A phenomenological investigation into the lived experiences of patiens with cancer suffering from fungating/cancerous wounds

“A phenomenological investigation into the lived experiences of patients with\ud cancer suffering from fungating/cancerous wounds”.\ud Fungating wounds are poorly understood and research in this area is scant.\ud Due to this fact, a Husserlian phenomenological approach was adopted to\ud begin the exploration of this subject from the perspective of the patient. The aim\ud of the study was to explore the lived experiences of patients with cancer\ud suffering from fungating/cancerous wounds.\ud Eight patients were recruited in a hospice setting in the UK and six in home care\ud or hospital setting in Italy to explore the lived experiences and cultural\ud differences with respect to the phenomena.\ud In depth semi-structured interviews were carried out. Data analysis was carried\ud out using “the conceptual framework”, which consists of a structure wherein the\ud data and emergent concepts are organized and exposed in a way that allows\ud for rigorous and transparent data management.\ud One of the themes extracted from the data was The impact of having a\ud fungating wound. From the data that emerged, it became apparent that the\ud growing wound represented an abnormality that could not be controlled or\ud predicted and this posed problems of both a managerial and emotional nature.\ud In all cases, this went on over considerable time, generally causing the patients\ud to become disheartened. There was a distinct wish to avoid seeing the wound\ud and eventually to estrange oneself from one's body.\ud The boundaries between what was inside the body and what was outside went\ud askew. The wound became a reminder and a hallmark of the imminent death and of the progress of the disease. Amongst the symptom intrusions, functional\ud limitations and pain were the most frequent issues related by the patients.\ud When the pain was very intense, all energy was centred on surviving the pain.\ud Looking at differences in the two groups, it would appear from this small sample\ud that the Italian participants experienced more pain, possibly because the pain\ud management was inadequate. The British participants generally attempted to\ud “think positive”, complained less, and used words such as “suffering” less\ud frequently than did the Italian participants.\ud Participants experienced a range of emotions fluctuating from despair to hope -\ud emotions that were rarely static or fixed. Patients tended to concentrate on one\ud key problem they were facing, which varied across the study population. In this\ud sense, each participant was unique and had specific individual needs.\ud In the study, difficulties were encountered relating to conducting research on dying\ud patients with cancer and gaining access to them. Such difficulties often reflected the\ud HCPs' unresolved issues around death and cancer. Similar difficulties were also\ud experienced by the researcher all related to this sensitive topic.\ud Recommendations for practice in the future: looking at the current research it\ud becomes apparent that the participants have a need to talk about their\ud experience and HCPs need to be able to listen in an empathic way. More\ud education regarding dressing technique skills and correct choice of dressing for\ud nurses is needed. Implementation of wound care strategies and psychosocial\ud support for patients with malignant fungating wounds (MFWs) in oncological\ud departments would be useful