PURPOSE: To have more in-depth understanding of death acceptance among patients with terminal cancer in Thailand.
METHODS: A qualitative descriptive research approach was used to capture the perspectives of patients with terminal cancer about death acceptance. Purposive sampling was used to recruit the participants. A semi-structured interview guide was used during data collection to obtain in-depth interviews with 12 patients diagnosed with terminal cancer. An interpretive descriptive method was used for analyzing data. Analysis of the data for this study was conducted by the analytic team beginning at initial data collection.
RESULTS: The findings of this study revealed six major themes relating to death acceptance: 1) perceiving death as a natural part of life; 2) perceiving that death cannot be controlled; 3) thinking that death can come at any time; 4) letting everything go before dying: finding a calmness; 5) additional Buddhist practices: clean living and making merit; and 6) additional means for attaining a peaceful death and peaceful life before death.
CONCLUSION: Understanding death acceptance is important for nurses providing care for patients with terminal cancer in order to find strategies and support for patients to accept death and live peacefully with their family in the time they have left.
Introduction: Patients with cervical cancer in the early period of diagnosis (0–3 months) often show denial, thus leaving the patient less cooperative with the treatment plan.
Objective: This study aims to identity the acceptance response whose diagnosed cervical cancer.
Method: This study is qualitative research study with phenomenological approach. Sampling was conducted by purposive sampling with a sample size of 12 participants. Data were collected using semi-structured in-depth interviews. Thematic analysis was performed using Collaizi steps.
Result: The themes that emerged were formulated based on the participants’ answers to interview questions and field notes during the interview process. This research produces 7 (seven) themes: responsibility, efforts to seek treatment, support, source of information, commitment, obstacles, and hope.
Conclusion: The emotional stability of cervical cancer patients was fluctuated and the feelings of loss occurred repeatedly even after reaching the acceptance state. Good self-adjustment enhance respondent's acceptance of their disease and bringing new hope for their life, so cervical cancer patients will have a positive expectation in his life. The role of health workers is important in the adjustment of early-diagnosed patients with cervical cancer by providing health education and consultation services related to the condition of the illness.
Context: Patients with advanced cancer face a life-limiting condition that brings a high symptom burden that often includes pain, fatigue, and psychological distress. Psychosocial interventions have promise for managing symptoms but need additional tailoring for these patients' specific needs. Patients with advanced cancer in the community also face persistent barriers—availability of interventions in community clinics as well as financial and illness-related factors—to accessing psychosocial interventions.
Objectives: The aim of the present study was to assess the feasibility and acceptability of telephone implementation of Engage, a novel brief combined Coping Skills Training and Acceptance and Commitment Therapy protocol, for reducing symptoms and increasing quality of life in community patients with advanced cancer.
Methods: Adult patients with advanced cancer receiving care in the community received Engage, four 60-minute manualized telephone sessions delivered by a trained psychotherapist and completed pretreatment and post-treatment assessments.
Results: Engage was feasible, achieving 100% accrual (N = 24) of a heterogeneous sample of patients with advanced cancer, with good retention (88% completed). Acceptability was demonstrated via satisfaction (mean 29 of 32; SD 2), engagement (95% attendance), and use of skills. Secondary analyses pointed to reductions in pain interference, fatigue, psychological distress, and improvements in psychological acceptance and engagement in value-guided activity after treatment.
Conclusion: Engage, our brief novel combined Coping Skills and Acceptance and Commitment Therapy intervention, demonstrated initial feasibility and acceptability when delivered over the telephone and increased access for community clinic patients with advanced cancer. Future research will assess the comparative efficacy of Engage in larger randomized trials.
"Papa, Maman, Faustine, ne vous inquiétez pas pour moi, je n'ai pas peur. Prenez soin de vous. Je vous aime." Ces mots sont ceux d'Emilie. Elle les écrit lorsqu'elle apprend qu'après deux années de combat contre le cancer, plus aucun traitement ne peut prolonger sa vie. A travers ces quelques mots, elle donne une leçon de vie à sa famille et à ses proches : elle fait le choix d'être heureuse pendant le peu de temps qui lui reste à vivre.
Elle souhaite partager son enjouement, son courage et sa force avec ceux qui l'ont toujours aimée et soutenue. Jusqu'où ira-t-elle dans le combat qu'elle mène contre la maladie ? Comment vivra-t-elle ses derniers instants ? Ses proches réussiront-ils à accepter la situation et à surmonter cette douloureuse épreuve ?
