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Qualitative Health Research
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Balancing: A Basic Process in End-of-Life Cancer Care

Hans Thulesius

Kronoberg County Research Centre and Department of Community Medicine, Malmö, Sweden

Anders Håkansson

Department of Community Medicine, Malmö

Kerstin Petersson

Kronoberg county Research Centre and the Faculty of Medicine, Lund University, Sweden

In this grounded theory study, the authors interviewed caregivers andpatients in end-of-life cancer care and found Balancing to be a fundamentalprocess explaining the problem-solving strategies of most participants and offering a comprehensive perspective on both health care in general and end-of-life cancer care in particular. Balancing stages wereWeighing— sensing needs and wishes signaled by patients, gauging them against caregiverresources in diagnosing and care planning; Shifting—breaking bad news, changing care places, and treatments; and Compensating—controlling symptoms, educating and team-working, prioritizing and "stretching" time, innovating care methods, improvising, and maintaining the homeostasis of hope. The Balancing outcome is characterized by Compromising, or "Walking a fine line," at best an optimized situation, at worst a deceit.

Key Words: end-of-life care • palliative care • cancer • grounded theory • balance model • qualitative research • hope

Qualitative Health Research, Vol. 13, No. 10, 1353-1377 (2003)
DOI: 10.1177/1049732303258369
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Other articles noted: 14 Nov 2003 to 30 Jan 2004
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