• Tatsuya Morita, Masako Kawa, Yoshifumi Honke, Hiroyuki Kohara, Etsuko Maeyama, Yoshiyuki Kizawa, Tatsuo Akechi, and Yosuke Uchitomi.
• Seirei Hospice, Seirei Mikatabara Hospital. 3453 Mikatabara-cho, 433-8558 Hamamatsu, Shizuoka, Japan. seireihc@jt6.so-net.ne.jp
• Support Care Cancer. 2004 Feb 1;12(2):137-40.

BackgroundAlthough alleviation of existential distress is important for terminally ill cancer patients, the concept of existential distress has not been fully understood. The aim of this study was to categorize existential concerns of Japanese terminally ill cancer patients and explore care strategies based on the categorizations.MethodsA multicenter cross-sectional study in 88 terminally ill cancer patients receiving specialized inpatient palliative care was performed. The nurses explored patient existential concerns by asking several key questions, and recorded the answers that they considered typically described the patients' concerns. All statements recorded by the nurses were analyzed using content analysis methods.ResultsA total of 89 statements were subjected to analysis. The categories and their prevalence were: relationship-related concerns (22%; isolation, concerns about family preparation, conflicts in relationship), loss of control (16%; physical control, cognitive control, control over future), burden on others (4.5%), loss of continuity (10%; loss of role, loss of enjoyable activity, loss of being oneself), uncompleted life task (6.8%), hope/hopelessness (17%), and acceptance/preparation (25%).ConclusionsExistential concerns of Japanese terminally ill cancer patients were categorized as relationship-related concerns, loss of control, burden on others, loss of continuity, uncompleted life task, hope/hopelessness, and acceptance/preparation. These themes seemed to encompass universal human suffering beyond cultural differences, and this conceptualization may contribute to the development of effective therapeutic interventions to alleviate existential distress.

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