Psycho-oncology
-
The use of continuous sedation until death for terminally ill cancer patients with unbearable and untreatable psychological and existential suffering remains controversial, and little in-depth insight exists into the circumstances in which physicians resort to it. ⋯ Physicians in our study used continuous sedation until death in the context of psychological and existential suffering after considering several pharmacological and psychological interventions. Further research and debate are needed on how and by whom this suffering at the end of life should be best treated, taking into account patients' individual preferences.
-
Fear of recurrence (FoR) is a widespread problem among breast cancer survivors. So far, little is known about prevalence, determinants, and consequences of FoR specifically in long-term breast cancer survivors, even though it was found to be one of the most important concerns in this group. ⋯ Fear of recurrence (mostly low levels) is highly prevalent among long-term breast cancer survivors and can negatively affect QoL and well-being. Therefore, it should be given appropriate consideration in research and clinical practice. As specifically younger women tended to be impacted by FoR, it is crucial to be particularly attentive to specific needs of younger survivors.
-
Encountering dying patients with implicit existential questions requires the nurses to have positive and comfortable attitude to talking about existential issues. This paper describes the nurses' reflections on existential issues in their communication with patients close to death. ⋯ This study supports the assertion that experience of talking about existential issues and supporting environment make nurses comfortable when counselling patients close to death. It was obvious from this study that having the courage to be present and confirming, having time and not trying to 'solve' every existential problem were the most important factors in conversations with the patients close to death.