Unmet Needs of Palliative Cancer Patients: A Grounded Theory Study

BackgroundAdult patients in oncological palliative care often do not readily express their concerns to physicians or nurses, leading to the oversight of needs that remain unexplored and require additional support. These needs that remain unaddressed are classified as unmet needs.AimThis study aimed to construct a conceptual framework of the unmet needs of cancer patients in palliative care settings. Method: Charmaz's constructivist grounded theory approach was adopted. Semi-structured interviews were conducted with eligible patients until theoretical saturation was reached, as outlined by the methodology. The interviews were transcribed and analyzed through two coding cycles: line-by-line coding and focused coding, using NVIVO 14 software.Setting/participantsA total of 29 patients were recruited from home palliative care, hospice, and outpatient settings at the Istituto Nazionale dei Tumori of Milan's Palliative Care - Hospice, Pain Therapy, and Rehabilitation Complex Unit.ResultsThis process led to the identification of five categories: Seeking Empowerment Through Daily Support, Need to Contain the Risk of Losing Dignity, Support in Managing the Progression of the Disease, Understanding and Openness to the Future, and Seeking Existential Support, along with a core category defined as the Need for Acknowledgment. The core category encompasses patients' need to express their most intimate needs, emphasizing how crucial it is for them to be seen and understood not only as individuals facing illness but as people with unique, complex life stories.ConclusionsThe conceptual model developed enabled the identification of these hidden needs, providing a deeper understanding of the emotional and psychological dimensions that shape the experience of advanced illness.