Cheng Svea, Lazris David, Bartel Christianna, Durica Krina C, Chen Leeann, Fedor Jennifer, Low Carissa A
University of Pittsburgh, Pittsburgh, PA, USA.
Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Support Care Cancer. 2025 Apr 5;33(4):352. doi: 10.1007/s00520-025-09397-7.
More people are living longer with stage IV cancer due to advances in cancer treatments. However, individuals living with advanced cancer must navigate unique day-to-day challenges and experiences that may be incompletely understood by their health care team. This study aims to better understand the activities, decisions, and experiences that characterize a "good day" versus a "bad day" for individuals living with advanced cancer.
Twenty participants with stage IV cancer completed semi-structured interviews which involved rating the quality of their day as well as characterizing their experiences and activities during the day. Participants were also asked to describe a theoretical "very good day" versus a "very bad day" for them personally, as well as advice they would give to another patient with advanced cancer about how to make a day better. Thematic analysis was used to analyze interview transcripts and identify common themes across participants.
Interviews revealed that "good days" were associated with feeling like oneself before cancer, bringing oneself to engage in activities that bring wellness and joy, feeling connected to others, feeling accomplished, and practicing positive thought patterns. On the other hand, loss of control, uncertainty/unpredictability, disruptive physical symptoms, negative experiences with health care, and inability to reach one's goals were common on "bad days."
This qualitative study highlighted common themes in what defines good and bad days living with stage IV cancer. Understanding individual values and priorities may help care teams support people with advanced cancer to optimize their quality of life and functioning and navigate treatment decisions.
由于癌症治疗的进展，越来越多的IV期癌症患者寿命延长。然而，晚期癌症患者必须应对独特的日常挑战和经历，而他们的医疗团队可能对此并未完全理解。本研究旨在更好地了解晚期癌症患者“好日子”与“坏日子”的活动、决策和经历特征。
20名IV期癌症患者完成了半结构化访谈，其中包括对当天的质量进行评分，以及描述当天的经历和活动。参与者还被要求描述对他们个人来说理论上的“非常好的一天”与“非常坏的一天”，以及他们会给另一位晚期癌症患者关于如何让一天变得更好的建议。采用主题分析法分析访谈记录，并确定参与者之间的共同主题。
访谈显示，“好日子”与患病前的自我感觉、让自己参与带来健康和快乐的活动、感觉与他人有联系、感觉有成就感以及践行积极的思维模式有关。另一方面，失去控制、不确定性/不可预测性、破坏性的身体症状、与医疗保健的负面经历以及无法实现目标在“坏日子”里很常见。
这项定性研究突出了IV期癌症患者定义好日子和坏日子的共同主题。了解个人价值观和优先事项可能有助于护理团队支持晚期癌症患者优化他们的生活质量和功能，并做出治疗决策。
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