Introduction: Old age is usually the natural time for people to prepare for death, which may evoke various emotions ranging from acceptance to hostility.
Aim of the work: The study aimed at specifying various degrees to which elderly people accept death.
Material and method: The study employed the diagnostic poll method and an Inventory of the Attitude towards Death (IAD) poll questionnaire. The investigation was administered in a cohort of 150 people over 65 years of age living in Poland.
Results: The highest results were noted both for males and females on the "Value" scale (M = 4.94 and M = 4.96) and on the "Necessity" scale (M = 4.79 and M = 4.95). These two scales also had the highest values in the cohorts of city dwellers and country dwellers. A statistically significant difference (Z = 2.339, p = 0.019) was found in the "Necessity" dimension between investigated people with higher education and others. Furthermore, statistically significant differences were found in the following dimensions: "Mysteriousness", "Value", "Dread", "Tragedy", and "Absurdity". Comparing death dimensions in people with chronic illnesses and in those without such illnesses, meaningful statistical differences were noted in the "Necessity" dimension (t = 1.983, p = 0.049). However, analysing death dimensions in people who suffered because of a severe illness in a family member and respondents whose families were healthy, statistically significant differences were noted in the "Absurdity" dimension (t = 2.057, p = 0.041).
Conclusions: Sex, the place of residence, and death of a close person did not affect elderly people's acceptance of death. On the other hand, those suffering from chronic diseases were more aware of the inevitability of death. People without higher education were also more aware of the inevitability of death. Suffering of a serious disease of a close one considerably affected acceptance of death in the elderly.
De plus en plus souvent, nous entendons parler d'euthanasie : que ce soit par les médias, par les politiques, par les services publics ou par diverses associations, la thématique est sur toutes les langues.
Cependant, force est de constater que le sujet est bien souvent abordé avec méconnaissance ou parti pris. Mon souhait est donc d'intervenir dans cet ouvrage pour décrire le plus fidèlement possible la très dure réalité qui entoure le processus d'euthanasie.
Non, la vie dans nos hôpitaux n'est pas - ou n'est plus - un long fleuve tranquille. Elle est en crue permanente, avec de nombreux débordements quotidiens. En tant que membre du personnel soignant, je constate combien il nous est difficile à nous, infirmiers, médecins, psychologues, assistants sociaux, de garder la tête hors de l'eau, lorsqu'il est question de ce qu'on appelle pompeusement "éthique".
La nuit où son père est mort, Régina a cru que son monde s'effondrait et qu'elle ne pourrait vivre sans lui. Mais elle va se laisser entraîner dans un étrange périple qui changera tout. Sous forme de parcours initiatique, Le grand voyage de Régina Fever est un conte plein de douceur et de tendresse sur le deuil et l'acceptation de la mort.
Le fossé moral entre les partisans et les opposants de l’aide médicale à mourir est large et peut être attribué à un certain nombre de croyances dichotomiques. Cet article porte sur un fondement particulier moins couramment décrit de ce fossé : l’acceptation humaine du déclin physique et de la mort en tant qu’étape importante de la vie, par opposition à la maîtrise humaine présumée du moment auquel les gens meurent et de la manière dont ils meurent. Des idées pratiques sont ensuite proposées aux systèmes de santé qui veulent combler le fossé en offrant à la fois de solides programmes de soins palliatifs de fin de vie ainsi qu’une aide médicale à mourir pour leurs patients, tout en préservant l’intégrité des travailleurs de la santé.
Context: Nursing care on the spiritual aspect is focusing on the patients' acceptance of their diseases; thus, people living with HIV (PLWH) are able to accept their diseases and are able to take the lesson. PLWH do not only deal with the condition of the disease but also by discriminative social stigma.
Aim: The aim of this study was to explore, describe, and interpret the experience of spirituality to self-acceptance in patients with HIV/AIDS.
Research Methodology: This research is a qualitative approach by descriptive phenomenology of participants involving as many as 10 people, consisting of 5 men and 5 women. All paticipants are muslim with the education level range from junior high school to university. The ages ranged from 29 to 46 years.
Results: This research identified the two themes which are: (1) being able to take the lesson from their diseases, and (2) self acceptance as people living with HIV-AIDS. There were 10 participants participated in this study. A method of in-depth interviews and observation is a help of data collection. Data analysis used was Creswell method.
Conclusion: Results of the study suggested the patients to get motivated and to develop aspects of spirituality so that it can help to ease in the process of self acceptance, asgetting closer to God through pray, read the Quran, fasting, etc.
