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Israel Journal of Health Policy Research
Published in: Israel Journal of Health Policy Research 1/2014

Open Access 01-12-2014 | Original research article

Coping strategies for existencial and spiritual suffering in Israeli patients with advanced cancer

Authors: Netta Bentur, Daphna Yaira Stark, Shirli Resnizky, Zvi Symon

Published in: Israel Journal of Health Policy Research | Issue 1/2014

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Abstract

Coping with existential and spiritual concerns is inescapable in end-of-life care although not enough is known about the strategies and mechanisms involved. This pilot study focused on identifying the strategies for coping with existential and spiritual suffering at the end of life of secular Jews with advanced-stage cancer. Using the phenomenological approach to data collection, in-depth interviews were conducted with 22 patients receiving symptom relief care at a daycare oncology clinic. The interviews were recorded and transcribed verbatim, and the content was analyzed.
Advanced-stage cancer patients employ several approaches to cope with existential and spiritual concerns. The themes emerging from the interviews present five dimensions of coping strategies: openness and choosing to face reality, connectedness and the significance of family, pursuit of meaning, the connection of body, mind and spirit and, lastly, humor and a positive outlook.

Conclusions

Since these concerns cause suffering and distress, intervention models targeting existential and spiritual suffering should be disseminated among professionals involved in caring for people with life-threatening illnesses.
Literature
1.
2.
Cassell EJ, Rich BA: Intractable end-of-life suffering and the ethics of palliative sedation. Pain Med. 2010, 11: 535-438. 10.1111/j.1526-4637.2010.00809.x.CrossRef
3.
Wilson KG, Chochinov HM, McPherson CJ, LeMay K, Allard P, Chary S, Gagnon PR, Macmillan K, De Luca M, O'shea F, Kuhl D, Fainsinger RL: Suffering with advanced cancer. J Clin Oncol. 2007, 25: 1691-1697. 10.1200/JCO.2006.08.6801.CrossRefPubMed
4.
Chochinov HM: Dying, dignity, and new horizons in palliative End-of-life care. CA Cancer J Clin. 2006, 56: 84-103. 10.3322/canjclin.56.2.84.CrossRefPubMed
5.
Puchalski C, Kilpatrick SD, McCullough ME, Labron DB: A systematic review of spiritual and religious variables in palliative medicine. J Pain Symptom Manag. 2003, 1: 7-13.
6.
Antonovsky A: Health, stress and coping. 1979, San Francisco: Jossey-Bass
7.
Antonovsky A: Unraveling the mystery of health. How people manage stress and stay well. 1987, San Francisco: Jossey-Bass
8.
Bolmsjo I: Existential issues in palliative care–interviews with cancer patients. J Palliat Care. 2000, 16: 20-24.PubMed
9.
Tompson GN, Chochinov HM: Reducing the potential for suffering in older adults with advanced cancer. Palliat Support Care. 2010, 8: 83-93. 10.1017/S1478951509990745.CrossRef
10.
Balboni TA, Vanderwerker LC, Block SD, Paulk ME, Lathan CS, Peteet JR, Prigerson HG: Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. J Clin Oncol. 2007, 25 (5): 555-560. 10.1200/JCO.2006.07.9046.PubMedCentralCrossRefPubMed
11.
Puchalski CM: Spirituality and the Care of Patients at the End-of-Life: An Essential Component of Care. OMEGA-Journal of death and dying. 2007-2008, 56 (1): 33-46. 10.2190/OM.56.1.d.CrossRef
12.
Sulmasy DP: Spiritual issues in the care of dying patients "It's Okay between me and god". JAMA. 2006, 296 (11): 1385-1392. 10.1001/jama.296.11.1385.CrossRefPubMed
13.
LeMay K, Wilson KG: Treatment of existential distress in life threatening illness: A review of manualized interventions. Clin Psychol Rev. 2008, 28: 472-93. 10.1016/j.cpr.2007.07.013.CrossRefPubMed
14.
Boston P, Bruch A, Schreiber R: Existential suffering in the palliative care setting: an integrated literature review. J Pain Symptom Manag. 2011, 41: 604-618. 10.1016/j.jpainsymman.2010.05.010.CrossRef
15.
Krikorian A, Limonero JT, Mate J: An integrated view of suffering in palliative care. J Palliat Care. 2012, 28: 41-50.PubMed
16.
Wilson KG, Chochinov HM, Skirko MG, Allard P, Chary S, Gagnon PR, Macmillan K, De Luca M, O'shea F, Kuhl D, Fainsinger RL Clinch JJ: Depression and anxiety disorders in palliative cancer care. J Pain Symptom Management Year. 2007, 33: 118-129. 10.1016/j.jpainsymman.2006.07.016.CrossRef
17.
