The need for palliative chemotherapy. A patient, family and nurse perspective

Abstract

The objectives of the study were to gain insight into what motivates cancer patients to undergo palliative chemotherapy and how they experience the treatment. An exploratory qualitative design was used. The research setting was a private ambulatory cancer care centre in Port Elizabeth. Purposive sampling was used and data saturation determined the sample size. Data were gathered by means of qualitative interviews guided by an interview schedule and analysed. Eleven patients participated in the study; diagnosed with various cancers. Three themes arose from the data: the hope and decision: “I want to live longer”; the good and the bad: “fatigue is the biggest stumbling block”; the sources of support, God, the family and others: “it makes me feel normal”. Participants agreed that palliative chemotherapy gave them hope; some still hoped to be cured, some hoped to have time to do what remains to be done whilst others wished for additional time with their families. Eleven family members participated in the study. Three themes arose from the data: chemotherapy gives hope: “It is not over yet”; sources of support: “I try to do things for him…”; quality of life: “making the most of the time we’ve got”. For the family palliative chemotherapy brought hope – hope for comfort and cure. It was a positive experience for the family members as they witnessed an improvement in quality of life. Eleven nurses participated in the study; all females with oncology experience. Two themes arose from the data: clinging to hope: “They still think there’s hope”; the positive influence of palliative chemotherapy: “Palliative chemotherapy is a positive experience for me”. The nurses believed that patients consenting to palliative chemotherapy had false hope and that they were pressurized by family members to undergo chemotherapy. In general nurses experienced palliative chemotherapy as positive when patients’ quality of life improved and symptoms were relieved. Improved quality of life was important to all groups that participated in the study. The study provided evidence that palliative chemotherapy gave patients and their families hope, hope to live longer and have a better quality of life. Despite experiencing many side effects, of which fatigue was the worst, patients and their families persevered in order to have more time together. Although nurses were of the opinion that patients often had false hope, they still found that caring for patients receiving palliative chemotherapy was a positive experience, especially when they saw an improvement in the patients’ quality of life