'I am still valuable' - A qualitative study of incurable cancer patients coping in hospice care

Abstract

Background: Knowledge of the experiences of coping in patients with incurable cancer is essential for high-quality palliative and end-of-life care.

Aim and objective: To describe the coping experiences of patients with incurable cancer in hospice care to better develop patient-centred care.

Methods: The data for this qualitative study were collected through semi structured interviews, with patients with incurable cancer in hospice care (N = 20) and analysed with inductive content analysis. Ethical and organisational approvals were obtained, and the participants received both verbal and written information before consenting to participate.

Results: The patients' coping was enhanced with their involvement in treatment-related decisions. Valuing day-to-day living and coping with emotional stressors helped them accept their own life situations. Accepting their increasing fragility was enhanced by their self-reappraisal. The patients found security in the possibility of receiving support when they needed it. Although the ordinariness of dying in hospice care settings was sometimes too much to bear, they understood dying to be a part of the natural cycle of life. They questioned the responsiveness of healthcare services because they felt that they were not always heard.

Study limitations: Because this study was limited to a specific population of cancer patients in hospice care, the results might not be generalised to other patient groups with chronic diseases or other palliative care settings.

Conclusions: The experiences of patients in hospice care of coping with incurable cancer were reminiscent of the common coping process descriptions. Surprisingly, even though participants voiced that they had accepted their situation, dying itself was something they did not find crucial to discuss. The crucial aspects - without being in denial - dealt more with focusing on positive thinking and facing life.

Keywords: coping; hospice care; incurable cancer; inductive content analysis; patient experience; qualitative; supportive care.