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Cancer patients' interpretations of verbal expressions when given information about ending cancer treatment.

https://arctichealth.org/en/permalink/ahliterature18988
Source
Palliat Med. 2002 Jul;16(4):323-30
Publication Type
Article
Date
Jul-2002
Author
Maria J Friedrichsen
Peter M Strang
Maria E Carlsson
Author Affiliation
Palliative Research Unit, Linköping University, Norrköping, Sweden. maria.friedrichsen@lio.se
Source
Palliat Med. 2002 Jul;16(4):323-30
Date
Jul-2002
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Awareness
Choice Behavior
Female
Home Care Services, Hospital-Based
Humans
Interpersonal Relations
Male
Middle Aged
Neoplasms - psychology - therapy
Palliative Care
Perception
Physician-Patient Relations
Refusal to Treat
Research Support, Non-U.S. Gov't
Sweden
Truth Disclosure
Verbal Behavior
Abstract
BACKGROUND: Cancer patients' interpretations of the meaning of words used when given bad news are not well studied in medical settings. The aim of this study was to ascertain what significance verbal expressions had for cancer patients when they were given information about ending active tumour treatment, and what message they felt they received. METHODS: Tape-recorded semi-structured interviews were performed and analysed using a qualitative phenomenographical approach. RESULTS: Thirty patients with incurable cancer admitted to hospital-based home care unit in Sweden participated. Three main categories about the significance of words emerged: 1) words could indicate indirect warnings as being forewarnings, evasive or ambiguous; 2) words could also be perceived as emotionally trying, as threats or abandoning; 3) other words were fortifying and strengthened the patient in this situation. The overall message given during the information could be interpreted differently: either focused on treatment, on quality of life, or on threat and death. CONCLUSION: The understanding of the significance of words to tailor the information to patients helps the physician to use forewarnings and fortifying words and to identify and avoid the use of threatening words.
PubMed ID
12132545 View in PubMed
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Constipation in Specialized Palliative Care: Prevalence, Definition, and Patient-Perceived Symptom Distress.

https://arctichealth.org/en/permalink/ahliterature271796
Source
J Palliat Med. 2015 Jul;18(7):585-92
Publication Type
Article
Date
Jul-2015
Author
Eva Erichsén
Anna Milberg
Tiny Jaarsma
Maria J Friedrichsen
Source
J Palliat Med. 2015 Jul;18(7):585-92
Date
Jul-2015
Language
English
Publication Type
Article
Keywords
Constipation - epidemiology - physiopathology - psychology
Cross-Sectional Studies
Health Knowledge, Attitudes, Practice
Humans
Logistic Models
Palliative Care
Prevalence
Sweden
Terminally ill
Abstract
The prevalence of constipation among patients in palliative care has varied in prior research, from 18% to 90%, depending on study factors.
The aim of this study was to describe and explore the prevalence and symptom distress of constipation, using different definitions of constipation, in patients admitted to specialized palliative care settings.
Data was collected in a cross-sectional survey from 485 patients in 38 palliative care units in Sweden. Variables were analyzed using logistic regression and summarized as odds ratio (OR).
The prevalence of constipation varied between 7% and 43%, depending on the definition used. Two constipation groups were found: (1) medical constipation group (MCG): =3 defecations/week, n=114 (23%) and (2) perceived constipation group (PCG): patients with a perception of being constipated in the last two weeks, n=171 (35%). Three subgroups emerged: patients with (1) only medical constipation (7%), (2) only perceived constipation (19%), and (3) both medical and perceived constipation (16%). There were no differences in symptom severity between groups; 71% of all constipated patients had severe constipation.
The prevalence of constipation may differ, depending on the definition used and how constipation is assessed. In this study we found two main groups and three subgroups, analyzed from the definitions of frequency of bowel movements and experience of being constipated. To be able to identify constipation, the patients' definition has to be further explored and assessed.
PubMed ID
25874474 View in PubMed
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Doctors' strategies when breaking bad news to terminally ill patients.

