Healthcare professionals’ perceptions of existential distress in patients with advanced cancer
Abstract
mok e., lau k‐p., lam w‐m., chan l‐n., ng j.s.c. & chan k‐s. (2010) Healthcare professionals’ perceptions of existential distress in patients with advanced cancer. Journal of Advanced Nursing 66(7), 1510–1522. Title. Healthcare professionals' perceptions of existential distress in patients with advanced cancer. Aim. This paper is a report of an exploration of the phenomenon of existential distress in patients with advanced cancer from the perspectives of healthcare professionals. Background. Existential distress is an important concern in patients with advanced cancer; it affects their well‐being and needs to be addressed in the provision of holistic care. Method. Focus groups were conducted from November 2008 to February 2009 with physicians, nurses, social workers, occupational therapists, physiotherapists, and chaplains working in a palliative care unit that served patients with advanced cancer in Hong Kong. Data collection and analysis were guided by the grounded theory approach. All categories were saturated when five focus groups had been held with a total number of 23 participants. Findings. We found three causal conditions of existential distress: anticipation of a negative future, failure to engage in meaningful activities and relationships, and having regrets. Three basic (caring, relating and knowing) and six specific (positive feedback, religious support, new experiences, task setting, exploring alternatives and relationship reconciliation) intervening strategies were identified. Whether the intervening strategies would be effective would depend on patients’ openness and readiness; healthcare professionals’ self‐awareness, hopefulness, and interest in knowing the patients; and a trusting relationship between patients and healthcare professionals. A sense of peace in patients was considered a consequence of successful interventions. Conclusion. This paper acknowledges the lack of an accepted conceptual framework of existential distress in patients with advanced cancer. It is based on healthcare professionals’ views, and further studies from the perspectives of patients and their families are needed.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Some people with advanced progressive illness find it hard to engage in meaningful activities and relationships, may lose hope, and experience anticipatory grief.
“Some people find it hard to engage in meaningful activities and relationships, may lose hope, and experience anticipatory grief .6,7”
Cites
Basics of Qualitative Research
Ozanne, J. L., Strauss, A., & Corbin, J. M. (1992) · Journal of Marketing Research · doi:10.2307/3172751 · Cited by 17,852 · see citing works
Constructing Grounded Theory. A Practical Guide Through Qualitative Analysis
Boyle, C., & Barker, A. (2006) · QMiP Bulletin · doi:10.53841/bpsqmip.2006.1.2.36 · Cited by 11,842 · see citing works
(1990) · Cited by 11,110 · see citing works
Qualitative Communication Research Methods
Lindlof, T. R., & Taylor, B. C. (1994) · Cited by 5,366 · see citing works
Qualitative data analysis: A sourcebook of new methods
Dijkstra, L. (1985) · European Journal of Operational Research · doi:10.1016/0377-2217(85)90239-5 · Cited by 2,913 · see citing works
THE NATURE OF SUFFERING AND THE GOALS OF MEDICINE
Cassel, E. J. (1982) · New England Journal of Medicine · doi:10.1056/nejm198203183061104 · Cited by 2,149 · see citing works
Sepulveda, C. R., Marlin, A., Yoshida, T., & Ullrich, A. (2002) · Journal of Pain and Symptom Management · doi:10.1016/s0885-3924(02)00440-2 · Cited by 1,295 · see citing works
Focus group interviews as a data collecting strategy
McLafferty, I. (2004) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2004.03186.x · Cited by 798 · see citing works
Demoralization Syndrome — a Relevant Psychiatric Diagnosis for Palliative Care
Kissane, D. W., Clarke, D. M., & Street, A. F. (2001) · Journal of Palliative Care · doi:10.1177/082585970101700103 · Cited by 624 · see citing works
Demoralization: its phenomenology and importance
Clarke, D. M., & Kissane, D. W. (2002) · Australian & New Zealand Journal of Psychiatry · doi:10.1046/j.1440-1614.2002.01086.x · Cited by 590 · see citing works
Using focus groups to facilitate culturally anchored research
Hughes, D. L., & Dumont, K. A. (1993) · American Journal of Community Psychology · doi:10.1007/bf00942247 · Cited by 433 · see citing works
Overview of Focus Group Research
Asbury, J.-E. (1995) · Qualitative Health Research · doi:10.1177/104973239500500402 · Cited by 399 · see citing works
Lin, H., & Bauer‐Wu, S. (2003) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.2003.02768.x · Cited by 383 · see citing works
Treatment of existential distress in life threatening illness: A review of manualized interventions
LeMay, K., & Wilson, K. G. (2008) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.07.013 · Cited by 280 · see citing works
Suffering in the Advanced Cancer Patient: A Definition and Taxonomy
Cherny, N. I., Coyle, N., & Foley, K. M. (1994) · Journal of Palliative Care · doi:10.1177/082585979401000211 · Cited by 234 · see citing works
Henoch, I., & Danielson, E. (2009) · Psycho-Oncology · doi:10.1002/pon.1424 · Cited by 217 · see citing works
Spiritual Pain among Patients with Advanced Cancer in Palliative Care
Mako, C., Galek, K., & Poppito, S. R. (2006) · Journal of Palliative Medicine · doi:10.1089/jpm.2006.9.1106 · Cited by 182 · see citing works
Twinn, S. F. (1998) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.1998.00708.x · Cited by 178 · see citing works
Hope and quality of life, two central issues for cancer patients: a theoretical analysis
en, T. R. (1995) · Cancer Nursing · doi:10.1097/00002820-199510000-00004 · Cited by 148 · see citing works
Existential pain—an entity, a provocation, or a challenge?
