Death awareness, feelings of uncertainty, and hope in advanced lung cancer patients: can they coexist?

Patients diagnosed with stage-IV lung cancer are forced to quickly transition from a cancer-free and perhaps healthy life to one of serious illness, uncertainty, and anticipation of a premature death. Health professionals may be too quick to label the patient as being in denial if they hope for healing. Hope may not be lost when reality is accepted. Studies have investigated what it is like to live with awareness of impending death. Using a patient case study this paper discusses the concepts of death awareness, uncertainty, and hope. The aim is to provide a deeper understanding of how these seemingly antithetical emotions can coexist to the benefit of the patient, and to provide clinicians with practical considerations for supporting patients' hope throughout their terminal illness.

[1]  W. Duggleby,et al.  Hope against hope: exploring the hopes and challenges of rural female caregivers of persons with advanced cancer , 2013, BMC Palliative Care.

[2]  O. Hellzén,et al.  Meanings of being old, living on one's own and suffering from incurable cancer in rural Norway. , 2013, European journal of oncology nursing : the official journal of European Oncology Nursing Society.

[3]  J. Kearsley,et al.  Living with advanced cancer and an uncertain disease trajectory: an emerging patient population in palliative care? , 2013, BMJ Supportive & Palliative Care.

[4]  E. Cassell.  The nature of Healing: The Modern practice of Medicine , 2012 .

[5]  I. Joa,et al.  Patient experiences of uncertainty - a synthesis to guide nursing practice and research. , 2012, Journal of nursing management.

[6]  D. Hutchings.  Living with the Twin mysteries of Prognostication and Death Awareness , 2012, Journal of Palliative Care.

[7]  J. Curtis,et al.  Supporting hope and prognostic information: nurses' perspectives on their role when patients have life-limiting prognoses. , 2010, Journal of pain and symptom management.

[8]  T. Hassard,et al.  The landscape of distress in the terminally ill. , 2009, Journal of pain and symptom management.

[9]  J. Eliott,et al.  Hope, Life, and Death: A Qualitative Analysis of Dying Cancer Patients' Talk About Hope , 2009, Death studies.

[10]  A. Back,et al.  An approach to understanding the interaction of hope and desire for explicit prognostic information among individuals with severe chronic obstructive pulmonary disease or advanced cancer. , 2008, Journal of palliative medicine.

[11]  M. Bern-Klug.  The ambiguous dying syndrome. , 2004, Health & social work.

[12]  A. Norberg,et al.  The meaning of the lived experience of hope in patients with cancer in palliative home care , 2001, Palliative medicine.

[13]  M. Mishel.  Uncertainty in Chronic Illness , 1999, Annual Review of Nursing Research.

[14]  C. Nekolaichuk,et al.  On the Nature of Hope in Palliative Care , 1998, Journal of palliative care.

[15]  Mary E. Pennell.  Patients' and nurses' constructions of death and dying in a hospice setting , 1997 .

[16]  S. Timmermans.  Dying of awareness: the theory of awareness contexts revisited , 1994 .

[17]  M. Mishel,et al.  Perceived uncertainty and stress in illness. , 1984, Research in nursing & health.

[18]  Nadezhda Mandelstam,et al.  Hope against Hope , 1971 .

[19]  Anselm L. Strauss,et al.  Awareness of Dying , 1966 .

[20]  D. Briggs.  The meaning of illness. , 1957, Military medicine.

[21]  P. Stephenson,et al.  Spirituality and uncertainty at the end of life. , 2014, Oncology nursing forum.