Understanding the Will to Live in Patients Nearing Death

Chochinov, Harvey Max; Hack, Thomas F.; Hassard, Thomas; Kristjanson, Linda J.; McClement, Susan; Harlos, Mike

doi:10.1176/appi.psy.46.1.7

Cited by 139 publications

(103 citation statements)

References 18 publications

(27 reference statements)

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“…This study found that physical deterioration and increasing dependency was a major concern to the participants and to maintain control was of the highest importance (Waterworth and Jorgensen 2010). To feel like a burden to others has previously been shown to be associated with loss of dignity, depression and the will to live in older people near the end of life (Chochinov et al 2005).…”

Section: Discussion and Recommendationsmentioning

confidence: 77%

To adjust and endure: a qualitative study of symptom burden in older people with multimorbidity

Eckerblad

Theander

Ekdahl

et al. 2015

Applied Nursing Research

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Context. Older people with multimorbidity are vulnerable and often suffer from conditions that produce a multiplicity of symptoms and a reduced health-related quality of life.Objectives. The aim of this study is to explore the experience of living with a high symptom burden from the perspective of older community-dwelling people with multi-morbidity.Method. A qualitative descriptive design with semi-structured interviews, including 20 community-dwelling older people with multi-morbidity and a high symptom burden. The participants were 79-89 years old with a mean of 12 symptoms per person. Data were analyzed using content analyses.Results. The experience of living with a high symptom burden revealed the overall theme, "To adjust and endure" and three sub-themes. The first subtheme was "To feel inadequate and limited". Participants reported they no longer had the capacity or the ability to manage and they felt limited and isolated from friends or family. The second sub-theme was "To feel dependent". This was a new and inconvenient experience, the burden they put on others caused a feeling of guilt. The final sub-theme was "To feel dejected". The strength to manage and control their conditions was gone, the only thing left to do was to sit or lie down and wait for it all to pass.Conclusion. This study highlights the importance of a holistic approach when taking care of older people with multi-morbidity. This approach should employ a broad symptom assessment to reveal diseases and conditions that it is possible to treat or improve.

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Section: Discussion and Recommendationsmentioning

confidence: 77%

To adjust and endure: a qualitative study of symptom burden in older people with multimorbidity

Eckerblad

Theander

Ekdahl

et al. 2015

Applied Nursing Research

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“…(Clayton et al, 2005). According to Chochinov et al (2005), healthcare staff should better understand the importance of existential issues and their impact on the will to live of patients who are near death.…”

Section: Introductionmentioning

confidence: 99%

Existential encounters: Nurses' descriptions of critical incidents in end-of-life cancer care

Browall

Henoch

Melin‐Johansson

et al. 2014

European Journal of Oncology Nursing

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a b s t r a c tNurses working with cancer patients in end of life care need to be prepared to encounter patients' psychosocial and spiritual distress. Aim: The aim of this study was to describe nurses' experiences of existential situations when caring for patients severely affected by cancer. Methods and sample: Nurses (registered and enrolled) from three urban in-patient hospices, an oncology clinic and a surgery clinic and a palliative homecare team were, prior to the start of a training program, invited to write down their experiences of a critical incident (CI), in which existential issues were featured. Results: Eighty-eight CIs were written by 83 nurses. The CIs were analyzed with qualitative content analysis. Two main themes were found: Encounters with existential pain experiences, which concerned facing death and facing losses; and Encountering experiences of hope, which concerned balancing honesty, and desire to live. Conclusions: This study points out that health care professionals need to be aware of patients' feelings of abandonment in exposed situations such as patients' feelings of existential loneliness. That there are some patients that express a desire to die and this makes the nurses feel uncomfortable and difficult to confront these occurrences and its therefore important to listen to patients' stories, regardless of care organization, in order to gain access to patients' inner existential needs.

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“…Research on endstage cancer patients demonstrated a signifcant correlation between the will to live and existential, psychological, social, and physical sources of distress. 15 Oncologic pain emergencies may also arise. In particular, malignant epidural spinal cord compression is a medical emergency that afects about 5%-10% of adult solid tumor patients.…”

Section: Syndromesmentioning

confidence: 99%

Cancer-related pain management in clinical oncology

Cipta¹,

Pietras²,

Weiss³

et al. 2015

J Community Support Oncol

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Uncontrolled pain is one of the most feared and debilitating symptoms among cancer patients, and many suffer unnecessarily from suboptimal pain control. Cancer-related pain is often multidimensional and can affect all aspects of a patient's life. Hence, achieving adequate pain relief among cancer patients involves a proper assessment of psychosocial, spiritual, and physical pain issues, matched with an individualized treatment plan involving pharmacologic, nonpharmacologic, and procedural therapies when appropriate. Providing effective pain relief can help ease the overall burden of disease among oncology patients while helping them tolerate cancer-directed therapies and achieve the most optimal quality of life throughout all phases of the disease continuum. In this review, the authors will discuss the syndromes, assessment of, and treatment for cancer-related pain in the outpatient setting.

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Understanding the Will to Live in Patients Nearing Death

Cited by 139 publications

References 18 publications

To adjust and endure: a qualitative study of symptom burden in older people with multimorbidity

To adjust and endure: a qualitative study of symptom burden in older people with multimorbidity

Existential encounters: Nurses' descriptions of critical incidents in end-of-life cancer care

Cancer-related pain management in clinical oncology

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