Despair of Treatment

Abstract

Cirrhotic patients are exposed to illness progression and life-threatening side effects. The nature of the disease, its incurability, limitations of liver transplantation, and the intensity of threatening conditions lead to psychological distress for the patients and change in their perception of the treatment. To provide holistic care, it is necessary to clarify the patient's perception of the treatment. The aim of this study was to clarify cirrhotic patients' perception of their treatment. This qualitative study was carried out through a content analysis approach. The participants were 15 cirrhotic patients. Data were collected via semistructured, in-depth interviews and analyzed on the basis of the Granheme and Landman method. Despair of treatment was revealed through four categories: (1) disease perception (quiet start and quiet death, living in an aggravating limitation, intensifying threatening conditions), (2) self-perception (living in the shadow of death, loss of self, preferring family to oneself), (3) perception of treatment (difficulty of treatment compliance, believed to be incurable, treatment conditioned to die, treatment limitation), and (4) spirituality-religion (destiny and divine test, asking God instead of doctors). The study shows that despair of treatment is considered as one of the main concerns of cirrhotic patients. Nurses should program their surveillance to support patients effectively based on the study findings.

AASLD Practice Guidance: Palliative care and symptom‐based management in decompensated cirrhosis

“…[20] The limited relevant spirituality research in cirrhosis includes two qualitative studies that identified spirituality as a key determinant of HRQoL and perceptions of medical care. [99,100] General palliative care guidelines recommend routinely evaluating the spiritual and cultural needs of patients and their families through F I G U R E 3 Structured frameworks for goals-of-care conversations. (A) Ask-Tell-Ask is a simple approach that can be used to deliver bad news.…”

NAC1 transcriptional activation of LDHA induces hepatitis B virus immune evasion leading to cirrhosis and hepatocellular carcinoma development

“…Cirrhosis is a chronic liver injury caused by multiple factors, characterized by the remodeling of liver tissue structure and the obstruction of blood flow [ 2 ]. The occurrence of cirrhosis significantly amplifies the challenge of treatment due to the limited regenerative potential of liver cells [ 3 ]. Moreover, liver cirrhosis is considered one of the primary risk factors for HCC [ 4 ].…”