Experiential group work for cancer patients shaped by experiences of participants during group intervention.

Cancer tends to have an impact on a person's psychological and social well-being. Group work is one approach that can help manage the psychosocial impact of cancer. Group interventions for people living with cancer have existed for a number of decades with a majority of them adopting the cognitive-behavioral approach. While this approach has been found to be efficacious, it may be limited for people who prefer acts of service and metaphors. This article describes an experiential approach to group intervention, an alternative to cognitive-behavioral groups. The group intervention featured is designed for participants of Enreach Retreat, a retreat for people living with cancer and their caregivers, by the Department of Psychosocial Oncology, National Cancer Centre Singapore.

Healthcare Needs of Patients with Amyotrophic Lateral Sclerosis (ALS) in Singapore: A patient-centred qualitative study from multiple perspectives.

BACKGROUND: One challenge for those who manage amyotrophic lateral sclerosis (ALS) is to understand patients' needs. AIM: The aim of this study was to examine the needs of Singapore ALS patients from their perspective as well as that of their caregivers and healthcare professionals in order to develop a template for better services. METHODS: A cross-sectional qualitative study was conducted, with one-to-one interviews and focus group discussions. RESULTS: All 30 participants, key stakeholders in the field of caring for ALS patients, identified these needs categories: psychological--diagnosis must be staged and comfortably paced, and efforts must be made to encourage patients' resilience; social--positive relationships, open communication, and spiritual support must be developed; physical--attention should be paid to alleviating discomfort and disability; and environmental--appropriate services should be made available. CONCLUSION: The identified needs categories do overlap, but there are significant differences. Our findings provide a template for developing individualized patient services, which should be done within the framework of a comprehensive palliative care program.

Understanding the concept of a "good death" among bereaved family caregivers of cancer patients in Singapore.

OBJECTIVE: The aim of this study was to examine the concept of a good death from the perspectives of both the dying person and the family caregiver, as perceived by bereaved family caregivers of advanced cancer patients. METHOD: The data were gathered from five focus group discussions and one face-to-face qualitative interview conducted over 8 months among 18 bereaved family caregivers recruited from a local hospice. The transcripts of the focus groups and the interview were entered into NVivo Version 8 and were analyzed using the thematic approach. RESULTS: A good death may be understood as having the biopsychosocial and spiritual aspects of life handled well at the end of life. Five major themes were identified. These were preparation for death, family and social relationships, moments at or near death, comfort and physical care, and spiritual well-being. Differences were also noted in what is important at the end of life between the patients and caregivers. Having a quick death with little suffering was perceived to be good by the patient, but the family caregiver wanted to be able to say a final goodbye to the patient. Patients tend to prefer not to die in their children's presence but the children wished to be present for the final moment. In addition, family caregivers reported it was important for them to be able to give the patients permission to die, to feel recognized for the efforts made, and to have had a fulfilling caregiving experience. SIGNIFICANCE OF RESULTS: Whereas there are global attributes of a good death, our findings suggest that patients and family caregivers may define a good death differently. Therefore, there is a need to respect, address, and reconcile the differences, so that all parties may have a good experience at the end of a person's life.