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Despair of Treatment

A Qualitative Study of Cirrhotic Patients' Perception of Treatment

Shabanloei, Reza, PhD, RN; Ebrahimi, Hossein, PhD, RN; Ahmadi, Fazlollah, PhD, RN; Mohammadi, Eesa, PhD, RN; Dolatkhah, Roya, PhD, MD

doi: 10.1097/SGA.0000000000000162
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Cirrhotic patients are exposed to illness progression and life-threatening side effects. The nature of the disease, its incurability, limitations of liver transplantation, and the intensity of threatening conditions lead to psychological distress for the patients and change in their perception of the treatment. To provide holistic care, it is necessary to clarify the patient's perception of the treatment. The aim of this study was to clarify cirrhotic patients' perception of their treatment. This qualitative study was carried out through a content analysis approach. The participants were 15 cirrhotic patients. Data were collected via semistructured, in-depth interviews and analyzed on the basis of the Granheme and Landman method. Despair of treatment was revealed through four categories: (1) disease perception (quiet start and quiet death, living in an aggravating limitation, intensifying threatening conditions), (2) self-perception (living in the shadow of death, loss of self, preferring family to oneself), (3) perception of treatment (difficulty of treatment compliance, believed to be incurable, treatment conditioned to die, treatment limitation), and (4) spirituality-religion (destiny and divine test, asking God instead of doctors). The study shows that despair of treatment is considered as one of the main concerns of cirrhotic patients. Nurses should program their surveillance to support patients effectively based on the study findings.

Reza Shabanloei, PhD, RN, Liver and Gastrointestinal Diseases Research Center, Tabriz, Iran.

Hossein Ebrahimi, PhD, RN, is Associate Professor of Nursing Education, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

Fazlollah Ahmadi, PhD, RN, is Professor of Nursing Education, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Eesa Mohammadi, PhD, RN, is Associate Professor of Nursing Education, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Roya Dolatkhah, PhD, MD, Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Correspondence to: Hossein Ebrahimi, PhD, RN, School of Nursing and Midwifery, West Shariati, Postal Code 5138947977, Tabriz University of Medical Sciences, Tabriz, Iran (ebrahimih@tbzmed.ac.ir).

The authors declare no conflicts of interest.

Received October 16, 2014

Accepted February 28, 2015

© 2017 by the Society of Gastroenterology Nurses and Associates, Inc.