The doctor's role in helping dying patients with cancer achieve peace: a qualitative study

Palliat Med. 2014 Oct;28(9):1139-45. doi: 10.1177/0269216314536455. Epub 2014 Jun 9.

Abstract

Background: Being at peace is important for the quality of life of dying cancer patients, but its features, and the role of the doctor in facilitating peace, are unclear.

Aim: We sought to understand the features of a peaceful patient, and patients' preferences regarding the role of the doctor in facilitating a sense of peace.

Design: A grounded theory approach was used with semi-structured interviews. Patients were asked about the things that gave their life meaning and a sense of peace and how the doctor could support their spiritual well-being. Patients were also questioned about their concerns for their future.

Setting/participants: In total, 15 cancer patients with advanced disease were interviewed in a variety of care settings.

Results: Patients were observed to be along a spectrum between having peace and not having peace. Features of the two extreme positions are described. Doctors could facilitate peace by developing a good relationship with cancer patients and supplying clear and honest information about what patients could expect as they approached their death.

Conclusion: Spiritual well-being in cancer patients can be promoted by communication from doctors regarding prognosis, which allows them time to prepare for death, and recognition of their fears. However, acceptance of death does not always lead to the patient experiencing peace.

Keywords: Peace; cancer; doctor–patient relations; physician–patient relations; spirituality; terminal care.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude to Death
  • Communication
  • Female
  • Grounded Theory
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / psychology*
  • Neoplasms / therapy
  • Patient Preference
  • Physician's Role* / psychology
  • Physician-Patient Relations*
  • Qualitative Research
  • Quality of Life*
  • Spirituality
  • Surveys and Questionnaires
  • Terminal Care / psychology*
  • Terminally Ill / psychology*