Perspectives Of Existential Distress Of Young Or Middle-aged Patients With Advanced Cancer: Patients And Family Caregivers

Objective:1.To clarify the concept of existential distress of cancer patients;2.To elicit the experience of existential distress among young and middle-aged patients with advanced cancer;3.To explore the perspectives of family caregivers in existential distress among young and middle-aged patients with advanced cancer.Methods:1.The Walker and Avant concept analysis approach was applied to clarify the concept of existential distress of cancer patients.2.A phenomenological study was conducted.Eighteen young or middle-aged advanced cancer patients were recruited—using the purposive sampling.The in-depth interviews were conducted and the Colaizzi method was employed to perform the data analysis.3.This was a qualitative descriptive study.Twenty family caregivers of advanced cancer patients were invited to participate in semi-structured interviews.Data were analyzed using content analysis.Results:1.For cancer patients,the concept of existential distress included four core attributes:(1)lack of meaning;(2)loss of autonomy;(3)loss of dignity;and(4)hopelessness.Existential distress was a key factor causing poor quality of life,negative emotions,demoralization and even premature death.It was often accompanied by pain,serious psychological morbidity and a perceived sense of being a burden on others.2.Five themes were emerged from the experience of the existential distress of the young or middle-aged advanced cancer patients:(1)trouble their families;(2)meaninglessness of life;(3)hopelessness;(4)loneliness;and(5)helplessness.3.Six themes were emerged from family caregivers:(1)physical pain;(2)loss of autonomy;(3)trouble their families;(4)alienation;(5)low self-esteem;and(6)unfinished business.Conclusions:1.Meaninglessness,loss of autonomy,loss of dignity and hopelessness could be considered as the existential distress in cancer patients.This concept analysis could be used as a basis to advance our understanding of the theoretical structures of existential distress,which helps health providers gain a better understanding and an easier way to screen for this problem and may also provide a theoretical framework for further scientific research.2.Young and middle-aged patients with advanced cancer patients and their family caregivers both agree that troubling family is existential distress.From the perspective of the patients,meaninglessness,hopelessness,loneliness and helplessness are also manifestations of existential distress.From the perspective of family caregivers,they put more emphasis on physical pain.They believe that patients suffering physical pain is an important manifestation of existential distress.This study describes the experience of existential distress of young and middle-aged advanced cancer patients in China,from the perspective of patients and family caregivers.It helps nurses understand its specific connotation,and further provides a reference for clinical practice.