Impact Of Advanced Cancer Research Articles

Social consequences of advanced cancer in patients and their informal caregivers: a qualitative study

PurposeCancer threatens the social well-being of patients and their informal caregivers. Social life is even more profoundly affected in advanced diseases, but research on social consequences of advanced cancer is scarce. This study aims to explore social consequences of advanced cancer as experienced by patients and their informal caregivers.MethodsSeven focus groups and seven in-depth semi-structured interviews with patients (n = 18) suffering from advanced cancer and their informal caregivers (n = 15) were conducted. Audiotapes were transcribed verbatim and open coded using a thematic analysis approach.ResultsSocial consequences were categorized in three themes: “social engagement,” “social identity,” and “social network.” Regarding social engagement, patients and informal caregivers said that they strive for normality by continuing their life as prior to the diagnosis, but experienced barriers in doing so. Regarding social identity, patients and informal caregivers reported feelings of social isolation. The social network became more transparent, and the value of social relations had increased since the diagnosis. Many experienced positive and negative shifts in the quantity and quality of their social relations.ConclusionsSocial consequences of advanced cancer are substantial. There appears to be a great risk of social isolation in which responses from social relations play an important role. Empowering patients and informal caregivers to discuss their experienced social consequences is beneficial. Creating awareness among healthcare professionals is essential as they provide social support and anticipate on social problems. Finally, educating social relations regarding the impact of advanced cancer and effective support methods may empower social support systems and reduce feelings of isolation.

Marital therapy for couples facing advanced cancer: Case review

The purpose of this article is to provide a brief review of the empirical literature regarding the impact of advanced cancer on the marital relationship. The link between attachment, caregiving, and care-receiving behaviors are defined. Both are activated and challenged in this population because the continuity of the marital bond is threatened, as well as the balance of reciprocal caregiving, often resulting in heightened marital distress. Emotionally focused therapy (EFT), based in a synthesis of systemic, experiential, and attachment theory, is introduced as a marital protocol to both conceptualize and potentially mitigate the level of increased marital distress, and to achieve reciprocal caregiving. Two case studies are presented and support the benefit of EFT for those couples facing end of life. The findings from these case reviews advance the literature and offer an empirically validated marital therapy for this population. Such a protocol that emphasizes attachment theory and the inherent link to caregiving and care receiving may serve as a powerful tool to both explain and alleviate marital distress for couples facing end of life. Working models of attachment can contribute significantly to our understanding of why individuals' distress and their experience of emotional support from spouse caregivers vary in the context of end-stage cancer.

The impact of advanced cancer on the functional status of patients attending oncology clinics in selected urban areas.

The primary purpose of the study was to obtain information from out patients with advanced cancer on their functional status, and to construct a profile of existing needs, which may be of use for nurses involved with planning and rendering support. A secondary purpose was to determine whether an existing instrument would provide a reliable means of assessing the degree of symptom distress and its impact on the functional status of patients with advanced cancer in this country. The population consisted of patients who had been diagnosed as suffering from cancer with metastases to at least one of the following organs - liver, lung, bone or brain - and who were under active therapy or supervision at an oncology clinic of a large hospital as out patients. Six clinics were selected; however, only four participated. Random samples of one or two patients per clinic day were selected during the period from October 1987 to January 1988for interviews. A total of 146 patients participated. The Chairmen of the Regional Oncology Nursing Societies were the chief investigators. Selected oncology nurses assisted with data collection. The instrument was found to be reliable and a positive relationship between symptom distress and functional status was established. Areas of problems and concerns of cancer patients were identified and a profile was constructed as an aid to nurses planning or rendering cancer care.