Abstract
BackgroundCancer has consequences not only for the sick person but also for those who have a close relationship with that person. Greater knowledge about how family members manage the situation in the period immediately following the diagnosis means greater opportunity to provide the best possible support for the family. The purpose of this study was to explore management strategies that family members use when the patient is in the early stage of treatment for advanced cancer.MethodsTwenty family members of cancer patients were included in the study shortly after the diagnosis. The patients had been diagnosed 8-14 weeks earlier with advanced lung cancer or gastrointestinal cancer. The data were collected in interviews with family members and subjected to qualitative latent content analysis. Through the identification of similarities and dissimilarities in the units of meaning, abstraction into codes and sub-themes became possible. The sub-themes were then brought together in one overarching theme.ResultsThe overall function of management strategies is expressed in the theme Striving to be prepared for the painful. The family members prepare themselves mentally for the anticipated tragedy. Family relationships become increasingly important, and family members want to spend all their time together. They try to banish thoughts of the impending death and want to live as normal a life as possible. It becomes important to family members to live in the present and save their energy for the time when they will need it the most. How participants handle their worries, anxiety and sadness can be categorized into seven sub-themes or management strategies: Making things easier in everyday life, Banishing thoughts about the approaching loss, Living in the present, Adjusting to the sick person's situation, Distracting oneself by being with others, Shielding the family from grief, and Attempting to maintain hope.ConclusionsThe findings revealed that the family members have their own resources for handling the early stage of the cancer trajectory in an acceptable way. There is a need for longitudinal studies to generate knowledge for designing evidence-based intervention programmes that can prevent future ill-health in these vulnerable family members.
Highlights
Cancer has consequences for the sick person and for those who have a close relationship with that person
Up until the sick person’s death, the family members shoulder the grief of the rest of the family and spare them emotional strain
The findings in this study bring into focus the challenges confronting family members when one in the family has been diagnosed with advanced cancer
Summary
Cancer has consequences for the sick person and for those who have a close relationship with that person. The purpose of this study was to explore management strategies that family members use when the patient is in the early stage of treatment for advanced cancer. Confronted with the life-threatening situation of their loved one, family members experience shock, psychological distress and a sense of vulnerability [1,2,3]. There are often symptoms of anxiety, sadness and depression in family members of persons with cancer [4,5]. The increased use of outpatient services for cancer treatment, with less time in the hospital, creates an increased need for better understanding of the family members’ role as caregiver to a person with advanced cancer [6,7,8]. The psychological and physical stress exposes family members, in particular those who are caregivers, to greater risk of ill-health [9]
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