Consideration of sense of coherence in a structured communication approach with stage IV lung cancer patients and their
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ORIGINAL ARTICLE
Consideration of sense of coherence in a structured communication approach with stage IV lung cancer patients and their informal caregivers: a qualitative interview study Katja Krug 1 & Jasmin Bossert 1,2 & Lydia Stooß 1 & Anja Siegle 2 & Matthias Villalobos 2 & Laura Hagelskamp 2 & Corinna Jung 2,3 & Michael Thomas 2 & Michel Wensing 1 Received: 27 May 2020 / Accepted: 26 August 2020 # The Author(s) 2020
Abstract Objective Salutogenetic aspects are valuable for consideration in patient-centred care of advanced oncological diseases with a limited life expectancy. The Milestone Communication Approach (MCA), involving physician-nurse tandems, addresses specific challenges and needs over the disease trajectory of patients with stage IV lung cancer and their informal caregivers. This study aims to explore patients’ and informal caregivers’ salutogenetic experiences with the MCA concept. Methods This qualitative study used face-to-face semi-structured interviews with patients and informal caregivers. All generated data were audio-recorded, pseudonymised and transcribed verbatim. Data were structured using Qualitative Content Analysis. The material was coded deductively into themes related to the components of sense of coherence (Aaron Antonovsky) and emerging sub-themes. All data was managed and organised in MAXQDA. Results In 25 interviews, sense of coherence was referred to with all three components: “Comprehensibility” was supported by information conveyed suitably for the patients; “meaningfulness” was addressed as accepting the situation; and “manageability” led to advance care planning the patients were comfortable with. Patients and informal caregivers experienced the interprofessional tandem as an added value for patient care. Conclusions Participants appreciate the MCA in its support for coping with a life-limiting disease. Considering salutogenetic aspects facilitates prognostic awareness and advance care planning. Nevertheless, individual needs of patients and informal caregivers require an individualised application of the MCA. Keywords Communication . Lung neoplasms . Oncology . Palliative care . Patient participation . Sense of coherence
Background The diagnosis of cancer is potentially life-threatening for those affected. Improvement in treatment options and survival rates Katja Krug and Jasmin Bossert contributed equally to this work. * Katja Krug [email protected] 1
Department of General Practice and Health Services Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
2
Thoraxklinik Heidelberg, Department of Thoracic Oncology, Heidelberg University Hospital, Röntgenstraße 1, 69126 Heidelberg, Germany
3
Medical School Berlin, Calandrellistr. 1-9, 12247 Berlin, Germany
affects only subgroups of patients; still, the vast majority suffer from a high psychological burden, which can lead to reduced quality of life and distress. Anxious thoughts about the course of the disease are among the stress-related symptoms experienced by
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