Living Fully in the shadow of Mortal Time: Psychosocial Assets in Advanced Cancer

Abstract

Objective To characterize the strategies and psychosocial conditions that influence how resilient people live in the face of advanced cancer. Methods Grounded theory interviews and surveys of ten resilient people with advanced cancer were collected and analyzed. Findings Personal assets including positive relationships, purpose in life, faith, and a sense of mastery contributed to living fully in “mortal time.” Strategies included embracing paradox, reframing time, deepening connections, and aligning actions with priorities. Open-ended interviews yielded rich illness and life stories; many participants requested a copy of the transcript. Conclusions Resilient people use a range of strategies to thrive in the face of advanced cancer.

The Coping and Support Needs of Incurable Cancer Patients

“…2,24,25,29 The patients interviewed to this study selected being open about the illness, facing reality, having a sense of humour and a positive attitude to life similarly contributed substantially to the coping process, which is also in line with other studies. 26,30 Like in this study, also Wise & Marchard (2013) similarly reported that the personal resources of the patients included not only the ability to understand the meaningfulness of life, but also positive relationships and the willingness to live life to the fullest and enjoy every moment despite the illness. As in previous studies like Giuliani et al (2015), the time perspective transforms with respect to the future in a way that the patients view the everyday life, despite their appreciation for it, as a reminder of the limited time they have left.…”

The Cancer Stories Project: narratives of encounters with cancer in Aotearoa, New Zealand

“…While the concept of ‘resilience’ was not overtly discussed during the interviews it might be considered an undercurrent to many of the themes. Wise & Marchand's interviews of ‘resilient people’ with advanced cancer found personal assets, ‘including positive relationships, purpose in life, faith and mastery’ added to quality of life (p.76) . The benefits of a positive attitude on the cancer journey are supported by the literature , specifically in relation to positive attitudes facilitating or being related to the phenomena of post‐traumatic growth .…”

Malestar emocional y estrategias de afrontamiento en pacientes avanzados ante la situación de final de vida

“…La segunda parte consiste en una observación y registro por parte del profesional sanitario de la presencia de signos externos de malestar emocional. El DME permite obtener una puntuación de entre 0 y 20 formada por la suma de las puntuaciones de las respuestas a las preguntas referentes a la valoración del estado de ánimo y a la de percepción de afrontamiento de la situación, clasificando el malestar en leve (0-8), moderado (9-13) o grave (14)(15)(16)(17)(18)(19)(20). Las preguntas sobre preocupaciones o signos externos de malestar emocional permiten a los profesionales sanitarios una atención más específica.…”

“…Entre las primeras se incluye: la búsqueda de apoyo emocional y social, la actitud de espíritu de lucha y la aceptación, combinadas con los esfuerzos por mantener el autocontrol sobre la enfermedad. Las estrategias menos adaptativas incluirían una actitud de desesperanza y resignación, combinada con una actitud pasiva y de evitación [12][13][14] .…”