Abstract and Introduction
Abstract
Diagnosis and treatment of a terminal illness can significantly impact patients and their families, as well as their functionality and daily routines. This study aimed to understand the palliative care needs of a group of families with an adult relative with advanced cancer receiving palliative care. A qualitative approach was used to conduct a content analysis. Fourteen semistructured interviews were carried out with family members in Cundinamarca (Colombia) between March and April 2022. The information was analyzed by coding and categorizing the emerging themes using NVivo. Three main categories emerged: the diagnosis' harsh surprise, the family's coping with the disease, and the palliative care needs of families. Identifying the resources available to families to care for relatives with advanced cancer can facilitate the work of palliative care teams. It is necessary to prevent the family from giving up on caring, which can result from exhaustion due to various causes. Families who have an adult relative with advanced cancer in palliative care face significant challenges. Their situation involves accepting the diagnosis, changing family routines, dealing with the disease and the health care system, and coping with circumstances that create needs of different kinds.
Introduction
Receiving a cancer diagnosis can be shocking for patients and their families. At every stage of the disease, including death, nursing and palliative care teams should consider the changes and the care needs of patients and families.[1] According to the World Health Organization, of 41 million deaths per year due to chronic noncommunicable diseases, 9 million are due to cancer, which ranks second.[2] By the year 2040, the incidence of this disease is projected to be 30.2 million, which shows that its growth is constant and will continue to impact people's quality of life.[3] As the disease progresses, most patients lose functional capacity and become more dependent; they cannot perform basic activities autonomously and require support, mainly from their families, to meet their needs. Thus, complex situations susceptible to intervention to improve family relationships emerge.[4] In Maslow's theory of human motivation, needs are classified in a hierarchical order: physiological needs, safety, love, belonging, esteem, and self-actualization,[5] which must be addressed and considered by nurses providing palliative care, attending not only to patients but also to their families and caregivers, as stated by the International Association for Hospice and Palliative Care.[6]
As subjects of care, families may experience different circumstances that trigger needs of different types, which in turn cause them to experience suffering.[7] The needs of a family going through a palliative situation correspond to those requirements of a physical, social, emotional, financial, informational, or communicative nature or requirements for availability of resources, comprehensive care, or spiritual care to maintain family's development and functionality while providing care to a family member in palliative care.[7,8] The sum of the family's needs following the cancer diagnosis could be considered a family disease.[7]
There is scant research addressing families as subjects of care during the palliative care phase of cancer patients. Chua et al[8] In demonstrated that the primary needs of patients with advanced cancer disease and their families are related to information, financial support, and policy management; however, family members reported greater needs for instrumental, emotional, and psychological support, as well as access to health services. In Brazil, family members of advanced cancer patients reported experiencing changes (emotional and psychological consequences) and psychological, emotional, physical, and social needs.[8]
When a family member receives the diagnosis of a terminal illness, there is an impact on both patients and families because the disease affects family organization and relationships in different ways, affecting adaptation to the process.[9] The human population of Cundinamarca (Colombia) is relevant to understand this phenomenon because many patients requiring health services in Bogota come from this department. It is necessary to know the needs of the families of adults with advanced cancer receiving palliative care to call for greater recognition of the impact of terminal cancer on patients' families.
Journal of Hospice and Palliative Nursing. 2023;25(4):197-203. © 2023 Lippincott Williams & Wilkins
