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Needs of cancer patients in palliative care during medical visits: Qualitative study
Dominik Melhem1, Serge Daneault2
1Family physician practising in Beloeil, Que. dominik.melhem@gmail.com.
Objective:
To explore the needs of cancer patients in palliative care and to determine how care providers, including family physicians, could meet these needs more fully.
Design:
Qualitative study performed using semistructured interviews.
Setting:
Palliative care departments (ambulatory and intrahospital).
Participants:
Twelve patients with a diagnosis of cancer deemed to be in the palliative phase, who had already received either chemotherapy or radiation treatment.
Methods:
The interviews were recorded and transcribed. They were then coded and categorized to identify and define themes describing the participants' experience. Data were collected until new interviews no longer yielded new categories of results.
Main Findings:
Study participants primarily needed the expertise of their physicians, but they also needed reassurance by means of clear information about their disease, its treatment, and the prognosis delivered over the course of patient-physician visits, and by means of various measures that could act as safety nets. Participants needed to be heard without being judged. In terms of follow-up care, the oncology nurse navigator was just as important as the physician and could stand in for him or her to meet most relational needs and share and explain information on the disease.
Conclusion:
Non-family physician specialists cannot meet all of the patients' complex needs; throughout the palliative phase, non-family physician specialists need the support of a family physician and an oncology nurse navigator. Each care provider must be made aware of the patient's needs and ensure that they are met, to the best of his or her ability. Failing to do so might exacerbate the loneliness and anxiety experienced by terminally ill patients.
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