An existential support program for people with cancer: Development and qualitative evaluation

Elisabeth Assing Hvidt; Niels Christian Hvidt; Vibeke Graven; Karen la Cour; Nina Rottmann; Karsten Flemming Thomsen; Ole Lindqvist; Annette Rasmussen; Helle Skaarup; Kirsten Kaya Roessler

doi:10.1016/j.ejon.2020.101768

An existential support program for people with cancer: Development and qualitative evaluation

Eur J Oncol Nurs. 2020 May 13:46:101768. doi: 10.1016/j.ejon.2020.101768. Online ahead of print.

Affiliations

¹ Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, 5000, Odense C, Denmark; Department for the Study of Culture, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark. Electronic address: ehvidt@health.sdu.dk.
² Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, 5000, Odense C, Denmark.
³ REHPA, National Knowledge Center for Rehabilitation and Palliative Care, Region of Southern Denmark and University of Southern Denmark, Vestergade 17, 5800, Nyborg, Denmark.
⁴ Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, 5000, Odense C, Denmark; REHPA, National Knowledge Center for Rehabilitation and Palliative Care, Region of Southern Denmark and University of Southern Denmark, Vestergade 17, 5800, Nyborg, Denmark; Department of Psychology, University of Southern Denmark, Odense M, Denmark.
⁵ M22 Art and Creativity. LV-Malu Iela 22, 3301, Kuldiga, Latvia.
⁶ Løgumkloster Refugium, Refugievej 1, 6240, Løgumkloster, Denmark.
⁷ Department of Psychology, University of Southern Denmark, Odense M, Denmark.

PMID: 32446197
DOI: 10.1016/j.ejon.2020.101768

Abstract

Purpose: To describe the development process of an existential support program and to explore participants' evaluation of supportive/unsupportive processes of change.

Method: A five-day existential support program called "Energy for life" was designed including three main elements: 1. existential group counseling, 2. art therapy and 3. interaction with nature and aesthetic surroundings. The program was implemented at two different study sites. Focus group interviews were conducted to evaluate the program.

Results: 40 subjects were recruited (20 for each one of the two study sites) and 36 completed the study (31 women, five men) in the age range from 31 to 76 years and living with cancer across all stages and types. The program resulted in supportive processes of "existential sharing". The existential group counseling included a sharing process which led to an increased awareness and acceptance of one's existential situation and a preparation for the next steps in one's life. Art therapy offered a respite from the illness or the opportunity to express and share difficult thoughts and feelings connected to the illness experience. The interaction with nature/surroundings induced feelings of calmness and peace, increasing self-worth and spiritual belonging. Unsupportive processes of change related to the organization of the existential counseling groups, feelings of discomfort with creative engagement and feelings of distress provoked by a hospital environment.

Conclusion: Through "Energy for life" existential concerns and distress were shared, contained and transformed. Knowledge has been gained about how an existential support program can be designed that explicitly focuses on alleviating patients' existential distress.

Keywords: Cancer; Existential distress; Existential support; Existential well-being; Program; Qualitative evaluation; Rehabilitation; Residential; Spirituality.