Patient control and end-of-life care part II: the advanced practice nurse perspective.
OBJECTIVE
To explore the nature of what people with advanced cancer want regarding personal control and comfort at the end of life.


METHODS
Descriptive, naturalistic, using Denzins model of interpretive interactionism.


METHODS
A variety of urban and rural communities throughout the state of Texas.


METHODS
7 people with advanced cancer diagnoses.


METHODS
Participants were recruited via oncology advanced practice nurses who also participated in the study. Interviews were recorded on audiotape and analyzed via Denzins interpretive process of data analysis.


METHODS
Patient control.


RESULTS
Thematic analysis revealed six themes: protection of dignity, control of pain and other symptoms associated with disease, management of treatment, management of how remaining time is spent, management of impact on family, and control over the dying process.


CONCLUSIONS
Participants expressed a wide variety of preferences for personal control and comfort. Their desires reflected personal values and beliefs about how they spend their time and how they want control over their care.


CONCLUSIONS
Nurses must be sensitive to the variety of preferences their patients with advanced cancer may have for engagement in decisions regarding treatment, care management, and activities of daily life.
Volker
Deborah L
DL
Austin School of Nursing, University of Texas, Austin, TX, USA. dvolker@mail.nur.utexas.edu
Kahn
David
D
Penticuff
Joy H
JH
D000328:Adult; D001293:Attitude to Death; D003657:Decision Making; D005260:Female; D017051:Hospice Care; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing* / Q000523:psychology* / Q000628:therapy; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology; D009859:Oncology Nursing / Q000193:education*; D010146:Pain / Q000517:prevention & control; D059408:Pain Management; D010166:Palliative Care; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D026684:Personal Autonomy; D012297:Right to Die; D013727:Terminal Care; D014342:Truth Disclosure