Tanyi RA: Toward clarification of the meaning of spirituality. J Adv Nurs. 2002, 39 (5): 500-509. 10.1046/j.1365-2648.2002.02315.x.CrossRefPubMed
18.
McSherry W, Cask K: The language of spirituality: an emerging taxonomy. Int J Nur Stud. 2004, 41: 151-161. 10.1016/S0020-7489(03)00114-7.CrossRef
19.
McClain CS, Rosenfeld B, Breitbart W: Effect of spiritual well-being on End-of-life despair in terminally-ill patients. Lancet. 2003, 361: 1603-1607. 10.1016/S0140-6736(03)13310-7.CrossRefPubMed
20.
Nelson CJ, Rosenfeld B, Breitbart W, Galietta M: Spirituality, religion and depression in the terminally ill. Psychosomatics. 2002, 43: 213-220. 10.1176/appi.psy.43.3.213.CrossRefPubMed
21.
Morita T, Tsunoda J, Inoue S, Chihara S: An exploratory factor analysis of existential suffering in Japanese terminally ill cancer patients. Psycho-Oncology. 2000, 9: 164-168. 10.1002/(SICI)1099-1611(200003/04)9:2<164::AID-PON447>3.0.CO;2-S.CrossRefPubMed
22.
Chochinov HM, Hack T, Hassard T, Kristianson LJ, McClement S, Harlos M: Understanding will to live in patients nearing death. Psychosomatics. 2005, 46: 7-10. 10.1176/appi.psy.46.1.7.CrossRefPubMed
23.
Morita T, Kawa M, Honke Y, Kohara H, Maeyama E, Kizawa Y, Akechi T, Uchitomi Y: Existential concerns of terminally ill cancer patients receiving specialized palliative care in Japan. Support Care Cancer. 2004, 12: 137-40. 10.1007/s00520-003-0561-6.CrossRefPubMed
24.
Boston PH, Mount BM: The caregiver's perspective on existential and spiritual distress in Palliative care. J Pain Symptom Manag. 2006, 32: 13-26. 10.1016/j.jpainsymman.2006.01.009.CrossRef
25.
Glaser BG: Advances in the methodology of grounded theory: Theoretical sensitivity. 1978, Mill Valley, CA: Sociology Press
26.
Charmaz K: Grounded Theory: objectivist and constructivist methods. Strategies of Qualitative Inquiry. Edited by: Denzin NK, Lincoln YS. 2003, London: Sage Publications, 249-318. 2
27.
Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP: Toxicity and response criteria of the eastern cooperative oncology group. Am J Clin Oncol. 1982, 5: 649-655. 10.1097/00000421-198212000-00014.CrossRefPubMed
28.
Bentur N, Emanuel LL, Cherny N: Progress in palliative care in Israel: comparative mapping and next steps. Isr J Health Pol Res. 2012, 1: 1-9. 10.1186/2045-4015-1-1.CrossRef
29.
Shuval JT: Social Dimensions of Health: The Israeli Experience. 1992, Westport, Co: Praeger
30.
Okon TR: Spiritual, religious, and existential aspects of palliative care. J Palliat Med. 2005, 8: 392-414. 10.1089/jpm.2005.8.392.CrossRefPubMed
31.
Kaasa S, Loge JH: Quality-of-life assessment in palliative care. Lancet Oncol. 2002, 3: 175-182. 10.1016/S1470-2045(02)00682-4.CrossRefPubMed
32.
Hermann CP: Spiritual needs of dying patients: a qualitative study. Oncol Nurs Forum. 2001, 28: 67-72.PubMed
33.
Moadel A, Morgan C, Fatone A, Grennan J, Carter J, Laruffa G, Skummy A, Dutcher J: Seeking meaning and hope: self-reported spiritual and existential needs among an ethnically-diverse cancer patient population. Psycho-Oncology. 1999, 8: 378-85. 10.1002/(SICI)1099-1611(199909/10)8:5<378::AID-PON406>3.0.CO;2-A.CrossRefPubMed
34.
Greisinger AJ, Lorimor RJ, Aday LA, Winn RJ, Baile WF: Terminally ill cancer patients: Their most important concerns. Cancer Pract. 1997, 5: 147-54.PubMed
35.
McGrath P: Spiritual pain: a comparison of findings from survivors and hospice patients. Am J Hospice Palliat Care. 2003, 20: 23-33. 10.1177/104990910302000109.CrossRef
36.
Antonovsky A: The structure and properties of the sense of coherence scale. Soc Sci Med. 1993, 36: 725-33. 10.1016/0277-9536(93)90033-Z.CrossRefPubMed
37.
Breitbart W, Gibson C, Poppito SR, Berg A: Psychotherapeutic interventions at the end of life: a focus on meaning and spirituality. Can J Psychiatry. 2004, 49: 366-372.PubMed
38.
Chochinov HM, McClement SM, Hack TF, McKeen NA, Rach AM, Gagnon P, Sinclair S, Taylor-Brown J: The patient dignity inventory: applications in the oncology setting. J Palliat Med. 2012, 15 (9): 998-1005. 10.1089/jpm.2012.0066.CrossRefPubMed
Metadata
Title
Coping strategies for existencial and spiritual suffering in Israeli patients with advanced cancer
Authors
Netta Bentur
Daphna Yaira Stark
Shirli Resnizky
Zvi Symon
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Israel Journal of Health Policy Research / Issue 1/2014
Electronic ISSN: 2045-4015
DOI
https://doi.org/10.1186/2045-4015-3-21

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