title: “Don't let the world become too small” – How patients with advanced cancer and their significant others cope with transitions during the last year of life. A qualitative study
abstract: Background: In the last year of life, persons with advanced cancer and their significant others are affected by several transitions. They perform psychological adjustment processes during transformation. This requires strategies for patients and their significant others. Research in German about this theme is missing. Aim: We explored the experiences with illness management during transitions in the last year of life of patients with advanced cancer and their significant others. Method: In this qualitative study, we conducted structured interviews with five dyads, consisting of persons with Karnofsky Index ≥ 60 % and life expectancy of six to twelve months as well as their significant others. To interpret the interviews, we used qualitative content analysis according to Mayring. Results: The main theme “Don't let the world become too small” expresses that limitations diminished the lifeworld and the participants struggled against this process. This is revealed in three categories: “Being shocked by diagnosis – realigning again”, “Bearing limitations and loss – finding new ways in daily life”, “Living in uncertainty – holding out together”. Conclusions: Patients and significant others live in changing lifeworlds caused by transitions. Health care professionals should be attentive and may gain deeper knowledge about transitions. Further research in German-speaking contexts will help to improve nursing care and psychooncological interventions.
authors.affiliation: 1 Institut für Pflegewissenschaft, Medizinische Fakultät, Universität Basel.|2 Stiftung Diaconis, Palliative Care, Bern.
authors.forename: Christiane
authors.initials: C
authors.lastname: Chabloz-Süssenbach
authors.affiliation: 3 Direktion Pflege / MTT, Inselspital, Universitätsspital Bern.|6 Palliative Pflege Expertise GmbH, Brünisried FR.
authors.forename: Monique
authors.initials: M
authors.lastname: Sailer Schramm
authors.affiliation: 4 Klinik für Onkologie, Universitätsspital Basel.
authors.forename: Hansruedi
authors.initials: H
authors.lastname: Stoll
authors.affiliation: 1 Institut für Pflegewissenschaft, Medizinische Fakultät, Universität Basel.|5 Direktion Pflege und MTTB, UniversitätsSpital Zürich.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Spirig
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing* / Q000523:psychology*; D036301:Qualitative Research; D012803:Sick Role; D012931:Social Environment; D013727:Terminal Care / Q000523:psychology*; D035501:Uncertainty
keywords: Dyade; Krankheitsmanagement; advanced cancer; dyad; fortgeschrittene onkologische Erkrankung; illness management; qualitative Forschung; qualitative research; transition; Übergang