Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Meanings and Aspects of Quality of Life for Cancer Patients: A Descriptive Exploratory Qualitative Study

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Meanings and Aspects of Quality of Life for Cancer Patients: A Descriptive Exploratory Qualitative Study

Article excerpt

Reviewing the oncological literature, particularly in the last two decades, indicates that investigators have been paying attention to quality of life (QoL). A range of QoL trials can be accessed involving various types of cancer, such as prostate (Galalae et al., 2004; Gall, 2004) lung (Bottomley, Efficace, Thomas, Vanvoorden, & Ahmedzai, 2003) gastrointestinal (Cense et al., 2004; de Liano et al., 2003) breast (Bardwell et al., 2004; Bloom, Stewart, Chang, & Banks, 2004; Bottomley, Therasse, Piccart, & Efficace, 2005) and colorectal (Efficace, Bottomley, Vanvoorden, & Blazeby, 2004; Guren et al., 2003). This research indicates that QoL is an important consideration when delivering care to cancer patients.

In regard to QoL research in a clinical area like oncology, there is no universally accepted definition of QoL and its definition is still under debate (Bottomley, 2002; Fayers & Machin, 2000; Hendry & McVittie, 2004; King et al., 1997). There are several reasons why there is a lack of consensus about the definition of QoL. Firstly, this concept has a highly individual nature that is closely related to an individual's personal values (Anderson & Burckhardt, 1999; Carr, Gibson, & Robinson, 2001; Holmes & Dickerson, 2003). A concept that is highly individual will inevitably make it difficult to offer a definition acceptable to all, because it constitutes issues that differ in how they are experienced by a broad range of people.

Secondly, the definition of QoL is often related to the perspective or culture from which an individual belongs. For example, many philosophers emphasise that QoL is related to personal happiness (Holmes, 1989). Chinese philosophers believe that QoL can only be achieved if there is a balance between Yin and Yang (Zhan, 1992). Therefore, different cultures have different approaches to defining QoL.

As with QoL definitions, disagreements exist as to exactly what aspects contribute to an individual's QoL. This is not surprising, because the aspects are closely related to the way QoL is defined. Generally speaking, there is not a general consensus about the range of aspects that underlie QoL (Draper, 1992; Ferrans & Powers, 1985; Schumacher, Olschewski, & Schulgen, 1991). In the past, the main QoL domain that has been measured was the physical domain. However, most experts would agree that QoL consists of, at the very least, the physical, psychological and social domains (Boling, Fouladi, & Basen-Engquist, 2003; Cox, 2003; Tallis, 2005). Additional domains have also been identifi ed including functional (Brunelli et al., 1998; Cella, Chang, Lai, & Webster, 2002; Fallowfield, 2002; Wilson, Dowling, Abdolell, & Tannock, 2000), emotional (Cella et al., 2002; Fallowfield, 2002; Movsas, 2003; Schumacher et al., 1991) and spiritual (Bonomi, Patrick, Bushnell, & Martin, 2000; Ferrell, Dow, & Grant, 1995; King et al., 1997).

In Australian populations, the meanings and aspects of QoL for cancer patients, as explored from the perspective of nurses, is scant. Nurses are in a close relationship with their cancer patients and also with their patients' situations. What meaning patients attribute to their QoL might be identified more clearly through nurses' eyes and perspectives than those of other practitioners. Due to the 'culturally-bound' nature of QoL, it is not appropriate to extrapolate the meanings and aspects of QoL for cancer patients from other cultures, countries or other patient populations to an Australian context. Therefore, this qualitative research study was conducted in an Australian setting to explore in-depth meanings and aspects of QoL for cancer patients as expressed by the nurses caring for them.

METHOD

This descriptive exploratory qualitative research study was based on the principles of a grounded theory. This is a more recent research method which emerged in nursing (Annells, 2007). Annells (2003) suggested that researchers might use some aspects of grounded theory, like coding up to a conceptual ordering level to obtain a basic understanding of a research area. …

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