Meanings of happiness among two ethnic groups living with advanced cancer in south London: a qualitative study.
OBJECTIVE
Happiness is a central component in quality of life but little is known about its meanings among people living with an advanced disease and those from diverse communities. This study explores and compares, for the first time, the centrality and interpretations of happiness across two cultural groups living with advanced cancer.


METHODS
Semi-structured interviews among 26 Black Caribbean and 19 White British cancer patients were conducted in hospital and home settings.


RESULTS
Thirty eight participants volunteered views on happiness, which were related to four main themes: empty lives, a theme associated with lives devoid of contentment; happiness and the physical form principally, associated with the absence of distressing symptoms; 'love and affection' associated with family and friends; and 'realising personal meaning in life', most common among the Black Caribbean participants and related to God, prayer and the sacred world. The presence of cancer pain even when refractory did not preclude manifestations of happiness in this domain.


CONCLUSIONS
We identified that happiness was central to many patients' quality of life during advanced cancer. Moreover, happiness was multidimensional and at times culturally patterned. We recommend that health and social care professionals increase their awareness and skills-set in relation to exploring happiness. Further, we recommend greater efforts are invested in cultural relativism to service the physical, psychological, social and spiritual issues that contribute towards moments of happiness among diverse communities.
King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, London, UK. jonathan.koffman@kcl.ac.uk
Jonathan
J
Koffman
Myfanwy
M
Morgan
Polly
P
Edmonds
Peter
P
Speck
Richard
R
Siegert
Irene J
IJ
Higginson
D000328:Adult; D000368:Aged; D001293:Attitude to Death; D044383:Black People / Q000523:psychology; D017691:Caribbean Region / Q000208:ethnology; D005260:Female; D006240:Happiness; D006801:Humans; D007407:Interviews as Topic; D008131:London; D008149:Love; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000208:ethnology / Q000523:psychology*; D036301:Qualitative Research; D013727:Terminal Care / Q000523:psychology; D044465:White People / Q000523:psychology