005.

6. Breitbart W, Bruera E, Chochinov H, Lynch M.Neuropsychiatric Syndromes and Psychological Symptoms in Patients with Advanced Cancer. J Pain Symptom Manag.1995;10(2):131-141.doi:10.1016/0885-3924(94)00075-v

7. Massie MJ, Holland JC. The Cancer Patient with Pain: Psychiatric Complications and Their Management. J Pain Symptom Manag.1992;7(2):99-109.doi:10.1016/0885-3924(92)90121-w

8. Block SD. Assessing and Managing Depression in the Terminally Ill Patient. Ann Intern Med.2000;132(3):209.doi:10.7326/0003-4819-132-3-200002010-00007

9. McClain CS, Rosenfeld B, Breitbart W. Effect of Spiritual Well-Being on End-of-Life Despair in Terminally-Ill Cancer Patients. Lancet.2003;361(9369):1603-1607.doi:10.1016/s0140-6736(03)13310-7

10. McClain CS, Rosenfeld B, Breitbart W. Effect of spiritual well-being on end-of-life despair in terminally-ill cancer patients. The Lancet.2003;361(9369):1603-1607.doi:10.1016/s0140-6736(03)13310-7

11. Braun V,Clarke V. Thematic analysis. In: APA Handbook of Research Methods in Psychology. Vol 2:Research designs. American Psychological Association;2012:57-71.https://doi.org/10.1037/13620-004

12. Morita T,Tsunoda J,Inoue S,Chihara S.An Exploratory Factor Analysis of Existential Suffering in Japanese Terminally Ill Cancer Patients. Psycho-Oncology.2000;9(2):164-168.

13.Zimmermann C.Denial of impending death:A discourse analysis of the palliative care literature.Social Science& Medicine.2004;59(8):1769-1780. doi:10.1016/j.socscimed.2004.02.012

14. Kehl KA. Moving Toward Peace: An Analysis of the Concept of a Good Death. American Journal of Hospice and Palliative Medicine®.2006;23(4):277-286. doi:10.1177/1049909106290380

15. Patrick DL, Engelberg RA, Curtis JR. Evaluating the Quality of Dying and Death. Journal of Pain and Symptom Management.2001;22(3):717-726. doi:10.1016/s0885-3924(01)00333-5

16. Seale C. Theories in health care and research:Theories and studying the care of dying people.BMJ.1998;317(7171):1518-1520.doi:10.1136/bmj.317.7171.1518

17. Pierson CM, Curtis JR, Patrick DL. A good death: A qualitative study of patients with advanced AIDS.AIDS Care.2002;14(5):587-598. doi:10.1080/0954012021000005416

18. Emanuel EJ, Emanuel LL. The promise of a good death.The Lancet.1998;351:SII21-SII29. doi:10.1016/s0140-6736(98)90329-4

19.Nissim R,Rennie D,Fleming S,Hales S,Gagliese L, Rodin G. Goals Set in the Land of the Living/Dying:A Longitudinal Study of Patients Living with Advanced Cancer. Death Studies.2012;36(4):360-390.doi:10.1080/07481187.2011.553324

20.Ferrell BR, Hassey Dow K, Grant M. Measurement of the quality of life in cancer survivors. Quality of Life Research.1995;4(6):523-531.doi:10.1007/bf00634747

21. Sand L, Strang P. Existential Lonely in a Palliative Home Care Setting. Journal of Palliative Medicine.2006;9(6):1376-1387.doi:10.1089/jpm.2006.9.1376

22. Chochinov HM, Breitbart W. Handbook of Psychiatry in Palliative Medicine. Oxford University Press;2000.

23. Wilson KG, Chochinov HM, Graham Skirko M,et al. Depression and Anxiety Disorders in Palliative Cancer Care. Journal of Pain and Symptom Management.2007;33(2):118-129.doi:10.1016/j.jpain symman.2006.07.016

24. Pessin H, Rosenfeld B, Breitbart W. Assessing Psychological Distress Near the End of Life. American Behavioral Scientist.2002;46(3):357-372. doi:10.1177/000276402237769

25. Lehto RH, Stein KF. Death Anxiety: An Analysis of an Evolving Concept. Research and Theory for Nursing Practice.2009;23(1):23-41.doi:10.1891/1541-6577.23.1.23

