title: Problems to discuss with cancer patients in palliative care: a comprehensive approach.
abstract: This study presents a comprehensive overview of the problems patients experience in a palliative phase of cancer. A two-step qualitative method was used: in-depth interviews with patients and relatives (N=9 patients+7 relatives), followed by interviews (N=31patients+15 relatives) using a checklist to confirm and complete the picture. Quality of life and quality of care domains were addressed. Patients experienced problems in all of these palliative care domains, although individual patients may have experienced only a few problems. Fatigue, feelings of futility, reluctance to accept help, fear of suffering and the fear that help would not be available if needed, were common problems. Communication problems arose when a grudge against a GP had remained, or because one family member tried to spare the other a confrontation with his/her feelings of fear or grief. A comprehensive checklist of relevant problems is presented.
authors.affiliation: Center for Quality of Care Research (HSV-WOK229), University Medical Center St. Radboud, P.O. Box 9101, 6500HB Nijmegen, The Netherlands. b.osse@hsv.kun.nl
authors.forename: Bart H P
authors.initials: BH
authors.lastname: Osse
authors.forename: Myrra J F J
authors.initials: MJ
authors.lastname: Vernooij-Dassen
authors.forename: Egbert
authors.initials: E
authors.lastname: Schadé
authors.forename: Berna
authors.initials: B
authors.lastname: de Vree
authors.forename: Maria E T C
authors.initials: ME
authors.lastname: van den Muijsenbergh
authors.forename: Richard P T M
authors.initials: RP
authors.lastname: Grol
mesh_terms: D000223:Adaptation, Psychological; D006301:Health Services Needs and Demand; D006801:Humans; D020380:Needs Assessment; D009369:Neoplasms / Q000523:psychology*; D010166:Palliative Care / Q000379:methods*; D011787:Quality of Health Care; D012944:Social Support