Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/31982
Appears in Collections:Faculty of Health Sciences and Sport eTheses
Title: The haemato-oncology patient experience of the process of palliative care in the last year of life: A Constructivist grounded theory study
Author(s): Campbell, Karen Elizabeth
Supervisor(s): Harris, Fiona
Stoddart, Kathleen
Keywords: cancer
qualitative
advanced
incurable
grounded theory
Constructive
experience
Patient
Haemato-oncology
palliative care
Issue Date: Jan-2020
Publisher: University of Stirling
Abstract: Haemato-oncology patients comprise 8.5% of all adult cancers within the UK. Despite advances in treatment, the majority will eventually enter a palliative care phase. Evidence suggests that palliative care arrives too late or not at all for haemato-oncology patients, resulting in suboptimal care and many patients dying in hospital. Various reasons have been cited that affect the integration of palliative care services. However, to date, there have been no studies about the patient’s perspective of the process of palliative care in the last year of life. Using Constructivist grounded theory, 21 semi-structured patient interviews were conducted from two health boards. Constant comparative analysis was used to drive the collection and analysis of data. The substantive theory of ‘Suspended and silent status passage: The incurable haemato-oncology illness trajectory’ was generated from the two core categories ‘facing death’ and ‘talking about death’. This substantive theory describes the length of time, which is suspended, that haemato-oncology patients have to face death where, overtime, there is less opportunity to discuss dying and future care needs as they are silenced. This is a new conceptualisation regarding the last year of life, for this patient group. The findings have substantial implications for practice as they reconceptualise the incurable pathway as a ‘status passage’, with the inevitable outcome being death rather than the possibility of cure. As personalised care is central to the UK’s health and social care integration agenda, it is a timely piece of work, illustrating that individuals diagnosed with an incurable haemato-oncology disease should be offered a holistic needs assessment which incorporates elements of palliative care and long-term remission. The findings also illustrate that palliative care service provision should be based upon critical episodes of care in combination with longer term follow up, allowing more flexibility and a responsive process of palliative care.
Type: Thesis or Dissertation
URI: http://hdl.handle.net/1893/31982

Files in This Item:
File Description SizeFormat 
kcampbell_ Thesis.pdf2.99 MBAdobe PDFUnder Embargo until 2023-12-01    Request a copy

Note: If any of the files in this item are currently embargoed, you can request a copy directly from the author by clicking the padlock icon above. However, this facility is dependent on the depositor still being contactable at their original email address.



This item is protected by original copyright



Items in the Repository are protected by copyright, with all rights reserved, unless otherwise indicated.

If you believe that any material held in STORRE infringes copyright, please contact library@stir.ac.uk providing details and we will remove the Work from public display in STORRE and investigate your claim.