Relating to the Experience of Contingency in Patients With Advanced Cancer: An Interview Study in U.S. Patients

Document Type

Journal Article

Publication Date

3-1-2018

Journal

Journal of Pain and Symptom Management

Volume

55

Issue

3

DOI

10.1016/j.jpainsymman.2017.11.007

Keywords

advanced cancer; American cancer patients; Experiences of contingency; interview study; spirituality

Abstract

© 2017 American Academy of Hospice and Palliative Medicine Context: Being diagnosed with incurable cancer can be a life-changing experience, evoking different spiritual questions and needs. Confronting a serious life-threatening event occurs not only often unexpected but also can disrupt a person's self-image and ideals of their personhood. This confrontation makes it difficult for people to integrate it into their personal life story—otherwise referred to as an experience of contingency. Objectives: Different modes of relating to the contingent life event of having cancer have been studied in a Dutch patient population. Here we present an interview study in an U.S. population with advanced cancer patients. Methods: We included eight American patients with advanced cancer from the George Washington University Cancer Center. All patients were interviewed twice discussing their life events and life goals using a semistructured interview model. All interviews were transcribed and analyzed focusing on how patients described the way they related to the experience of having advanced cancer. The constant comparative method with a directed content analysis approach was used to code the themes in the interviews. Results: The analyses show that the four modes of relating to contingency that we found in the Dutch study population can also be found in an American advanced cancer patient population. Differences were found in the extended way American patients described the fourth mode of “receiving.” Conclusion: This study ensures a broader and deeper understanding of relating to the experience of contingency in having incurable cancer, which is crucial in developing accurate spiritual care in the palliative phase of patients.

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