This study analyzed patients' accounts of how living with terminal illness affects their quality of life and their experiences of attending S1. Christopher's Hospice, which operates a psychosocial model of day care. Thirty-four patients took part in six audiotape recorded "goldfish bowl" teaching sessions for medical students. The tapes were transcribed and analyzed and the following themes were identified. Firstly, terminal illness causes multiple losses to quality of life; specific examples of physical limitations, loss of social interaction, low mood, and changed family dynamics were commonly experienced. Secondly, attending the day centre brought about beneficial changes. Patients described change of mood; enjoyment; achievement; sense of community, belonging, and mutual support; and were able to address problems with their relationships. It is concluded that attending day care improved these patients' quality of life. This study, which attends to patients' experiences of day care, builds on data acquired from studies using existing quality of life scales. Resume I Cette etude analyse les reclts des patients en phase terminale qui expliquent comment la maladie a attecte leur quallte de vie. C'est lors de sessions a l'unlte psychosociale des solns de jour du St. Christopher's Hospice que les patients ont pu en parler sans restrictions tout en exprimant leur satisfaction au sujet de ces sessions qui, selon eux, les ont aides a amellorer leur quallte de vie. Trente-quatre patients ont partlclpe a 6 sessions, enreqlstrees pour I'enseignement aux etudtants en rnedeclne. Les principaux themes suivants sont ressortis de la transcription et de I'analyse des sessions. Tout d'abord, la maladie en phase terminale a pour consequence de causer de multiples pertesdans la qualite de vie, soit: les Iimites physiques, la perte des relations soclales, la mauvaise humeur et Ie changement de la dynamique familiale. Ensuite, les patients ont mentionne que leur participation a ces sessions au centre de jour leur avait apporte beaucoup de changements beneflques dans leur vie. On mentionne entre autre un changement de I'humeur, la notion d'accomplissement, Ie sens d'appartenance et I'encouragement mutuel, ainsi que la capacite de regler les problemes survenus dans les relations personnelles. On conclut donc que la frequentation d'un centre de jour a arneliore la qualite de vie de ces patients. Cette etude qui rapporte l'experience des patients dans un centre de jour, se base sur des etudes precedentes qui ont utilise les actuels instruments de mesure de la quatlte de vie.
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