Suffering experiences of people with cancer undergoing chemotherapy: A meta‐ethnographic study

Abstract

This meta‐ethnography had the objectives of identifying, evaluating, and summarizing the findings of qualitative studies regarding the suffering experiences of people undergoing chemotherapy, as well as developing an explanatory conceptual structure regarding what affects these experiences. A systematic literature review was carried out, covering the past 10 years, in the following databases: CINAHL, Embase, Medline, LILACS and Scopus. By using meta‐ethnographic synthesis methods, the following themes were found: the pain of loss; evaluating, measuring, and neutralizing the threat; and social contours of suffering. The experience of living with cancer and undergoing chemotherapy was synthesized into a theoretical‐explanatory model with a structure that resembles barbed‐wire loops. The model expresses people's suffering experiences as marked by the feeling of loss, restraint of emotions, and resilience. While transcendent movements broke the cycle of suffering, resilience emerged as a learning experience that made patients more resistant to the pain of loss. The results indicated a complex and diverse set of factors that influence suffering, which confirmed that experiences are individual, comprehensive, and continuously reinterpreted.

Distress and Spiritual Well-Being in Brazilian Patients Initiating Chemotherapy during the COVID-19 Pandemic—A Cross-Sectional Study

“…It is important to emphasize that before the first treatment cycle, the emotional disorders cited in the PL can predominate and result in more distress. Qualitative [ 27 ] and quantitative [ 36 , 38 ] studies have explained this result. It is postulated that the distress state, critical at this point, is characterized by the shock caused by the diagnosis, sadness due to loss of hope, fear of the effects of the cytotoxic therapy, and concerns about an uncertain future.…”

“…Other authors have discussed how diagnostic inaccuracy, fear that the disease will progress, and movement among several health units in search of care bring about the perception of unnecessary delay, culminating in feelings of anger, indignation, and legal implications, such as medical malpractice claims and payment of compensation [ 27 , 71 , 72 ]. This body of evidence serves as a warning to leaders about the need, not only to stop virus dissemination, but also to develop strategies that ensure that patients have the right to complete their diagnostic investigation, get timely cancer treatment, receive psychosocial care, and be submitted to rigorous COVID-19 screening.…”

“…Brazilian studies on distress in cancer patients have indicated that even more important than the physical condition of the patients are the spiritual resources they have at their disposal and the way they interpret and reevaluate the experience of living with the disease [ 10 , 27 ]. According to this view and Folkman’s theoretical framework [ 83 ], people with incurable cancer can have their distress counterbalanced by hope, a construct that is considered subjective, dynamic, and contextual.…”

“…Spirituality, in turn, construed as a more sacred dimension of people and not limited to rituals or institutions, played a more intense role in the process of coping with distress. We believe that a deep reevaluation of who they were before and after cancer offered the participants the possibility, not only of experiencing personal growth, but also of developing a new sense of being [ 27 ]. This may have motivated patients with higher existential well-being scores to transcend distress.…”

“…Others have found no association between these variables [ 25 , 26 ]. These differences may be the result of factors that are not entirely understood, such as willingness to report distress, cultural aspects, observation bias, and the subjective nature of the concept [ 10 , 22 , 27 , 28 , 29 ].…”