Psychological responses of terminally ill patients who are experiencing suffering: A qualitative study

Abstract

Background: Suffering is not only characterized by the feeling of being threatened, but also by the feeling of impotence to deal with such a threat. Literature identifies a terminal illness as a period during which several experiences implying an intense suffering are endured, but little attention has been paid to the psychological responses when reacting to threats.

Objective: Identify the psychological responses that terminally ill patients put in place to face up to the demands of the end of life, as a foundation for future nursing interventions.

Design: Qualitative methodology with an interpretative phenomenological approach.

Settings: Different hospitals health centers around the region of Granada (Spain).

Participants: Twenty-four participants were finally chosen to take part in the research. The sampling procedure was intentional, and it was made taking into account exclusion and inclusion criteria. Patients with a cognitive impairment, who had been diagnosed with psychiatric alterations, who at that time suffered from uncontrollable symptoms such as intense pain were excluded from the sample.

Methods: The patients were interviewed following a script (semistructured interview) carried out using the suggested theoretical framework. The interviews were analyzed using the sequence suggested by Strauss and Corbin: Open, axial and selective codification.

Results: The analysis of the participants' answers to the different questions of the semi-structured interview has allowed us to identify a main category "To realize that life is short". There are three categories where the different ways of facing up to the end of life concentrate: "Re-Evaluation of life", "Opportunity for growth", "Resignation/Acceptance".

Conclusions: Nurses, have to try to alleviate the impact the terminal illness has on the subject, not only by controlling the symptoms but also encouraging the patients responses, by promoting the feeling of satisfaction in life, providing honest and sensitive information, establishing with the patient realistic goals, and facilitating a quality communication between patients and their family.