CN90 - “To get through to survive”: Exploring the symptom cluster management process during oncological treatment from the perspective of patients with lung cancer

Background

Despite advances in oncological treatments, patients with lung cancer continue to experience symptom clusters that negatively affect their daily lives. It is essential to understand how patients manage symptom clusters to find areas where healthcare professionals may provide adequate support. Symptom cluster management is a complex dynamic process involving the patient, healthcare professionals, friends, and family members. Nursing care including interventions and the patients’ self-care are key elements in the symptom cluster management process, to alleviate or prevent symptoms and thereby improve health-related outcomes.

Methods

Constructivist grounded theory was used to collect and analyze rich data from 15 patients with lung cancer during curative oncological treatment via individual interviews and a two-dimensional symptom assessment scale.

Results

A situational theoretical model was constructed from the patients’ narratives, describing their symptom cluster experience and management strategies. It illustrates the main category ‘To get through to survive’, with related categories concerning the patients’ management strategies, and also describing the outcome in their daily life. Impacting conditions originating in the context of the patients’ situation were found to be interrelated and of importance to the symptom cluster management process. During the cancer care trajectory, symptom clusters would change, and the patients’ strategies would alter along the way, as they gained knowledge and experience, received support or not, and attached different meanings to their symptoms.

Conclusions

Patients with lung cancer often feel left to their own device to deal with symptom clusters, and are hesitant when it comes to evaluating the seriousness of certain symptoms. Symptoms are regarded as normal and to be expected, and patients do not ask for support, or support is not being offered to them. Healthcare professionals should consider the peril of normalizing symptoms and the patients’ altered time perspective that derives from the approach of living one day at a time, in further development of person-centered care for this population.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Karlstad University, Karlstad, Sweden.

Funding

The County Council of Värmland, Sweden.

Disclosure

All authors have declared no conflicts of interest.