Strang, P. M., Strang, S., Hultborn, R., & Arnér, S. (2004) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2003.07.003 · Cited by 122 · see citing works
A place of healing : working with suffering in living and dying
Kearney, M. (2000) · Oxford University Press eBooks · Cited by 116 · see citing works
Saunders, D. C. (1988) · Journal of Palliative Care · doi:10.1177/082585978800400306 · Cited by 116 · see citing works
Nurses' perspectives on the meaning of hope in patients with cancer: a qualitative study.
Owen, D. C. (1989) · PubMed · Cited by 110 · see citing works
Gottlieb, L. N., & Rowat, K. (1987) · Advances in Nursing Science · doi:10.1097/00012272-198707000-00008 · Cited by 105 · see citing works
Murata, H. (2003) · Palliative & Supportive Care · doi:10.1017/s1478951503030086 · Cited by 83 · see citing works
Murata, H., & Morita, T. (2006) · Palliative & Supportive Care · doi:10.1017/s1478951506060354 · Cited by 72 · see citing works
Yelland, J. S., & Gifford, S. M. (1995) · Australian Journal of Public Health · doi:10.1111/j.1753-6405.1995.tb00440.x · Cited by 58 · see citing works
Analysing data using grounded theory
Wainwright, S. P. (1994) · Nurse Researcher · doi:10.7748/nr.1.3.43.s6 · Cited by 23 · see citing works
AIDS: Home, Ambulatory, and Palliative Care
Mansell, P. W. A. (1988) · Journal of Palliative Care · doi:10.1177/082585978800400408 · Cited by 23 · see citing works
Analysing data using grounded theory
Wainwright, S. R. (1994) · Nurse Researcher · doi:10.7748/nr1994.04.1.3.43.c6296 · Cited by 13 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Conceptual analysis of suffering in cancer: a systematic review
Best, M. C., Aldridge, L. J., Butow, P. N., Olver, I., & Webster, F. (2015) · Psycho-Oncology · doi:10.1002/pon.3795 · Cited by 92 · see citing works
Hunt, P., Denieffe, S., & Gooney, M. (2019) · European Journal of Cancer Care · doi:10.1111/ecc.13124 · Cited by 77 · see citing works
Encountering existential loneliness among older people: perspectives of health care professionals
Sundström, M., Edberg, A., Rämgård, M., & Blomqvist, K. (2018) · International Journal of Qualitative Studies on Health and Well-Being · doi:10.1080/17482631.2018.1474673 · Cited by 74 · see citing works
Longing for ground in a ground(less) world: a qualitative inquiry of existential suffering
Bruce, A., Schreiber, R. S., Petrovskaya, O., & Boston, P. H. (2011) · BMC Nursing · doi:10.1186/1472-6955-10-2 · Cited by 71 · see citing works
Olsman, E., Leget, C. J. W., Onwuteaka-Philipsen, B. D., & Willems, D. L. (2013) · Palliative Medicine · doi:10.1177/0269216313482172 · Cited by 70 · see citing works
Palliative Care in the Greater China Region: A Systematic Review of Needs, Models, and Outcomes
Chung, H., Harding, R., & Guo, P. (2020) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2020.08.040 · Cited by 54 · see citing works
Mak, Y. W., Chiang, C. L. V., & Chui, W. T. (2013) · International Journal of Palliative Nursing · doi:10.12968/ijpn.2013.19.9.423 · Cited by 47 · see citing works
Existential Distress in Cancer Patients
Chen, W., Chen, Y., & Xiao, H. (2021) · Cancer Nursing · doi:10.1097/ncc.0000000000000925 · Cited by 44 · see citing works
Niles, H. F., Fogg, C., Kelmendi, B., & Lazenby, M. (2021) · BMC Palliative Care · doi:10.1186/s12904-021-00889-x · Cited by 39 · see citing works
The concept and relevance of existential issues in nursing
