Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
chemotherapy. Therefore, it is important to assess and reinforce
information at different stages of the treatment period (Knowles et
al 1999).
However, there are always patients who do not want information or
explanations at any stage of their disease trajectory and who use
denial as a coping strategy. Many of the patients who were
interviewed suggested that they did use denial at certain times as a
coping strategy while undergoing chemotherapy, as this was how
they always reacted to bad news. Comments such as ‘I just wanted
to forget about what was happening to me’ were not uncommon.
Indeed many nurses share the same concerns and fears about
cancer as the general public (Corner 1993) and may use denial as a
coping mechanism if faced with a cancer diagnosis themselves;
therefore they should be aware of and understand the significance
for patients of using denial as a coping strategy.
Denial can be a useful coping strategy when faced with a lifethreatening
event and can be described as ‘positive avoidance’
whereby a patient can minimise the impact of the diagnosis and the
resulting treatment (Greer et al 1990). In a study conducted on
breast cancer patients with metastatic disease, Greer et al found
that denial can be associated with a reduction in psychological
distress and that it may even contribute to prolonged survival.
Therefore, health care professionals should be aware of this, and
understand that some patients will use denial to help them cope
with their illness and that it is acceptable for them to do so.
For those patients using denial as a coping mechanism, completing
the DDCs may have been difficult. Some of them referred to the
completion of the DDCs as a trigger that reminded them of their
illness which they described as ‘not very nice to be reminded of it
every day’. Perhaps this is something that health care professionals
should consider when asking patients to complete documentation
relating to their illness.
During the past two decades, the literature concerning information
provision for patients with cancer and patient education has grown
immensely, with each profession of the multidisciplinary care team
being an active contributor (Knowles et al 1999). The provision of
information about diagnosis and treatment modalities is now
regarded as being of positive value in assisting patients with cancer
to cope with life threatening illness (Meredith et al 1996). The
Cancer Plan 2000 suggests that all patients should have
documented information about all aspects of their care (DOH 2000).
Almost all oncology units and centres have introduced and
developed patient information booklets over the past few years to
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