Drake Emily K, Weeks Lori E, Taylor Dani, Ricci Ian, Curran Janet, van Manen Michael
Faculty of Health, Dalhousie University, Halifax, NS, Canada.
School of Nursing, Dalhousie University, Halifax, NS, Canada.
Qual Health Res. 2025 Mar 28:10497323251325471. doi: 10.1177/10497323251325471.
What is it like for young adults living with metastatic/advanced cancers to engage in conversations about palliative care with healthcare providers? Often, young people are not introduced to palliative care. Instead, healthcare providers may assume that they are already well-supported, that their symptoms are aptly managed, or that introducing palliative care will somehow spoil any remaining hope they live with. While some of the benefits of palliative care have been explored in the literature, the experiences of young people living with metastatic/advanced cancers as they are introduced to these conversations have largely been ignored. Drawing on interviews with young adults, the aim of this study was to gain insights into these experiences. From their reflections, we may understand these conversations as an experience of an opening for talk, conversations as an experience of need and relief, and conversations as an experience of reflection. Having a discussion about palliative care may serve as a conversational opening not only to discuss additional support, but also to explore that which is meaningful for them as they live with serious illnesses. We may appreciate at the heart of these conversations are physical, relational, and existential needs that may be relieved by palliation. Significantly, these conversations afford personal reflections and frank discussions of dying and death. In this way, a phenomenological understanding of palliative care conversations provides healthcare providers with reflective insights and practical considerations for approaching these important conversations with young people, recognizing that the conversations themselves may be deeply personal and decidedly individual.
对于患有转移性/晚期癌症的年轻人来说,与医疗服务提供者谈论姑息治疗是怎样的体验呢?通常情况下,年轻人并没有接触过姑息治疗。相反,医疗服务提供者可能会认为他们已经得到了充分的支持,他们的症状得到了妥善处理,或者认为引入姑息治疗会在某种程度上破坏他们所剩的希望。虽然文献中已经探讨了姑息治疗的一些益处,但患有转移性/晚期癌症的年轻人在参与这些谈话时的经历在很大程度上被忽视了。基于对年轻人的访谈,本研究的目的是深入了解这些经历。从他们的反思中,我们可以将这些谈话理解为一种开启谈话的体验、一种需求与解脱的体验以及一种反思的体验。谈论姑息治疗不仅可以作为一个谈话的开端,用以讨论额外的支持,还可以探索在他们身患重病时对他们有意义的事情。我们可以认识到,这些谈话的核心是身体、人际关系和存在方面的需求,而姑息治疗可以缓解这些需求。值得注意的是,这些谈话提供了对死亡和临终的个人反思和坦诚讨论。通过这种方式,对姑息治疗谈话的现象学理解为医疗服务提供者提供了反思性的见解以及与年轻人进行这些重要谈话的实际考量,要认识到这些谈话本身可能非常个人化且因人而异。