Life situation, information needs, and information seeking in patients with oesophageal cancer and their family members

This thesis explores the experiences of living with oesophageal cancer from the perspective of patients and family members. Also, their needs for information and how they seek information in relation to the illness were investigated. The thesis comprises one qualitative meta-analysis and three empirical studies including data from patients, family members, and health-care professionals.

Paper I was a qualitative meta-analysis the aim of which was to extend knowledge about patients' and family members' experiences of living with oesophageal cancer and clinically similar cancer forms, mainly head and neck cancer. As a result of the thematic analysis we have shown that both patients and family members 'run into an unpredictable enemy'. Patients had to 'endure a fading body' Running into an unpredictable enemy and enduring a fading body led to -entering social silence' for patients and family members.

The aim of paper II was to describe patients' experiences of living with oesophageal cancer and how they seek information in relation to the illness. Data was collected by qualitative interviews with thirteen patients and analysed by qualitative content analysis. The findings describe patients' experiences of receiving the diagnosis, their experiences of vague symptoms, and of existential concerns evoked by the illness. Undergoing investigations and treatment caused extreme tiredness. Patients experienced that the illness intruded upon their daily life. In order to manage the life-threatening illness, they sought information about the illness.

The aim of paper III was to describe family members' experiences of living with a patient suffering from oesophageal cancer, their information needs and information seeking Data was collected by means of qualitative interviews with nine family members and analysed by qualitative content analysis. The findings describe that family members lacked awareness of the disease. When faced with the diagnosis, shock, stress, and disbelief were evoked. The cancer illness became intrusive into their everyday lives, routines, and life plans. Uncertainty about the course and prognosis of the disease was the main source of distress among them. In order to learn, obtain understanding for the illness, and manage this uncertainty, family members entrusted themselves to the experts and sought information from them.

Paper IV was a pilot study the aim of which was to describe patients' and family members' information needs following a diagnosis of oesophageal cancer, their satisfaction with information obtained, and health-care professionals' perceptions concerning patients' and family members' information needs. Data was collected by means of a study-specific questionnaire and analysed with descriptive statistics. The results indicate that patients' and family members need for information following a diagnosis of oesophageal cancer was substantial and had not been adequately met by health-care professionals.

In conclusion, the receipt of the diagnosis of oesophageal cancer was an abrupt change from feeling healthy with vague symptoms to having a life-threatening illness. The illness disrupts patients' and family members' social world and relationships, and the whole family is affected. For understanding and managing the illness, they sought information from health-care professionals, social networks, and various media.

List of scientific papers

I. Andreassen S, Randers I, Ternulf Nyhlin K, Mattiasson AC (2006). A meta-analysis of qualitative studies on living with oesophageal and clinically similar cancer forms, seen from the perspective of patients and family members. [Submitted]

II. Andreassen S, Randers I, Naslund E, Stockeld D, Mattiasson AC (2006). Patients' experiences of living with oesophageal cancer. J Clin Nurs. 15(6): 685-95.
https://doi.org/10.1111/j.1365-2702.2006.01412.x

III. Andreassen S, Randers I, Naslund E, Stockeld D, Mattiasson AC (2005). Family members' experiences, information needs and information seeking in relation to living with a patient with oesophageal cancer. Eur J Cancer Care. 14(5): 426-34.
https://doi.org/10.1111/j.1365-2354.2005.00602.x

IV. Andreassen S, Randers I, Naslund E, Stockeld D, Mattiasson AC (2006). Information needs following a diagnosis of oesophageal cancer; self-perceived information needs of patients and family members compared with the perceptions of health-care professionals: A pilot study. European Journal of Cancer Care. [Accepted]
https://doi.org/10.1111/j.1365-2354.2006.00742.x