"There won't' be anything else...it's over": perceptions of women referred to palliative care only.
BACKGROUND
It is not well-known how women with advanced breast and gynecological cancers cope with the transition to palliative care (PC) only, but we anticipate that this is a challenging situation for them.


OBJECTIVE
To investigate women's understanding on the reasons of anticancer treatment withdrawal, their ideas about PC, and also perceptions of the communication of bad news.


METHODS
Twenty women were interviewed by a single researcher after being informed that their antineoplastic treatment would be discontinued and they would be exclusively monitored by PC staff. The interviews were audiotaped, transcribed verbatim, and analyzed according to content analysis.


RESULTS
Three categories were identified in the participants' narratives: (1) an understanding of the meaning of PC; (2) a lack of understanding of the shift in treatment and follow-up; (3) differing perspectives about hope. The PC Unit was stigmatized as a place to die, resulting in a "place to die" subcategory. The narratives of the participants who previously had experienced PC converged on a subcategory that reveals better recognition of the importance of the PC Unit as "a place that enhances the quality of life".


CONCLUSIONS
The participants manifested little knowledge about PC and the forthcoming strategies for their clinical follow-up. In addition, the PC Unit was patently stigmatized as a place to die. Early referral to PC seems to be associated with a less painful therapeutic transition, based on more accurate knowledge of the importance of PC.
Palliative Care Department, Barretos Cancer Hospital, Pio XII Foundation, Barretos, SP, Brazil. Electronic address: fernandacrugno@hotmail.com.
Fernanda Capella
FC
Rugno
Researcher Support Center, Learning and Research Institute, Barretos Cancer Hospital, Pio XII Foundation, Barretos, SP, Brazil. Electronic address: bsrpaiva@gmail.com.
Bianca Sakamoto Ribeiro
BS
Paiva
Department of Clinical Oncology, Barretos Cancer Hospital, Pio XII Foundation, Barretos, SP, Brazil. Electronic address: jsnunes@hcancerbarretos.com.br.
João Soares
JS
Nunes
Department of Clinical Oncology and Researcher Support Center, Learning and Research Institute, Barretos Cancer Hospital, Pio XII Foundation, Barretos, SP, Brazil. Electronic address: drcarlosnap@gmail.com.
Carlos Eduardo
CE
Paiva
D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D003142:Communication; D005260:Female; D005833:Genital Neoplasms, Female / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology*; D036301:Qualitative Research; D028761:Withholding Treatment
Advanced cancer; Content analysis; Palliative care; Qualitative research