Illness Awareness in Hospice: Application of a Semi-Structured Interview

Abstract

This study describes the results of a semi-structured interview to assess the illness awareness of cancer patients in Hospice. The results of this study are based on the interviews made in Rimini and Savignano sul Rubicone Hospices (n = 51). Psychologists evaluated illness awareness of the participants interviewed independently from the code system that is provided for the interview. According to the psychologists, 18 patients (35%) were aware, 11 patients (22%) were unaware, and 22 patients (43%) were aware with defense mechanisms. According to the code system of the interview, the results were the following: 18 patients (35%) were aware, 2 patients (4%) were unaware, and 29 patients (57%) were aware with defense mechanisms. Two participants had to be reassessed because of inconsistency in some factors. In conclusion, the data analysis underlined that the congruence of the 2 assessment methods was found in 33 of the 51 patients examined (65%) and that the degree of concordance was rather low (kappa = .46; 95% CI = 0.24-0.68).

Awareness of cancer, satisfaction with care, emotional distress, and adjustment to illness: an Italian multicenter study

“…Likewise, Numico et al [12] found that among 649 cancer patients, although about three-quarters were aware of their diagnosis, knowledge about the palliative or curative aims of future treatments was evident in only half of the sample. This finding is in line with other Italian data showing that when the prognosis is unfavorable, the percentage of patients aware of their situation tends to decrease [13][14][15].…”

Culture and End of Life Care: A Scoping Exercise in Seven European Countries

“…Awareness studies published between 1994 and 2009 showed that a trend of partial and non disclosure persisted [279], [280], [281], [282], [283], [284], [285], [286]. The choice of partial or non-disclosure arises within families, independently of patients’ requests [287].…”

The Challenges Patients Experience in Speaking About Death

“…However, although many patients acknowledge their approaching death, they may choose not to speak about it openly during their illness journey (Baider, 2008). Andruccioli et al (2009) explain that the patient may be so consumed with the intensity of his or her illness that he or she is unable to focus on anything else. Patients can also move back and forth from acknowledging to denying their approaching death due to recurring changes in their cognitive status, intensity of their illness (Andruccioli et al, 2009), or choosing to use The established ways of communication within a family group will largely be maintained following the diagnosis of a life-limiting illness.…”

“…Andruccioli et al (2009) explain that the patient may be so consumed with the intensity of his or her illness that he or she is unable to focus on anything else. Patients can also move back and forth from acknowledging to denying their approaching death due to recurring changes in their cognitive status, intensity of their illness (Andruccioli et al, 2009), or choosing to use The established ways of communication within a family group will largely be maintained following the diagnosis of a life-limiting illness. These individual patterns of communication influence the way in which the patient will share his or her thoughts and wishes throughout his or her illness journey.…”

“…While being aware of any changes in the patient's illness awareness (Andruccioli et al, 2009), respect the times the patient does not wish to talk about dying.…”