title: A pilot study of transformation, attributed meanings to the illness, and spiritual well-being for terminally ill cancer patients.
abstract: OBJECTIVE
  The present study investigated what types of transformation terminally ill cancer patients experienced from diagnosis until the terminal stage, what meanings terminally ill cancer patients attributed to their illness, and whether or not those who attributed positive meaning to their illness achieved high levels of spiritual well-being as a preliminary study.
  
  
  METHODS
  Ten terminally ill cancer patients in the hospice wards of two general hospitals participated. A clinical psychologist conducted a semistructured interview with the patients individually for about 60 min. Patients completed the FACIT-Sp and HADS before the interview and talked about the meanings of cancer experience. The contents of the interviews were analyzed qualitatively. Patients were separated into high and low levels of spiritual-well being by the median of FACIT-Sp scores.
  
  
  RESULTS
  Three types of transformation were extracted: "group with peaceful mind," "group with both positive attitude and uneasy feeling," and "groups with uneasy feeling." As attributed meanings to the illness, five categories were extracted: "positive meaning," "natural acceptance," "negative acceptance," "search for meaning," and "regret and sorrow." Patients in the high level spiritual well-being group attributed the meaning of illness to "positive meaning" and "natural acceptance," and those in the low level spiritual well-being group attributed it to "regret and sorrow" and "search for meaning."
  
  
  CONCLUSIONS
  Some Japanese terminally ill cancer patients experienced positive transformation, and patients who attributed "positive meaning" and "natural acceptance" to their illness experience achieved high levels of spiritual well-being.
authors.affiliation: Faculty of Nursing, St. Mary's College, Kurame City, Fukuoka, Japan. andou@st-mary.ac.jp
authors.forename: Michiyo
authors.initials: M
authors.lastname: Ando
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Morita
authors.forename: Virginia
authors.initials: V
authors.lastname: Lee
authors.forename: Takuya
authors.initials: T
authors.lastname: Okamoto
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000739:Anecdotes as Topic; D001293:Attitude to Death; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007564:Japan; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010865:Pilot Projects; D011788:Quality of Life; D012068:Religion and Medicine; D012944:Social Support; D029181:Spirituality; D011795:Surveys and Questionnaires; D019452:Terminally Ill / Q000523:psychology*