Experiences Of Self-Perceived Burden Of Advanced Cancer Paitents And Coping Of Self-Perceived Burden: A Qualitative Research

Objectives:1.To describe the real experiencs of self-perceived burden(SPB) of advanced cancer patients, to enhance people's understanding of SPB.2.To explore the experiencs of coping with SPB of advanced cancer patients, to analyze the strategies to cope with SPB.3.To analyze the relevant factors of SPB of advanced cancer patients, to provide a theoretical scientific basis to evidence-based nursing practice, to provide basic research tools of SPB for further research and development.Methods:Phenomenological approach of qualitative research was chosen for the present investigation.The data were collected by in-depth interview and observation, processed and analyzed by means of data analysis based on Giorgi. In order to explore patients'experiences of SPB caused by illness and care needs, from January 2008 to June 2008, 16 terminal cancer patients (9men 7women), from two Taian general municipal hospitals, were interviewed.Results:In this study, the analysis of interview data found: SPB is a prevalent concern in advanced cancer patients. Participants'experiences of SPB were reflected in the following major interrelated categories.①The reasons for the formation of SPB—''Concern for others'':patients's SPB caused by illness and care needs ,includes the physical, economic, emotional, and social hardships patients believed they were creating for others, as well as concerns about the future and likely effect of their death on those around them.②emotional experiences of SPB—''Implications for Self'': feelings of responsibility for causing hardships to family, resulting in depression, self-blame, guilt, pain, regret, loss of self-esteem and lower self-esteem and other emotional responses.③strategies to cope with SPB—''Minimizing Burden'', which described strategies to cope with SPB used by patients to alleviate the burden on others and to reduce the negative impact on themselves, are classified as either problem-focused or emotion-focused.Conclusions:1. SPB is a prevalent experience and felling in advanced cancer patients, 90% of the patients have the feeling of burden, 76% of the patients have the feeling of burden from moderate to severe extent, of which the economic and emotional factors and the impact on families are the main reason for the formation of SPB. SPB is also one of the factors that affects patient's series of medical decision and the quality of life, and is easily neglected.2. Current situation of coping with SPB: the resarch shows that patients who express a strong sense of burden may experience significant distress in other areas, they may sometimes be inclined to conceal symptoms or needs in order to reduce the burden of others. Practitioners should encourage and guide patients to adopt positive and effective strategies, minimize the negative impacts on patients as much as possible.3. Suggestions generated by the study to nursing care are: results of this study provide the basis for evidence-based nursing practice for patients with advanced cancer, contribute to the effective implementation of the holistic care; SPB can be used as evaluation index of quality of life of cancer patients; In addition, to provide reference information for the development of Chinese cultural characterized phenomenological nursing research.