title: Self-determination and information seeking in end-stage cancer.
abstract: When patients learn that their cancer has recurred after primary treatments or is no longer responding to therapy and no alternative treatment options exist, their motivation to carry on living may be impacted greatly. Using the Self-Determination Theory, this article's reflective analysis explores the unique situation of a woman with end-stage cancer and her continuous motivation to seek information about her illness. Information was gathered during clinical observations and informal conversations. The analysis showed how the patient sought information about her illness, how she manifested motivation, and how the hospital's social environment influenced her behavior. To understand the experience of being confronted with a terminal illness, the following issues are identified: expansion of awareness, life-facing knowledge contradictions, being open-minded and an active explorer of information sources, medical truth, and professional attitudes toward patients' informational needs. Nurses must understand patients' reasons for self-determination when facing illness uncertainty. Reflecting on such situations will strengthen nursing practice.
authors.affiliation: School of Nursing, Ryerson University, USA. mzanchet@ryerson.ca
authors.forename: Margareth S
authors.initials: MS
authors.lastname: Zanchetta
authors.forename: Shari L
authors.initials: SL
authors.lastname: Moura
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001291:Attitude of Health Personnel; D002755:Choice Behavior; D003142:Communication; D005260:Female; D015438:Health Behavior; D006272:Health Facility Environment; D006801:Humans; D007389:Internal-External Control; D009042:Motivation; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D024802:Nurse's Role / Q000523:psychology; D009723:Nurse-Patient Relations; D009859:Oncology Nursing / Q000458:organization & administration*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010353:Patient Education as Topic; D026684:Personal Autonomy; D011582:Psychological Theory; D012648:Self Care / Q000379:methods / Q000523:psychology; D012931:Social Environment; D012944:Social Support; D013727:Terminal Care / Q000523:psychology*