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. 2019 May 14;18(1):40.
doi: 10.1186/s12904-019-0424-7.

Living at the end-of-life: experience of time of patients with cancer

Jordy Johannes Eduardus Rovers  1 , Elze Jantien Knol  1 , Jelte Pieksma  1 , Wytse Nienhuis  1 , Anne Barbara Wichmann  2 , Yvonne Engels  1
Affiliations

Living at the end-of-life: experience of time of patients with cancer

Jordy Johannes Eduardus Rovers et al. BMC Palliat Care. .

Abstract

Background: The aim of this study was to gain insight into the experience of time of terminal patients with cancer. Experience of time is relevant in palliative care in both policy and practice. On a policy level, the Quality Adjusted Life Year (QALY), the most used outcome measure for cost-effectiveness analysis in healthcare, assumes time to be a linear and additive variable, which is one of the reasons that its applicability in palliative care is questioned. On a practice level, a better understanding of the experience of time of patients with limited time left, could help to recognize if and how these patients can have a more meaningful use of time. The main focus of this study was to discover whether time perception of these patients in their last months of life had changed as compared to earlier periods of time in their lives in good physical health. The pace of time and time dominance (comparison of past, present and future) were investigated.

Methods: In several hospices and palliative care units in the Netherlands, twelve semi-structured interviews were conducted with terminal patients with cancer.

Results: Time perception at the end of life had changed for most participants. They all lived on a day-to-day basis in the terminal phase, independent of their way of life in the healthy phase. Furthermore, the experienced duration of a day turned out to be very different between patients, but also between days, depending on daily activities. Besides, for most patients for whom the future was the dominant period of time in the healthy phase, the dominant period of time in the terminal phase had become the past.

Conclusions: Time perception of terminal patients with cancer differed from the time perception in their relatively healthy phase of life. This suggests that the LY part of the QALY is not comparable for all phases of life.

Keywords: Palliative care; Patients; Qualitative research; Time perception.

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Conflict of interest statement

Ethics approval and consent to participate

The research protocol was sent to the Committee of Human Related Research (Commissie van Mensgebonden Onderzoek [CMO], file number 2016–2905) for ethical approval of the conduct of the interviews. The CMO noted that for this study no official approval was required. Patients received oral and written information about the study and written and/or oral consent was obtained.

Consent for publication

Consent for publication of the (anonymised) collected data was obtained by means of written and/or oral consent.

Competing interests

Yvonne Engels is member of the BMC Palliative Care editorial board (Associate Editor).

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Illustration of some of the possible outcomes of Cottle’s Circles Test. a Future dominance b) Past dominance c) Present dominance d) A different outcome: Past, present and future are equally valued
See this image and copyright information in PMC

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References

    1. Augustinus A, Boudling M, Rotelle JE. The confessions; book 11. 1997. The works of saint Augustine: a translation for the 21st century.
    1. Le Poidevin R. The experience and perception of time. In: Zalta EN, editor. The Stanford Encyclopedia of Philosophy, Summer 2015. Stanford University: Metaphysics Research Lab; 2015.
    1. Rao SM, Mayer AR, Harrington DL. The evolution of brain activation during temporal processing. Nat Neurosci. 2001;4(1):317–323. doi: 10.1038/85191. - DOI - PubMed
    1. Jaldow EJ, Oakley DA, Davey GCL. Performance of decorticated rats on fixed interval and fixed time schedules. Eur J Neurosci. 1989;1(5):461–470. doi: 10.1111/j.1460-9568.1989.tb00352.x. - DOI - PubMed
    1. Davies K. The tensions between process time and clock time in care-work. Time Soc. 1994;3(3):277–303. doi: 10.1177/0961463X94003003002. - DOI

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