https://arctichealth.org/en/permalink/ahliterature18187
Source
J Palliat Med. 2003 Aug;6(4):565-74
Publication Type
Article
Date
Aug-2003
Author
Maria J Friedrichsen
Peter M Strang
Author Affiliation
Department of Welfare and Care, Linköping University, Campus Norrköping, 601 74 Norrköping, Sweden. marfr@ivv.liu.se
Source
J Palliat Med. 2003 Aug;6(4):565-74
Date
Aug-2003
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Female
Humans
Male
Medical Futility - psychology
Middle Aged
Neoplasms
Physician-Patient Relations
Sweden
Truth Disclosure
Abstract
Breaking bad news to patients with a terminal disease is a difficult task for physicians. The aim of this study was to study how doctors perceive their strategies when giving information to cancer patients about discontinuing active tumour treatment. Thirty doctors with different demographic characteristics working with patients with cancer in Sweden participated. Semistructured interviews were conducted and analyzed using a qualitative phenomenographic method. The goal when giving this information was described as making the patient understands while being as considerate as possible. However, the strategies for reaching this goal were different: (1) explaining and convincing information, (i.e., giving a long explanation about why treatment has to be discontinued); (2) softening the impact of the information, with the doctor recommending discontinuation of treatment; (3) and preparing either the patient or the physician himself/herself for the information; (4) adapting or tailoring the information to the patient, with the doctor actively seeking knowledge about the patient in order to be able to adapt the information to the patient's level, or with the doctor briefly describing the situation and then remaining silent, allowing room for the patient's reactions and questions (i.e., letting the patient take an active part). When giving information, the doctors' goal was to make patients understand, but the strategies differed depending on the context.
PubMed ID
14516498 View in PubMed
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Justification for information and knowledge: perceptions of family members in palliative home care in Sweden.

https://arctichealth.org/en/permalink/ahliterature16380
Source
Palliat Support Care. 2003 Sep;1(3):239-45
Publication Type
Article
Date
Sep-2003
Author
Maria J Friedrichsen
Author Affiliation
Faculty of Health Sciences, Department of Welfare and Care, Palliative Care, Linköping University, 601 74 Norrköping, Sweden. marfr@ivv.liu.se
Source
Palliat Support Care. 2003 Sep;1(3):239-45
Date
Sep-2003
Language
English
Publication Type
Article
Abstract
OBJECTIVE: Several studies have concluded that family members in palliative home care want information about the patient's disease. The aim of this study was to describe family members' perceptions of their motivation for receiving information about the patient's disease. METHOD: Semistructured tape-recorded interviews were performed with 20 family members of patients with incurable progressive cancer who were admitted to hospital-based home care in Sweden. Data were analyzed using a qualitative phenomenographic method. RESULTS: Family members justified their informational needs by emphasizing that they needed to understand and confirm what would happen when the disease progressed, to be mentally prepared for the future, to organize their daily life, to be a source of information to others, and that receiving information was a natural right. SIGNIFICANCE OF RESULTS: This study has revealed some explanations as to why family members want information. In clinical practice, it is important that palliative care team members are aware of family members' level of knowledge and their need for information, as this mental preparation is important.
PubMed ID
16594424 View in PubMed
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Patient-Nurse Communication about Prognosis and End-of-Life Care.

https://arctichealth.org/en/permalink/ahliterature275269
Source
J Palliat Med. 2015 Oct;18(10):865-71
Publication Type
Article
Date
Oct-2015
Author
Lisa Hjelmfors
Martje H L van der Wal
Maria J Friedrichsen
Jan Mårtensson
Anna Strömberg
Tiny Jaarsma
Source
J Palliat Med. 2015 Oct;18(10):865-71
Date
Oct-2015
Language
English
Publication Type
Article
Keywords
Aged
Attitude of Health Personnel
Communication
Comorbidity
Cross-Cultural Comparison
Female
Health Care Surveys
Heart Failure - nursing
Humans
Male
Netherlands
Nurse's Role
Nurse-Patient Relations
Outpatient Clinics, Hospital - standards - statistics & numerical data
Patient Education as Topic - standards - statistics & numerical data
Prognosis
Sweden
Terminal Care - methods - psychology - standards
Abstract
Although several studies advise that discussions about prognosis and end-of-life care should be held throughout the whole heart failure (HF) trajectory, data is lacking on the prevalence and practice of such discussions in HF care.
The study objective was to explore how often and why HF nurses in outpatient clinics discuss prognosis and end-of-life care in the context of patient education.
This was a descriptive and comparative study. Participants were HF nurses from Swedish and Dutch HF outpatient clinics. Measurements were taken via a survey for both quantitative and qualitative data. Additional data was collected via open-ended questions and analyzed with content analysis.
Two hundred seventy-nine nurses registered 1809 patient conversations using a checklist. Prognosis and end-of-life care were among the least frequently discussed topics, whereas symptoms of HF was discussed most often. Prognosis was discussed with 687 patients (38%), and end-of-life care was discussed with 179 patients (10%). Prognosis and end-of-life care were discussed more frequently in The Netherlands than in Sweden (41% versus 34%, p
PubMed ID
26068058 View in PubMed
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