OBJECTIVE: Death acceptance may indicate positive adaptation in cancer patients. Little is known about what characterizes patients with different levels of death acceptance or its impact on psychological distress. We aimed to broaden the understanding of death acceptance by exploring associated demographic, medical and psychological characteristics.
METHODS: At baseline, we studied 307 mixed cancer patients attending the University Cancer Center Hamburg and a specialized lung cancer center (age M=59.6, 69% female, 69% advanced cancer). At one-year follow-up, 153 patients participated. We assessed death acceptance using the validated Life Attitude Profile-Revised. Patients further completed the Memorial Symptom Assessment Scale, the Demoralization Scale, the Patient Health Questionnaire, and the Generalized Anxiety Disorder Questionnaire. Statistical analyses included multinomial and hierarchical regression analyses.
RESULTS: At baseline, mean death acceptance was 4.33 (SD=1.3, range 1-7). There was no change to follow-up (p=.26). When all variables were entered simultaneously, patients who experienced high death acceptance were more likely to be older (OR=1.04, 95%CI 1.01-1.07), male (OR=3.59, 95%CI 1.35-9.56), widowed (OR=3.24, 95%CI 1.01-10.41), and diagnosed with stage IV (OR=2.44, 95%CI 1.27-4.71). They were less likely to be diagnosed with lung cancer (OR=.20, 95%CI .07-.58) and their death acceptance was lower with every month since diagnosis (OR=.99, 95%CI.98-.99). High death acceptance predicted lower demoralization and anxiety at follow-up, but not depression.
CONCLUSIONS: High death acceptance was adaptive. It predicted lower existential distress and anxiety after one year. Advanced cancer did not preclude death acceptance, supporting the elaboration of death-related concerns in psychosocial interventions.
La mort du grand-père Félicien est comparée à un long voyage, son dernier voyage. Sylvestre, son petit-fils, rêve de lui perdu dans la forêt à la suite d'une tempête... Il va aider Félicien à atteindre la mer pour un dernier voyage. Au réveil, Sylvestre réalise dans les bras de sa maman que son grand-père est mort.
Background: Patients in palliative care suffer variously due to underassessment of needs and suboptimal intervention, coupled with lack of access to palliative care. This study attempts to identify effective coping strategies which lead to life satisfaction, among those afflicted with terminal cancer.
Materials and Methods: This observational, cross-sectional study was carried out among terminally-ill cancer patients undergoing palliative care. Cancer patients receiving palliative care who give consent and were aged 18 years or older were included in the study. Those with cognitive deficits, delirium, or psychosis were excluded from the study. COPE scale, Temporal Satisfaction with Life Scale, and sociodemographic Performa were administered and analyzed. Pearson's r correlation coefficient test and multiple linear regression analyses were used to evaluate correlation and effect of coping strategies on life satisfaction.
Results: Religious coping was the most frequently used coping strategy by patients, followed by acceptance. Females showed higher problem-focused coping, whereas males had higher emotion-focused and avoidant coping strategies. Females manifested more religious coping. Males showed more acceptance of their illness. Those without a partner had significantly higher emotion-focused coping strategies and higher religious coping. Income, social support, and problem-oriented coping were positively related to quality of life. Life satisfaction showed significant negative correlation with denial, substance use, and venting utilized as coping methods.
Conclusion: Problem-focused coping (religious coping and acceptance) was found to be more effective than other methods. Patients in palliative care could be instructed for the use of problem-focused coping. Such training might enhance their life satisfaction, helping them experience greater control over the course of illness.
The aim of this research was to determine the relation between death attitude and distress tolerance and aggression and anger. For this, 135 subjects among 7,535 professional and specialist members of the Iran National Library were selected using convenience sampling method. They replied to Death Attitudes Profile-Revised, distress tolerance questionnaire, and aggression questionnaire. The results showed that the attitudes of approach acceptance, neutral acceptance, and escape acceptance had positive relation to distress tolerance and negative relation to aggression and anger while the attitudes of fear of death and death avoidance had negative relation to distress tolerance and positive relation to aggression and anger. Furthermore, all death attitudes predicted distress tolerance. But only the attitudes of approach acceptance, escape acceptance, fear of death, and death avoidance predicted aggression, and only approach acceptance, neutral acceptance, fear of death, and death avoidance predicted anger.
