The burden of the ?RA RA? positive: survivors? and hospice patients? reflections on maintaining a positive attitude to serious illness

McGrath, Pam

doi:10.1007/s00520-003-0547-4

Cited by 32 publications

(24 citation statements)

References 20 publications

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“…The burden of and pressure to be positive and present a "fighting spirit" to family, friends, and HPs has been voiced by cancer patients in recent studies. 25,26 As emphasized by participants in the current study, any advice given by HPs to patients and their families regarding ways of coping with the illness must be balanced with allowing them to express a full range of emotions, both positive and negative.…”

Section: Discussionmentioning

confidence: 98%

Fostering coping and nurturing hope when discussing the future with terminally ill cancer patients and their caregivers

Clayton

Butow

Arnold

et al. 2005

Cancer

242

266

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BACKGROUNDIt is challenging for clinicians to foster coping and allow hope when discussing prognosis and end‐of‐life (EOL) issues with terminally ill cancer patients and their caregivers. To the authors' knowledge, little research evidence is currently available to guide clinical practice.METHODSThe authors conducted focus groups and individual interviews with 19 patients with far advanced cancer and 24 caregivers from 3 palliative care (PC) services in Sydney, and 22 PC health professionals (HPs) from around Australia. The focus groups and individual interviews were audiotaped and fully transcribed. Additional focus groups or individual interviews were conducted until no additional topics were raised. The participants' narratives were analyzed using qualitative methodology.RESULTSAll participant groups believed there were ways of fostering coping and nurturing hope when discussing prognosis and EOL issues. Themes identified from the transcripts regarding ways of helping patients with a limited life expectancy to cope were: 1) emphasize what can be done (namely: a) control of physical symptoms; b) emotional support, care, and dignity; and c) practical support), 2) explore realistic goals, and 3) discuss day‐to‐day living. Two additional themes were identified regarding ways of fostering hope: the balance between truth telling and nurturing hope, and the spectrum of hope. All these themes were raised by the patients, caregivers, and HPs. However, there were some differences of opinion within the three participant groups.CONCLUSIONSThe results of the current study demonstrated that most participants believed there were ways of fostering coping and maintaining hope and that HPs have a role in facilitating this with terminally ill cancer patients and their caregivers. Cancer 2005. © 2005 American Cancer Society.

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Section: Discussionmentioning

confidence: 98%

Fostering coping and nurturing hope when discussing the future with terminally ill cancer patients and their caregivers

Clayton

Butow

Arnold

et al. 2005

Cancer

242

266

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“…57 Featuring in medical and lay accounts of illness, this discourse also constitutes the individual as responsible for their health, implicitly holding patients responsible for poor outcomes following treatment. 31,58 Although this moral evaluation attaches to conventional medical treatments, it may be more salient for CAM which not only presuppose and espouse a mindbody connection but also define it as the foundation of any effect, and particularly for those CAM that have not been shown to have a definable physiologic mechanism, and thus may be more readily understood as dependent upon a belief or mind-body connection. In this context, some patients' lack of faith in the efficacy of CAM, precisely where faith is believed crucial to its success, may account for their dismissal of CAM's relevance to their circumstances.…”

Section: Discussionmentioning

confidence: 98%

(Using) Complementary and Alternative Medicine: The Perceptions of Palliative Patients with Cancer

Eliott

Kealey

Olver

2008

Journal of Palliative Medicine

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Use of complementary and alternative medicine (CAM) is increasingly common within Western societies, including Australia. This parallels calls for or claims of integration of CAM into mainstream medical practice, with oncology and palliative care specifically nominated as appropriate arenas for integration. However, there is an absence of studies examining patient perceptions of both CAM and CAM users. In this study, 28 adult patients with cancer close to death were interviewed regarding treatment decisions at the end of life, including decisions about CAM. Thematic analysis of transcribed interviews found consistent differences in talk around CAM between 12 users and 16 nonusers of CAM, primarily related to the perceived value of these treatments. Drawing upon a mind-body discourse that holds individuals responsible for their health, users valued CAM for the perceived benefit to physical or psychological well-being and compatibility with a holistic approach to health care, deemed to complement or augment conventional medicine. However, some were self-critical of their failure to continue with CAM, despite practical and financial difficulties experienced. Nonusers devalued CAM as unable to cure their disease (but did not similarly devalue conventional medicine), and negatively construed CAM users as desperate, or as challenging medical wisdom. Despite increased legitimation and medicalization of CAM, patients assess CAM differently to allopathic medicine, with different (positive and negative) assessments attributable to users. The misperception by many (nonusers) that CAM are intended to cure and available negative moral and social judgments centred around CAM use may deter patient uptake of CAM in areas where they have proven efficacy in symptom control.

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“…25 Our experience suggests that doctors' awareness and acceptance of emotion in the clinical relationship can be key to the effectiveness of treatment. 26…”

Section: Longer Survivalmentioning

confidence: 97%

Is emotional restraint a healthy response to adversity?

Ecclestone¹,

Robinson²,

Wheeler³

2014

BMJ

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The burden of the ?RA RA? positive: survivors? and hospice patients? reflections on maintaining a positive attitude to serious illness

Abstract: The essential message is that a positive outlook cannot be imposed but requires a nurturing orientation that allows the expression of a full range of feelings in a supportive environment.

Cited by 32 publications

References 20 publications

Fostering coping and nurturing hope when discussing the future with terminally ill cancer patients and their caregivers

Fostering coping and nurturing hope when discussing the future with terminally ill cancer patients and their caregivers

(Using) Complementary and Alternative Medicine: The Perceptions of Palliative Patients with Cancer

Is emotional restraint a healthy response to adversity?

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