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Health care staff's opinions about existential issues among patients with cancer

Published online by Cambridge University Press:  18 February 2010

Maria Browall ,
Christina Melin-Johansson ,
Susann Strang ,
Ella Danielson  and
Ingela Henoch
Maria Browall*
Affiliation:
Sahlgrenska University Hospital, Department of Oncology, Clinical Trial Unit, Gothenburg, Sweden
Christina Melin-Johansson
Affiliation:
Mid Sweden University, Department of Health Sciences, Östersund, Sweden
Susann Strang
Affiliation:
The Sahlgrenska Academy, University of Gothenburg, Department of Clinical Neuroscience and Rehabilitation and Sahlgrenska University Hospital, Gothenburg, Sweden
Ella Danielson
Affiliation:
Mid Sweden University, Department of Health Sciences, Östersund, Sweden The Sahlgrenska Academy, University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden
Ingela Henoch
Affiliation:
Bräcke Diakoni Foundation, Research Unit, Gothenburg, Sweden Karolinska Institutet, Institution of Learning, Informatics, Management and Ethics, Medical Management Centre, Stockholm, Sweden
*
Address correspondence and reprint requests to: Maria Browall, Sahlgrenska University Hospital, Department of Oncology, Clinical Trial Unit, SE 413 45 SE, Gothenburg, Sweden. E-mail: maria.browall@vgregion.se
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Abstract

Objective:

The objective of this study was to explore health care staff's opinions about what existential issues are important to patients with cancer and staff's responsibility when existential issues are raised by patients.

Method:

Four focus group interviews were conducted with health care staff (N = 23) at an in-patient hospice, on an oncology ward, on a surgical ward, and with a palliative home health care team. The focus group interviews focused on two questions, first, about health care staff's opinions about patients' important existential questions and, second, about health care staff's responsibility when existential issues are raised by the patient. The interviews were taperecorded, transcribed verbatim, and analyzed by qualitative content analysis into subcategories and categories.

Results:

Four categories and 11 subcategories emerged from the first question. The first category, “life and death,” was based on joy of living and thoughts of dying. The second category “meaning,” consisted of acceptance, reevaluation, hope, and faith. The third category, “freedom of choice,” consisted of responsibility and integrity, and the fourth and last category, “relationships and solitude,” consisted of alleviation, dependency, and loss. One category emerged from the second question about the health care staff's responsibility, “to achieve an encounter,” which was based on the subcategories time and space, attitudes, and invitation and confirmation.

Significance of results:

One strength of this study was that the findings were fairly congruent in different settings and in different geographical areas. Health care staff were aware of the importance of existential issues to patients. The existential issues, mentioned by health care staff, are similar to findings from studies conducted among patients, which is another strength of the present study. Health care staff are also confident about how to act when these issues are raised by the patients. The challenge for the future is to implement the findings from this study among health care staff in different settings.

Keywords

Content analysisExistentialFocus groupsHealth care professionalsPalliative care
Type
Original Articles
Information
Palliative & Supportive Care , Volume 8 , Issue 1 , March 2010 , pp. 59 - 68
Copyright
Copyright © Cambridge University Press 2010

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