Gratitude among advanced cancer patients and their caregivers: The role of early palliative care

Abstract

ObjectiveA cancer diagnosis represents a unique trauma, given its life-threatening, multidimensional, and uncertain nature. Gratitude is a construct representing the emotional state that arises when individuals recognize that a benefit has been received as a result of someone else’s action or a spiritual entity’s intervention. Based on the positive psychological wellbeing, gratitude has been associated with improved health outcomes even in the disease setting. Thus, the models of care that foster gratitude should be adopted in the clinical context. This study aims to explore whether and how gratitude may originate in patients with advanced cancer and their caregivers undergoing early palliative care (EPC).MethodsWe analyzed 251 reports from 133 patients and 118 caregivers describing their clinical experience in two EPC units. The sources of gratitude were identified and ranked based on their frequencies. Words expressing gratitude and words referring to communication and spirituality were collected by means of the Linguistic Inquiry and Word Count software and correlated.ResultsIn total, 123 (92.5%) of 133 patients’ and 97 (82.2%) of 118 caregivers’ reports, respectively, included explicit or implicit expressions of gratitude. Gratitude was associated specifically with successful physical symptom management, emotional support, improved attitude toward death, better information, humanity, and the familiar environment. The use of words of gratitude in patients’ reports was positively correlated with the use of words referring to communication (r = .215, p = .026) and spirituality (r = .612, p <.001).ConclusionOur results suggest that interventions within the EPC model based on doctor–patient–caregiver communication may allow patients and caregivers to experience a feeling of gratitude, and this may represent a resource to be exploited to improve their physical and psychosocial wellbeing.

What do cancer patients experience of the simultaneous care clinic? Results of a cross‐sectional study on patient care satisfaction

“…Feedback from patients proved the model put in place to be effective in helping them shape their treatment journey and decision at the end of life. It also highlighted areas where we could have been even more effective in improving our ability to listen and communicate 39 . We can conclude that SCOC has achieved its goal of offering holistic support to advanced cancer patients and family members.…”

Early palliative care for solid and blood cancer patients and caregivers: Quantitative and qualitative results of a long-term experience as a case of value-based medicine

“…At the time of the enrollment, patients had a life expectancy of more than 6 months and were not on interim evaluations to be referred to hospice or home care. The relevance of these studies is explained by the fact that the way patients and caregivers perceive hope and death, as well as the positive emotions arising, although unsolicited, after the EPC intervention, can make a huge difference on their QOL and quality of death and dying; moreover, there is a substantial lack of studies exploring these dimensions qualitatively and based on patients' and caregivers' perceptions ( 26 , 39 ).…”

“…In the third study, the hypothesis that a feeling of gratitude might be commonly encountered among cancer patients and their caregivers on EPC was explored ( 39 ). Reports from 251 patients with advanced cancer on EPC ( N = 133; 73 males, 60 female) and their caregivers ( N = 118; 39 males, 77 females) describing their clinical experience with the EPC model were analyzed through a content analysis and a quantitative text analysis program, to identify and rank the sources of gratitude and to quantify the use of words associated to categories of interest (i.e., gratitude, communication, spirituality), respectively.…”

The Importance of Being Early

“…Several trials have been conducted in order to understand the optimal intervention time for palliative care specialist, however, unequivocal results have not always been achieved [7][8][9][10]. Generally, EPC timing is suggested by symptoms reported, however, it would be desirable to identify signs and blood chemistry [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] to direct to the EPC schedule.…”

“…During patient's care pathway, intervention of a multidisciplinary palliative care team lightens the symptomatology due to cancer from the early onset of symptoms [12], especially if palliative care is required without waiting for appearance of severe symptoms [14]. Early multimodal intervention for cancer anorexia/cachexia syndrome is one of the clearest paradigms of the EPC [30].…”