Udo, C. (2014) · European Journal of Oncology Nursing · doi:10.1016/j.ejon.2014.04.002 · Cited by 37 · see citing works
Gibson Watt, T., Gillanders, D., Spiller, J. A., & Finucane, A. M. (2023) · Palliative Medicine · doi:10.1177/02692163231183101 · Cited by 32 · see citing works
“These processes are: (1) Acceptance – making space for challenging thoughts and emotions versus suppression or avoidance; (2) Defusion – stepping back from unhelpful thoughts and emotions to reduce their influence; (3) Contact with the present moment – maintaining flexible awareness of the present versus being overly…”
BackgroundLarsson, H., Edberg, A., Bolmsjö, I., & Rämgård, M. (2018) · Nursing Ethics · doi:10.1177/0969733018774828 · Cited by 32 · see citing works
Gagnon, P., Fillion, L., Robitaille, M.-A., Girard, M., Tardif, F., Cochrane, J.-P., Le Moignan Moreau, J., & Breitbart, W. (2015) · Palliative and Supportive Care · doi:10.1017/s147895151400073x · Cited by 29 · see citing works
Existential issues among nurses in surgical care – a hermeneutical study of critical incidents
Udo, C., Danielson, E., & Melin‐Johansson, C. (2012) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2012.06032.x · Cited by 30 · see citing works
Zhang, B., Li, H., Jin, X., Peng, W., Wong, C. L., & Qiu, D. (2021) · Asia-Pacific Journal of Oncology Nursing · doi:10.1016/j.apjon.2021.12.012 · Cited by 29 · see citing works
A Survival Guide for Health Research Methods
Ross, T. (2012) · Cited by 28 · see citing works
Forgiveness facilitation in palliative care: a scoping review
Silva, R. S., Caldeira, S., Coelho, A., & Apóstolo, J. (2020) · JBI Evidence Synthesis · doi:10.11124/jbisrir-d-19-00286 · Cited by 24 · see citing works
Vincenzo, F. D., Lombardo, L., Iani, L., Maruelli, A., Durante, S., Ragghianti, M., Park, C. L., Innamorati, M., & Quinto, R. M. (2023) · BMJ Supportive & Palliative Care · doi:10.1136/spcare-2022-003696 · Cited by 24 · see citing works
Dealing with ethical and existential issues at end of life through co-creation
Hemberg, J. A. V., & Bergdahl, E. (2019) · Nursing Ethics · doi:10.1177/0969733019874496 · Cited by 20 · see citing works
Udo, C., Danielson, E., Henoch, I., & Melin‐Johansson, C. (2013) · European Journal of Oncology Nursing · doi:10.1016/j.ejon.2013.02.002 · Cited by 17 · see citing works
A systematic review of grounded theory studies in physiotherapy
Ali, N., May, S., & Grafton, K. (2019) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2018.1474403 · Cited by 16 · see citing works
Meaning-centered dream work with hospice patients: A pilot study
Wright, S. T., Grant, P. C., Depner, R. M., Donnelly, J. P., & Kerr, C. W. (2014) · Palliative & Supportive Care · doi:10.1017/s1478951514001072 · Cited by 15 · see citing works
Bader, H., Farraj, H., Maghnam, J., & Omar, Y. A. (2024) · World Journal of Clinical Oncology · doi:10.5306/wjco.v15.i7.908 · Cited by 13 · see citing works
Dealing with parents' existential issues in neonatal intensive care
Wigert, H., & Bry, K. (2017) · Journal of Neonatal Nursing · doi:10.1016/j.jnn.2017.09.002 · Cited by 7 · see citing works
The effect of stress inoculation training on existential anxiety and resilience of cancer patients
Ahmadi, S., Salari, N., Rezaei, J., & Rahmati, M. (2021) · Current Psychology · doi:10.1007/s12144-021-01729-0 · Cited by 5 · see citing works
Palliative Sedierung bei psycho-existentieller Not
