TY - JOUR
T1 - Changes in Cancer Patients' and Caregivers' Disease Perceptions While Receiving Early Palliative Care
T2 - A Qualitative and Quantitative Analysis
AU - Borelli, Eleonora
AU - Bigi, Sarah
AU - Potenza, Leonardo
AU - Eliardo, Sonia
AU - Artioli, Fabrizio
AU - Mucciarini, Claudia
AU - Cottafavi, Luca
AU - Cagossi, Katia
AU - Razzini, Giorgia
AU - Cruciani, Massimiliano
AU - Pietramaggiori, Alessandra
AU - Fantuzzi, Valeria
AU - Lombardo, Laura
AU - Ferrari, Umberto
AU - Ganfi, Vittorio
AU - Lui, Fausta
AU - Odejide, Oreofe
AU - Cacciari, Cristina
AU - Porro, Carlo Adolfo
AU - Zimmermann, Camilla
AU - Efficace, Fabio
AU - Bruera, Eduardo
AU - Luppi, Mario
AU - Bandieri, Elena
N1 - Publisher Copyright:
© 2021 The Authors. The Oncologist published by Wiley Periodicals LLC on behalf of AlphaMed Press.
PY - 2021/12
Y1 - 2021/12
N2 - Background: Little is known about the underlying mechanisms through which early palliative care (EPC) improves multiple outcomes in patients with cancer and their caregivers. The aim of this study was to qualitatively and quantitatively analyze patients’ and caregivers’ thoughts and emotional and cognitive perceptions about the disease prior to and during the EPC intervention, and in the end of life, following the exposure to EPC. Materials and Methods: Seventy-seven patients with advanced cancer and 48 caregivers from two cancer centers participated in semistructured interviews. Their reports were qualitatively and quantitatively analyzed by the means of the grounded theory and a text-analysis program. Results: Participants reported their past as overwhelmed by unmanaged symptoms, with detrimental physical and psychosocial consequences. The EPC intervention allowed a prompt resolution of symptoms and of their consequences and empowerment, an appreciation of its multidimensional approach, its focus on the person and its environment, and the need for EPC for oncologic populations. Patients reported that conversations with the EPC team increased their acceptance of end of life and their expectation of a painless future. Quantitative analysis revealed higher use of Negative Affects (p <.001) and Biological Processes words (p <.001) when discussing the past; Agency words when discussing the present (p <.001); Positive Affects (p <.001), Optimism (p =.002), and Insight Thinking words (p <.001) when discussing the present and the future; and Anxiety (p =.002) and Sadness words (p =.003) when discussing the future. Conclusion: Overall, participants perceived EPC to be beneficial. Our findings suggest that emotional and cognitive processes centered on communication underlie the benefits experienced by participants on EPC. Implications for Practice: By qualitative and quantitative analyses of the emotional and cognitive perceptions of cancer patients and their caregivers about their experiences before and during EPC interventions, this study may help physicians/nurses to focus on the disease perception by patients/caregivers and the benefits of EPC, as a standard practice. The analysis of words used by patients/caregivers provides a proxy for their psychological condition and support in tailoring an EPC intervention, based on individual needs. This study highlights that the relationship of the triad EPC team/patients/caregivers may rise as a therapeutic tool, allowing increasing awareness and progressive acceptance of the idea of death.
AB - Background: Little is known about the underlying mechanisms through which early palliative care (EPC) improves multiple outcomes in patients with cancer and their caregivers. The aim of this study was to qualitatively and quantitatively analyze patients’ and caregivers’ thoughts and emotional and cognitive perceptions about the disease prior to and during the EPC intervention, and in the end of life, following the exposure to EPC. Materials and Methods: Seventy-seven patients with advanced cancer and 48 caregivers from two cancer centers participated in semistructured interviews. Their reports were qualitatively and quantitatively analyzed by the means of the grounded theory and a text-analysis program. Results: Participants reported their past as overwhelmed by unmanaged symptoms, with detrimental physical and psychosocial consequences. The EPC intervention allowed a prompt resolution of symptoms and of their consequences and empowerment, an appreciation of its multidimensional approach, its focus on the person and its environment, and the need for EPC for oncologic populations. Patients reported that conversations with the EPC team increased their acceptance of end of life and their expectation of a painless future. Quantitative analysis revealed higher use of Negative Affects (p <.001) and Biological Processes words (p <.001) when discussing the past; Agency words when discussing the present (p <.001); Positive Affects (p <.001), Optimism (p =.002), and Insight Thinking words (p <.001) when discussing the present and the future; and Anxiety (p =.002) and Sadness words (p =.003) when discussing the future. Conclusion: Overall, participants perceived EPC to be beneficial. Our findings suggest that emotional and cognitive processes centered on communication underlie the benefits experienced by participants on EPC. Implications for Practice: By qualitative and quantitative analyses of the emotional and cognitive perceptions of cancer patients and their caregivers about their experiences before and during EPC interventions, this study may help physicians/nurses to focus on the disease perception by patients/caregivers and the benefits of EPC, as a standard practice. The analysis of words used by patients/caregivers provides a proxy for their psychological condition and support in tailoring an EPC intervention, based on individual needs. This study highlights that the relationship of the triad EPC team/patients/caregivers may rise as a therapeutic tool, allowing increasing awareness and progressive acceptance of the idea of death.
KW - Caregivers
KW - Early palliative care
KW - Pain
KW - Patients
KW - Qualitative research
KW - Quantitative tool
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U2 - 10.1002/onco.13974
DO - 10.1002/onco.13974
M3 - Article
C2 - 34510624
AN - SCOPUS:85115995289
SN - 1083-7159
VL - 26
SP - e2274-e2287
JO - Oncologist
JF - Oncologist
IS - 12
ER -