Background Advanced oncological disease requires comprehensive health care, although attention is predominantly paid to the physical dimension of care. The consideration of personal positioning encompasses other dimensions of patients’ management of their illness, such as existential management and expanding forms of care. The objective of this study was to understand the personal positioning of cancer patients in palliative care. Methods This was a cross-sectional study using the mixed convergent parallel method. The sample consisted of 71 cancer patients in palliative care, of whom 14 participated in the qualitative and quantitative portions and 57 participated in only the quantitative portion. Phenomenological interviews were performed, and qualitative and quantitative methods were used to collect meaning of life (PIL-Test), quality of life (EORTC QLQ C-30), anxiety and depression (HADS) and sociodemographic data. The interview results were analysed according to the principles of classical phenomenology, and the quantitative data were analysed using the generalized structural equations model. Results The results showed that the patients turned to living, focusing on their possibilities and distancing themselves from the impact of the illness and the factuality of death, which the patients themselves associated with not succumbing to depression, a condition whose signs were exhibited by 21% of the sample. Sustaining this positioning required a tenacious fight, which feeds on sensitivity to life. Linked to this position was the belief in the continuation of life through religious faith, together with the patients’ realization of the meaning of their lives. In this same direction, there was a direct association between awareness of the meaning of life and increased scores on the functional scales (p <  0.01) and decreased scores for symptoms (p <  0.01), anxiety (p = 0.02) and depression (p < 0.01). The last element that emerged and structured this experience was the intense will to live and a sense of the value of life. Conclusions Through the use of mixed methods, the present study recognized the existential positioning of cancer patients in palliative care. This understanding can aid in the realization of more comprehensive and meaningful treatment plans and can contribute to the goal of achieving humanization in this area of treatment.

Background The condition of advanced oncological disorders demands a complete health care, although attention has been predominant on physical aspects. To consider personal positioning entails other aspects when dealing with patients’ diseases – such as their existential aspects – expanding forms of care. This study aims to comprehend the personal positioning of oncology patients receiving palliative care. Methods This is a cross-sectional, convergent parallel mixed-methods study. Seventy-one oncology patients in palliative care cooperated with this study, 14 of whom participated in a qualitative approach and 56 in a quantitative approach only. In the former approach, we conducted a phenomenological interview and, in the latter, we used tools to measure meaning of life (PIL-Test), quality of life (EORTC QLQ C-30), anxiety and depression (HADS), and to collect sociodemographic data. Data obtained through the interview were analyzed according to the principles of Classical Phenomenology, and the quantitative data were analyzed through generalized structural equation models. Results Our results showed that patients regained their focus on life, accentuating its possibilities and distancing themselves from the impact of their condition, such as imminent death, which was associated with giving up fighting depression. These signs were observed in 21% of the participants. This demands a tenacious fight that supports a positioning nurtured by sensitivity. Related to such position is the religious belief in life continuation, together with their awareness of the meaning of their own lives. Additionally, we found a direct association between purpose in life and an increase in the scores of functional scales (p < 0.01) and a decrease in scores of symptoms (p < 0.01), anxiety (p = 0.02) and depression (p < 0.01). The last elements to appear and structure the patients’ experience were their intense will to live and the value of life. Conclusions Through the complementarity of a mixed-method approach, this study acknowledged the existential positioning of oncology patients in palliative care that may help in more comprehensive and real treatment plans, contributing for humanization in this area.

The challenging experience of living daily with an advanced cancer diagnosis directs to understand the human being in a broader context that Palliative Care Cancer advocates. However, the evaluation and treatment of cancer patients are focused on physical questions, highlighting the difficulty in considering the individual in his uniqueness and values. Logotherapy and Viktor Frankl's existential analysis can contribute in this context, by recognizing the specific dimension of the human being, bioethics, in addition to the psychophysical dimensions. The focus is the search for the meaning of life and its importance when facing a life-threatening disease; and being associated with quality of life improvement and reduction of physical/emotional symptoms. The literature needs further analysis of patients' experiences in this confrontation, contributing to a better understanding of their positions and enabling to reorganize the line of care of these patients. Our study aimed to analyze the association between meaning of life, quality of life, anxiety and depression in patients with advanced cancer in palliative care and to contextualize and confront these quantitative data with their experiences of illness described from their own perspective. It was a transversal study of mixed methods with 71 patients analysed with scales to measure the level of meaning of life, quality of life; symptoms of anxiety and depression and functionality. Qualitative data were obtained from 14 patients submitted to an open interview which was recorded and later transcribed, and analyzed in an exploratory way, described according to the phenomenological aspect. All patients were in outpatient follow-up at Clinical Oncology and Palliative Care Services from Hospital of Clinics of Ribeirão Preto Medical School of University of São Paulo. The results demonstrated that patients intentionally turn to live, moving away from the disease condition and the factuality of death; seeking not to fear the future consequences and to be able to focus on what can be accomplished in life. This requires an inner struggle that underpins this stance and, together with life sensitivity, feeds and configures this struggle. These experiences involve some functionality and it was found that it mediated the relationship between cancer treatment and depression reduction, showing the importance of treatment that allows daily activities. Faith in the continuity of life, often inseparable from religious faith, and manifested in various ways in incurable diseases, sustains the hope in this continuity and allows us to consider possibilities of present and near future realization. In this intentional process, there is also a deeper understanding of the reasons/causes why patients are motivated to live. We identified a high sense of life index among patients, being associated with an increased quality of life and decreased in anxiety symptoms, depression and fatigue. The last element that appears and underlies this experience is the intense desire to live and the value of l...