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Poster Display session

471P - “A lot happens after best supportive care”: Unbottling the counter transference of health-related suffering in a community cancer palliative care setting – A case study method

Date

07 Dec 2024

Session

Poster Display session

Presenters

Vidya Viswanath

Citation

Annals of Oncology (2024) 35 (suppl_4): S1575-S1579. 10.1016/annonc/annonc1693

Authors

V. Viswanath1, V.P. Ravuru1, S. Ketireddi1, A. Karim1, M. Priyanshu2, A. Khan1, S.K. Duvvada1, B. Geddam1, C.R. Samanasi1, S. Shit1, D. Fernandes3, R. Miriyala4

Author affiliations

  • 1 Palliative Medicine, Homi Bhabha Cancer Hospital and Research Center, 530053 - Visakhapatnam/IN
  • 2 Department Of Palliative Medicine, Homi Bhabha Cancer Hospital and Research Center, 530053 - Visakhapatnam/IN
  • 3 Preventive Oncology, Homi Bhabha Cancer Hospital and Research Center, 530053 - Visakhapatnam/IN
  • 4 Radiotherapy Department, Homi Bhabha Cancer Hospital and Research Center Visakhapatnam, 530053 - Visakhapatnam/IN

Resources

This content is available to ESMO members and event participants.

Abstract 471P

Background

A downcast nurse and a doodle depicting the abandonment of a patient with cervical cancer, from her own home, set the background for this case study. This study aimed to explore experiences of the palliative care team caring for patients with cervical cancer at home.

Methods

This case study used multiple sources of data like four sketches with captions depicting patients with cervical cancer at home drawn by the doctor and its interpretation by the team; reflective journalling notes of multiprofessional palliative care team and the focus group interview with a semi structured questionnaire. The interview was video recorded and transcribed. After data familiarization, codes were generated from the transcript and journalling notes. Sub themes and themes were derived. The data was also examined by another researcher, analyzed and then discussed.

Results

Four themes were generated. The first theme described the dejection felt by the team members as they witnessed patients stoically surviving with disfigurement, stigma, uncertainty and often, neglect. These haunting memories lingered and caused frustration and helplessness among the team members who wondered if they were doing enough. The second theme dealt with the deliberations as they navigated from self-doubt. They yearned for more innovations in palliative care but felt grateful for the grounding that home visits gave them. The realization that home care is an invaluable experience as it went beyond the routinization of symptoms was the third theme. The reflection that “Every struggle is unique” came through the sketches, drawn from memories. This fourth theme discussed how art could help in training, learning and catharsis.

Conclusions

The results of our study resonate with the Dual process model of Grief. The Loss oriented response was visible in the sadness, angst and self-doubt the team felt as they witnessed suffering in patient’s homes. This then moved towards the Restoration oriented response where they felt gratitude and acknowledged the value of caring for the person at home. This was why they worked; they concurred. Art was the ice breaker in enabling this reflection.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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