Development and evaluation of a life review program for Chinese advanced cancer patients.

摘要

Aim. This study aimed to develop a life review program for Chinese advanced cancer patients and test its effects on a sample of advanced cancer patients in Fuzhou, China.;Method. Phase One of this study was to design a weekly 3-session life review program including reviewing a life and formulating a booklet. Phase Two was a RCT. Eighty subjects were randomly assigned to the control and experimental groups. The experimental group received the program. The QOL data measured by the SIS and QOLCE were collected before the commencement, immediately after, and three weeks after the program. The data about patients' perceptions of the program were collected through semi-structured interviews immediately after the program.;Results. The experimental patients demonstrated a significant improvement in the within-group, between-group, and interaction effects on overall QOL, negative emotions, existential distress, and value of life (p≤0.01); a significant increase in support in the interaction effects (p≤0.01); a significant improvement in healthcare concerns in the within-group and between-group effect (p≤0.05); and a significant decline in sense of alienation in the between-group and interaction effects (p≤ 0.01). The patients with improved overall QOL perceived that the program helped them to: accept one's unique life; have feelings of emotional relief; achieve a sense of meaning in life; leave a personal legacy; and make future orientations. The perceptions of the patients with unchanged overall QOL involved: struggling between accomplished tasks and unresolved conflicts; enhancing mood; leaving a generativity booklet; and feeling difficulty in reviewing a life due to uncontrolled physical discomfort. The perceptions of the patients with decreased overall QOL involved: being overwhelmed with negative feelings of encountering a painful life; and failing to freely share life experiences due to the presence of family members during the interviews.;Conclusion. Our life review program is a non-invasive care intervention for improving the psycho-spiritual well-being of Chinese patients with advanced cancer and helping them prepare for death. This program not only provides Chinese nurses with a new approach to meeting the unique needs of patients approaching death, but also poses a challenge to customary beliefs about death.