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Current Status and Influencing Factors of Death Preparedness in Advanced Cancer Patients Based on the PRECEDE‐PROCEED Model: A Cross‐Sectional Study

ABSTRACT

Background

Death preparedness is an important prerequisite for improving the quality of life and the quality of death in advanced cancer patients. However, research on the level of death preparedness in patients is insufficient, and there is little understanding of the current status and influencing factors of death preparedness in advanced cancer patients.

Aim

This study aims to assess the current status of death preparedness and its influencing factors in advanced cancer patients.

Methods

Based on the PRECEDE-PROCEED model, a structured survey questionnaire was designed to collect data on personal factors (such as gender, age and residence area), interpersonal factors (such as social support, caregiver readiness and healthcare worker readiness) and social factors (such as care resources, policy support and information supply). Through multiple linear regression and BP neural network analysis, the study explores the impact and significance of these influencing factors on death preparedness in advanced cancer patients.

Results

A total of 930 valid questionnaires were collected in this study. The death preparedness score in advanced cancer patients was 72.18 ± 22.82, indicating a moderate level, with the highest score being the ‘reflexive care’ dimension and the lowest score being the ‘hospice programme’ dimension. Multivariate analysis revealed that meaning in life and social support were the most significant predictors of death preparedness in advanced cancer patients. In addition, personal factors such as dignity, household income and coping style, also played an important role. Interpersonal factors like social support, as well as social factors such as care resources and policy support, also had an impact on patients' death preparedness to some extent.

Conclusion

Death preparedness in advanced cancer patients is generally at a moderate level, and death preparedness is influenced by a combination of personal factors, interpersonal factors and social factors.

Impact

This study is based on the PRECEDE-PROCEED model to comprehensively explore the influencing factors of death preparedness in advanced cancer patients. It provides theoretical support for improving life services for advanced cancer patients. It offers valuable practical experience and insights for societal attention and reform in end-of-life care.

Patient or Public Contribution

No Patient or Public Contributions were included in this paper.

The Experience of Reflexive Hospice Care for Patients With Advanced Cancer: A Qualitative Study

ABSTRACT

Background

Hospice care for patients with advanced cancer mainly takes the family members and healthcare professionals as the main body and the patients as the object. There is a lack of relevant research on reflexive hospice care that considers patients as subjects.

Aim

To explore the experience of reflexive hospice care for patients with advanced cancer.

Design

An empirical phenomenological approach to research was conducted.

Methods

Data were collected using face-to-face semi-structured interviews between April 3, 2024 and May 27, 2024 in the oncology wards of two comprehensive hospitals. Purposive sampling was used to recruit 18 patients with advanced cancer receiving hospice care. Colaizzi's phenomenological analysis method was used to analyse the data. We followed the consolidated criteria for reporting qualitative research (COREQ).

Results

Four themes were identified as being relevant to the experience of reflexive hospice care for patients with advanced cancer: the absence of prior awareness, reconciling with self and others, care and concern for others, and pursuing the meaning of life.

Conclusion

This study provides new insights into hospice care for patients with advanced cancer. It emphasises the importance of patients' participation as subjects in hospice care. In reflexive hospice care, patients can actively participate and express their care for others and their understanding of life, thus gaining more respect and care in the end-of-life stage. Therefore, placing patients as the subjects of hospice care and fully respecting and listening to their wishes and needs is one of the most important ways to promote the development of hospice care quality.

Patient or Public Contribution

No patient or public contribution.

Infertility psychological distress in women undergoing assisted reproductive treatment: A grounded theory study

Abstract

Background

While there exists an ample body of research in international contexts focused on the characterization and quantification of infertility psychological distress, the level of scholarly scrutiny directed towards this phenomenon within the context of China remains scant.

Aims and Objectives

To investigate the formation and developmental processes of psychological distress associated with infertility and infertility treatment among women within the Chinese cultural context and to construct a theoretical framework that elucidates this phenomenon.

Design

Qualitative approach with grounded theory methodology.

Methods

This study was conducted within the reproductive medicine department of a tertiary-level hospital located in central China from May to August 2023. Twenty-seven women who experienced infertility and underwent assisted reproductive treatment (ART) were interviewed. The interview sessions spanned durations ranging from 20 min to 1 h and 35 min. Data analysis included open coding, axial coding and selective coding. The study is reported using the COREQ checklist.

Results

The infertility psychological distress experienced by women undergoing ART is a socially constructed phenomenon influenced by a dynamic interplay of forces that construct and conciliate it. The formation and progression of infertility psychological distress are rooted in the process of self-construction. A Middle-Ranged Theory titled ‘self-reconstruction under the dome of infertility and infertility treatment’ (SUDIT theory) was developed to explain this phenomenon. Within this framework, infertility psychological distress manifests across three distinct phases under the gambling of the constructive force and conciliative force: (1) distress of disrupting the former self; (2) distress linked to the struggling present self; and (3) the renewed-self harmonized with distress.

Conclusions

It is imperative for healthcare professionals and policymakers to acknowledge the socially constructed nature of infertility psychological distress, and proactively implement measures aimed at ameliorating it.

Patient or Public Contribution

No patient or public contribution.

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