Making sense of receiving palliative treatment: its significance to palliative cancer care communication and information provision.
BACKGROUND
By receiving palliative treatment over time, a growing number of people with advanced gastrointestinal cancer are living longer. An image of palliative care, often existing in the public, as being exclusively for the dying could thus be particularly challenging in relation to patients' making sense of receiving palliative treatment over time.


OBJECTIVE
The aim was to interpret how patients diagnosed with advanced gastrointestinal cancer make sense of receiving palliative treatment.


METHODS
A phenomenological life-world approach was chosen. Seven men and 7 women with advanced gastrointestinal cancer receiving palliative treatment were followed up using repeated narrative interviews, which took place at a Swedish oncology clinic. In total, 66 interviews were conducted. The analysis followed hermeneutic principles and was interpreted stepwise.


RESULTS
Making sense was revealed as a phenomenon constructed narratively, through patients' searching for knowledge and understanding, approached by a dialectic pattern of living in wait and in the present, and finally, as a process of human learning through being and becoming, which transforms the experience and results in a changed personal experience.


CONCLUSIONS
Making sense of receiving palliative treatment is a process of human learning at the end of life, characterized by an ongoing search for knowledge and understanding. To enhance patients' sense making in this context, professionals need to go beyond "providing information."


CONCLUSIONS
The attention of health professionals must be directed at recognizing and enhancing patients' ways of seeking knowledge to help them make sense of receiving palliative treatment. Person-centered activities need to be developed.
Institute of Health Care Sciences, Sahlgrenska Academy at the University of Gothenburg, Norway. joakim.ohlen@gu.se
Joakim
J
Ohlén
Catarina
C
Wallengren Gustafsson
Febe
F
Friberg
D000368:Aged; D003142:Communication; D003657:Decision Making; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology / Q000523:psychology / Q000628:therapy*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods / Q000523:psychology*; D057240:Patient Preference; D011788:Quality of Life / Q000523:psychology*; D013548:Sweden; D019452:Terminally Ill; D016896:Treatment Outcome