Weichselbaumer, E., & Weixler, D. (2013) · Wiener Medizinische Wochenschrift · doi:10.1007/s10354-013-0246-9 · Cited by 5 · see citing works
Hope in palliative care: A longitudinal qualitative study
Olsman, E. (2015) · UvA-DARE (University of Amsterdam) · Cited by 5 · see citing works
(SQMDSP), S. Q. D. M. D. S. P. (2015) · Médecine Palliative · doi:10.1016/j.medpal.2015.09.009 · Cited by 4 · see citing works
Sacks, J. L., & Volker, D. L. (2015) · Journal of Hospice and Palliative Nursing · doi:10.1097/njh.0000000000000197 · Cited by 4 · see citing works
Reconciliation in palliative care: A concept analysis
Karlsson, M., Uhlman, A., Kämper, B., & Ahlström, B. H. (2024) · Palliative & Supportive Care · doi:10.1017/s1478951524001470 · Cited by 3 · see citing works
Udo, C. (2012) · Dalarna University College Electronic Archive · Cited by 3 · see citing works
Perspectives on Hope of Hospice and Palliative Care Nurses
Paquette, K. (2015) · doi:10.23860/diss-paquette-katherine-2015 · Cited by 3 · see citing works
Matos, R. S., Silva, A. C., Rego, L., Fernandes, R., & Gonçalves, S. D. (2025) · Palliative Medicine · doi:10.1177/02692163251383335 · Cited by 2 · see citing works
Sakitani, M. (2023) · Journal of Medical - Clinical Research & Reviews · doi:10.33425/2639-944x.1344 · Cited by 2 · see citing works
Existentiell ensamhet hos sköra äldre personer : ett närståendeperspektiv
Larsson, H. (2020) · doi:10.24834/isbn.9789178770625 · Cited by 1 · see citing works
Sacks, J. L. (2014) · Texas ScholarWorks (Texas Digital Library)
THE GENDERED EXPERIENCES OF NURSES IN UNDERSTANDING HOPE IN PALLIATIVE CARE
Einarsdottir, G. (2015) · DalSpace (Dalhousie University)
Engaging Personhood at End of Life: A Qualitative Study of Nurses’ Practice in Acute Care
Robinson, L. (2018) · uO Research (University of Ottawa) · doi:10.20381/ruor-22837
An exploration of the challenges facing critical care education
Finch, J. (2026) · e-space (Manchester Metropolitan University) · doi:10.83056/mmu.32479362
The Egyptian physiotherapist journey to emancipation: a grounded theory study
Ali, N. (2019) · Sheffield Hallam University · doi:10.7190/shu-thesis-00347
- Authors
- Mok, E., Lau, K., Lam, W., Chan, L., Ng, J. S. C., & Chan, K.
- Affiliations
- Hong Kong Polytechnic University (HK)
- Venue
- Journal of Advanced Nursing
- Publisher
- Wiley
- Published
- 2010-06-02
- Volume
- 66
- Issue
- 7
- Pages
- 1510-1522
- ISSN
- 0309-2402 (ISSN-L)
- 1365-2648
- OpenAlex
- W2137825625
- Cited by
- 43
- References
- 30
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2021: 4 · 2020: 3 · 2019: 3 · 2018: 4 · 2017: 1 · 2016: 1 · 2015: 6 · 2014: 5 · 2013: 4 · 2012: 4
- FWCI
- 2.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Advanced Nursing (publishedVersion)
- PubMed (publishedVersion)
- PolyU Institutional Research Archive (Hong Kong Polytechnic University) (submittedVersion)
- Funders
- Hong Kong Polytechnic University
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- existential suffering, advanced cancer, palliative care, healthcare professionals' perceptions, anticipatory grief, regret, meaningful relationships, religious support, patient-professional relationship, holistic care, coping strategies
- MeSH terms
- Adult, Attitude of Health Personnel, Existentialism, Female, Humans, Male, Middle Aged, Neoplasms, Palliative Care, Stress, Psychological, Focus Groups, Qualitative Research, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
