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  • br I think it would

    2020-08-24


    I think it 丝裂霉素C would be hard to say such things [bad prognosis]to a person, like one year .. .// He (the doctor) cannot be sure . and it would be hard to say it. Don’t you think so too? Would you like to say to someonedWell you might make it another year([but you probably won’t) .. .’’?
    A seventy-eight-year-old woman with metastases since 15 years, on her sixth line of palliative oncologic treatment.
    Hope
    The women explained that both patient-doctor communication about treatment and patient-family interaction were sources of hope. With ongoing treat-ment, they explained their hope grew stronger, espe-cially when they were able to take part in everyday life and talk about other things than the disease with
    family and friends. Maintained relations and life in itself were important sources of meaning.
    Patient-Doctor Communication. Patients said that infor-mation reassuring continuous treatment was essential for their feeling of hope, whereas withheld treatment was associated with thoughts of death.
    When the patients had raised questions about their impending death, they expressed they were relieved when the doctor dismissed it, as such responses fostered hope and meaning. When life was no longer a self-evident fact, it was valued so much more.
    I once said: Well I’d better go home and tidy up then before death. Then he (the doctor) said: Oh no, I will not listen to such nonsense.
    A seventy-seven-year-old woman with metastases since three years, on her third line of palliative chemotherapy.
    Patient-Family Interaction. The women expressed that family and friends were highly appreciated support but mainly served as a much needed distraction from the disease, not as partners to discuss treatment options and fear of death with. In a broad sense, however, close relationships were increasingly important: reciprocal affection, love, support, and consideration were narrated as important sources of meaning in their exposed situation.
    They also told how their friends and family put great faith in the treatment and expected them to continue with treatment to keep death at a distance. The women gave many examples of situations when they had refrained from telling family members about how they really felt, to protect their loved ones from worries.
    So I saiddBut you know I have to do this?dYes, answered my 10-year-old son, because if you don’t get your treatment you will die.’’
    A forty-four-year-old woman with metastases since four years, on her fifth line of palliative chemotherapy.
    No I have not([discussed treatment with family members). They take Variegation for granted that I will continue with anticancer therapy. What will happen if I don’t?’’
    A seventy-seven-year-old woman with metastases since three years, on her third line of palliative chemotherapy.
    The Doctor
    The Expert. The patients expressed that they put their faith and hope to the expertise, the doctor. They did not want the responsibility themselves to decide what to do next. All the women said they trusted their doc-tors and wanted him or her to decide about treatment, 
    as the doctor was the ‘‘expert.’’ They outlined they wanted the doctor to take care of their cancer, while they wished to focus on their everyday life themselves.
    If my doctor suggests a treatment, then I trust her.
    She is the expert and takes care of my disease, while
    I take care of my well-being.
    A fifty-year-old woman with metastases since nine years, on her eighth line of palliative chemo-therapy and antibody therapy.
    The women did not want to disappoint their doctor, and if he or she recommended new treatment, the women expressed they felt it was their mission to endure the side effects, because the doctors were the experts. Some women said they had begun to fear they would not be able to cope with more treatments as they felt so tired all the time. But when they had mentioned this to their doctors, they had been reas-sured that they were fine and treatment could continue.
    I have asked (the doctors), lots of timesdHow much treatment can the body manage? And the answer I got is thatdThe body can cope much longer than you think!
    A sixty-three-year-old woman with metastases since four years, on her second line of palliative chemotherapy.
    Positive Characteristics. The women described a good doctor as one who delivered good news and left you still able to hope for a future. They said a good doctor paid attention to them and knew what to do next. The majority said they looked for positive things in their patient-doctor communication. If there were bad news delivered, the women said they tried to focus on something positive to talk about with the doctor or with family members after the consultation. The in-formants said they appreciated the doctor to be honest, but in the next sentence, they would state that they wished for honesty within positive limits, as they did not want bad news.