Oncology Nurses’ Experiences With Patients Who Choose to Discontinue Cancer Chemotherapy

Kathy Boaz Dhotre, University of South Carolina
Swann Arp Adams, University of South Carolina
James R. Hebert, University of South Carolina
Matteo Bottai, Karolinska Institutet
Sue P. Heiney, University of South Carolina


Purpose/Objectives: To describe the experiences of oncology nurses whose patients prematurely discontinue cancer chemotherapy. Research Approach: Qualitative, in-depth interviews. Setting: Large oncology practice in South Carolina. Participants: Seven oncology nurses. Methodologic Approach: A general interview guide was used to obtain descriptions about nurses' experiences with patients who chose to discontinue chemotherapy. Interviews were analyzed using van Manen's approach to hermeneutic phenomenology. Findings: Nurses experienced mixed emotions and struggled to balance their feelings with their respect for patient autonomy. Participants perceived that treatment side effects and inconvenience, advanced age, pessimistic attitude, and lack of social support influenced patients' decisions to discontinue treatment. Conclusions: Findings indicate that nurses experience distress when patients prematurely discontinue treatment, and participants identified opportunities to support patients in continuing treatment. Interpretation: Oncology nurses respect patients' rationales for discontinuing therapy and support their right to independent decision making. Nurses also struggle to cope with their reactions to patients' decisions. This tug of war somewhat parallels patients' struggles to balance quality of life with longevity.