26.O'Neil R. Defining“A Good Death.” International Journal of Applied Philosophy.1983;1(4):9-17. doi:10.5840/ijap19831413

27. Institute of Medicine. Approaching Death.National Academies Press;1997. doi:10.17226/5801

28. Swensen CH,Fuller S, Clements R. Stage of Religious Faith and Reactions to Terminal Cancer.J Psychol Theol.1993;21(3):238-245. doi:10.1177/009164719302100307

29. Chao CS. The meaning of a good death for terminally ill cancer patients in Taiwan. Hu Li Za Zhi.1997;44(1):48-55.

30. Mahon SM, Casperson DS. Psychosocial Concerns Associated with Recurrent Cancer. Cancer Pract.1995;3(6):370-380.

31.Thomas J, Retsas A. Transacting Self-Preservation: A Grounded Theory of the Spiritual Dimensions of People with Terminal Cancer. Int J Nurs Stud.1999;36(3):191-201.doi:10.1016/s0020-7489(99)00012-7

32. Steinhauser KE, Alexander SC, Byock IR, George LK, Tulsky JA. Seriously Ill Patients' Discussions of Preparation and Life Completion: An Intervention to Assist with Transition at the End of Life. Pall Supp Care.2009;7(4):393-404. doi:10.1017/s147895150999040x

33. Benzein E, Norberg A, Saveman BI. The Meaning of the Lived Experience of Hope in Patients with Cancer in Palliative Home Care. Palliative Medicine.2001;15(2):117-126. doi:10.1191/02692160167561725

34. Fortner BV, Neimeyer RA. Death Anxiety in Older Adults: A Quantitative Review. Death Studies.1999;23(5):387-411.doi:10.1080/074811899200920

35.Hopwood P,Howell A, Maguire P. Psychiatric Morbidity in Patients with Advanced Cancer of the Breast: Prevalence Measured by Two Self-Rating Questionnaires.BrJ Cancer.1991;64(2):349-352.do i:10.1038/bjc.1991.304

36.Grabsch B,Clarke DM, Love A,et al. Psychological Morbidity and Quality of Life in Women with Advanced Breast Cancer: A Cross-Sectional Survey.Pall Supp Care.2006;4(1):47-56. doi:10.1017/s1478951506060068

37. Pickrel J.“Tell me your story”: Using life review in counseling the terminally Ill. Death Studies.1989;13(2):127-135. doi:10.1080/07481188908252290

38. Miller JF. Hope-Inspiring Strategies of the Critically III. Appl Nurs Res.1989;2(1):23-29. doi:10.1016/s0897-1897(89)80021-7

39. Miovic M, Block S. Psychiatric Disorders in Advanced Cancer. Cancer.2007;110(8):1665-1676. do i:10.1002/cncr.22980

40. Hinton J. The Progress of Awareness and Acceptance of Dying Assessed in Cancer Patients and Their Caring Relatives. Palliat Med. 1999;13(1):19-35.doi:10.1191/026921699672169546

41. Stanton AL. Psychosocial Concerns and Interventions for Cancer Survivors. J Clin Oncol.2006;24(32):5132-5137.doi:10.1200/jco.2006.06.8775

42. Lin HR, Bauer-Wu SM. Psycho-Spiritual Well-Being in Patients with Advanced Cancer: An Integrative Review of the Literature. J Adv Nurs.2003;44(1):69-80.doi:10.1046/j.1365-2648.2003.02768.x

43. Wilson KG,Dalgleish TL, Chochinov HM,et al.Mental Disorders and the Desire for Death in Patients Receiving Palliative Care for Cancer. BMJ Support Palliat Care.2014;6(2):170-177.doi:10.1136/bmjspcare-2013-000604

44. Flemming K. The Meaning of Hope to Palliative Care Cancer Patients. Int J Palliat Nurs.1997;3(1):14-18.doi:10.12968/ijpn.1997.3.1.14

45. Moestrup L, Hansen HP. Existential Concerns about Death. Am J Hosp Palliat Care.2014;32(4):427-436. doi:10.1177/1049909114523828

Conflict of interest
The authors declare no conflict of interest.
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Health Psychology Research, Electronic ISSN: 2420-8124 Published by Health Psychology Research