Dying cancer patients' experiences of powerlessness and helplessness.
OBJECTIVE
Experiences of powerlessness and helplessness are closely linked to incurable diseases but seldom studied in patients with disseminated cancer. The aim is to explore the perception, experiences and significance of powerlessness and helplessness, to study triggering factors and to make quantifications.


METHODS
One hundred three patients, enrolled in four different palliative home-care settings, completed a questionnaire with both Likert-type questions and open-ended questions. The response rate was 58%, and background data was reported as frequencies, whereas the main material was analysed using a qualitative content analysis.


RESULTS
Impending death, symptoms, loss of control and autonomy, ignorance, isolation and uncertainty constituted the basis for powerlessness and helplessness, but each factor was reinforced by the occurrence of suddenness, high intensity and/or lengthiness. In total, 65% reported definite experiences of powerlessness and helplessness. These feelings also held a deeper meaning, involving aspects such as existential loneliness and hopelessness. They were ultimately caused by an incapacity to control feelings and cope with the situation related to the impending death. The results are discussed in relation to Cassel's theory of suffering and existential psychology.
Sand
Lisa
L
ASIH Långbro Park, Unit for Palliative Medicine and Advanced Medical Home Care, Department of Oncology-Pathology, Karolinska Institute, Stockholms Sjukhems FoUU, Mariebergsgatan 22, 112 35 Stockholm [corrected] Sweden. lisa.sand@ki.se [corrected]
Strang
Peter
P
Milberg
Anna
A
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010166:Palliative Care / Q000523:psychology*; D010865:Pilot Projects; D011209:Power, Psychological; D011795:Surveys and Questionnaires; D013548:Sweden