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. 2010 Jun 9:340:c2581.
doi: 10.1136/bmj.c2581.

Archetypal trajectories of social, psychological, and spiritual wellbeing and distress in family care givers of patients with lung cancer: secondary analysis of serial qualitative interviews

Scott A Murray  1 , Marilyn Kendall, Kirsty Boyd, Liz Grant, Gill Highet, Aziz Sheikh
Affiliations

Archetypal trajectories of social, psychological, and spiritual wellbeing and distress in family care givers of patients with lung cancer: secondary analysis of serial qualitative interviews

Scott A Murray et al. BMJ. .

Abstract

Objective: To assess if family care givers of patients with lung cancer experience the patterns of social, psychological, and spiritual wellbeing and distress typical of the patient, from diagnosis to death.

Design: Secondary analysis of serial qualitative interviews carried out every three months for up to a year or to bereavement.

Setting: South east Scotland.

Participants: 19 patients with lung cancer and their 19 family carers, totalling 88 interviews (42 with patients and 46 with carers).

Results: Carers followed clear patterns of social, psychological, and spiritual wellbeing and distress that mirrored the experiences of those for whom they were caring, with some carers also experiencing deterioration in physical health that impacted on their ability to care. Psychological and spiritual distress were particularly dynamic and commonly experienced. In addition to the "Why us?" response, witnessing suffering triggered personal reflections in carers on the meaning and purpose of life. Certain key time points in the illness tended to be particularly problematic for both carers and patients: at diagnosis, at home after initial treatment, at recurrence, and during the terminal stage.

Conclusions: Family carers witness and share much of the illness experience of the dying patient. The multidimensional experience of distress suffered by patients with lung cancer was reflected in the suffering of their carers in the social, psychological, and spiritual domains, with psychological and spiritual distress being most pronounced. Carers may need to be supported throughout the period of illness not just in the terminal phase and during bereavement, as currently tends to be the case.

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Conflict of interest statement

Competing interests: All authors have completed the unified competing interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare (1) no financial support for the submitted work from anyone other than their employer; (2) no financial relationships with commercial entities that might have an interest in the submitted work; (3) no spouses, partners, or children with relationships with commercial entities that might have an interest in the submitted work; and (4) no non-financial interests that may be relevant to the submitted work.

Figures

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Fig 1 Fluctuations in psychological wellbeing in family carers of patients with lung cancer
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Fig 2 Fluctuations of spiritual wellbeing mapped with other trajectories of physical, social, and psychological wellbeing in family carers of patients with lung cancer
See this image and copyright information in PMC

References

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