Lorsqu’un adolescent sent ou pense qu’il risque de mourir, il a besoin des autres, d’être en lien, de se rapprocher de ceux qui l’aiment pour lutter contre l’inéluctable sentiment de solitude et d’angoisse de séparation. Il a aussi besoin d’une personne avec qui parler de sa mort. En nous mettant à son écoute et en l’aidant à formuler ses questions, qu’elles soient pleinement élaborées ou qu’elles se cherchent, nous l’aidons à dire, à penser, à ressentir, à verbaliser ses sensations, ses sentiments ou ses émotions. Il peut nous être difficile d’entendre ses tristesses, ses angoisses, ses colères, ses impuissances, son sentiment d’injustice… Notre rôle est de l’accompagner dans son cheminement, même lorsque nous n’avons pas de réponse à lui apporter, même lorsque nous nous sentons impuissants, que nous ne parvenons pas à le rassurer ou que nous avons envie de fuir. Ce qui est important, c’est que nous soyons là afin de recueillir, et si possible, de contenir ses affects négatifs et l’aider à réaliser qu’ils ne le définissent pas. Cela lui permettra alors d’entrer dans une sorte d’acceptation du destin.
Après le suicide de son grand amour, Ton, la narratrice essaie de se reconstruire. Elle rencontre des hommes grâce à des petites annonces et assume sa sexualité. Pourtant, dans cette maison qu'elle a habitée avec Ton, elle n'arrive pas à dormir aux côtés de ses conquêtes. Ce roman traite essentiellement de l'acceptation.
Accepter la réalité n'est pas évident après un deuil, une rupture, des traumatismes. Les auteurs donnent des conseils pour affronter les événements douloureux et ne pas adopter de mauvaises stratégies comme l'évitement, la fuite, les regrets et remords, la révolte.
OBJECTIVE: To identify the unique needs of lesbian, gay, bisexual, and transgender (LGBT) cancer patients and caregivers, and review recommendations supporting more effective and inclusive palliative and end-of-life care.
DATA SOURCES: Published research and clinical guidelines.
CONCLUSION: Transitions in care raise particular challenges for LGBT patients, including provider communication, perceptions of safety and acceptance, and assessing and respecting patients' definitions of family and spirituality.
IMPLICATIONS FOR NURSING PRACTICE: LGBT patients and their caregivers need competent nurses to support them, especially during transitions. Implementing LGBT-inclusive education, training, and practice will improve outcomes for LGBT cancer patients and their caregivers - and potentially all patients.
Palliative care for chronically ill patients is an important strategy to relieve suffering and to maintain quality of life. However, few studies have investigated the problems in the palliative care of chronic patients. This study explored the willingness to accept palliative care and related factors in patients with chronic obstructive pulmonary disease. The study adopted a descriptive-correlational design. A purposive sample of 101 patients from 2 teaching hospitals in central Taiwan was recruited. Structured questionnaires assessed patients’ knowledge, attitude, and willingness to accept palliative care. The results showed that most participants were willing to accept symptom control and unwilling to accept intubation, mechanical ventilation, and cardiopulmonary resuscitation. Associations between knowledge scores, willingness to accept palliative care, and attitude scores were found. Education level and attitude toward palliative care variables were predictive factors of willingness to accept palliative care. However, knowledge of palliative care was noticeably low in the study; only 14.9% of the participants were aware of palliative care. Educating patients about palliative care is necessary. Health professionals should advocate for palliative care and provide patients and their families with opportunities to discuss their views about palliative care so that appropriate care can be provided.
Suite à l’étude d'un cas clinique, la question centrale de ce mémoire était : "Pourquoi la mort est-elle si difficile à appréhender ?". L'hypothèse suivante est posée : le vécu d’une EMI permet l’acceptation de la mort.
Un questionnaire a été établi avec douze questions semi-directives (six sur la variable le vécu de l’EMI et six sur la variable l’acceptation de la mort) et des entretiens auprès de cinq personnes correspondant à la recherche ont été réalisés.
L'hypothèse est validée : le vécu d’une EMI permet l’acceptation de la mort.
Twenty-three nonclinical relatives of long-term missing persons were interviewed. Patterns of functioning over time were studied retrospectively by instructing participants to draw a graph that best described their pattern. Patterns most frequently drawn were a recovery and resilient/stable pattern. Participants were also asked to select 5 out of 15 cards referring to coping strategies, which they considered most helpful in dealing with the disappearance. Acceptance, emotional social support, mental disengagement, and venting emotions were most frequently chosen. This study provided some indication of coping strategies that could be strengthened in treatment for those in need of support.