Exploring the Comfort Experience of Adolescents with Metastatic Cancer

Friday, 26 July 2013: 8:50 AM

Riza Mauricio, PhD, RN
Pediatric Critical Care, The Children's Cancer Hospital of the University of Texas M.D. Anderson Cancer Center, Houston, TX
Rodrigo Mejia, MD
Pediatric Intensive Care Services, THe Children's Hospital of the University of Texas MD Anderson Cancer Center, Houston, TX
Lene Symes, PhD, RN
College of Nursing, Texas Woman's University - Nelda C. Stark College of Nursing, Houston, TX
Brenda K. Binder, PhD, RN, PNP
Nelda C. Stark College of Nursing, Texas Woman's University, Houston, TX
Sandra Cesario, PhD, RNC, FAAN
College of Nursing, Texas Woman's University - Houston, Houston, TX

Learning Objective 1: The learner will be able to discuss how descriptive phenomenology was used in this qualitative study.

Learning Objective 2: The learner will be able to describe the significance of comfort in adolescents with metastatic cancer.

Purpose:

Adolescents with cancer are challenged not only by the biophysical and emotional changes of a normally developing person; also pain and distress from their treatment affecting their quality of life. Most of our knowledge about adolescent comfort experience is derived from parent and staff perspectives. Parents cannot speak everything about their children. There is more to know about them being the least investigated age group. This study explored the meaning and significance of comfort experienced by adolescents with metastatic or progressive cancer. 

Methods:

Descriptive phenomenology was used to uncover the comfort experience of adolescents with metastatic or progressive cancer. This qualitative study utilized purposive sampling to recruit patients who were 15-21 years old, undergoing treatment for their disease in a children’s cancer hospital of a large tertiary cancer institution. Kolcaba’s comfort theory was used as the framework of the study. A questionnaire identified the demographics of the participants. Semi-structured interview questionnaire designed by the research team guided the interviews and explored the depth and breadth of the participants’ lived experience.

Results:

Van Manen’s method was used to analyze data from thirteen ethnically diverse middle and late adolescents who mostly had progressive disease. Eight broad themes emerged from their statements. They reported distorted body image, shock from the diagnosis, uncertain future, isolation from friends, help from Higher Being, existential well -being, social support from family, friends, health providers, and the uniquely adolescent environment. Their experiences fit the definition of comfort in Kolcaba’s theory. Comfort improved their wellbeing and helped them cope with the debilitating effects of cancer. 

Conclusion:

Comfort is significant to these adolescents because it gave them hope, motivation, and the will power to live. Healthcare staff should be sensitive for the presence of distressing symptoms and develop a standard of care to address the comfort needs of adolescents.