Experiences of Patients with Advanced Lung Cancer: Being Resigned to Sleep-Wake Disturbances while Maintaining Hope for Optimal Treatment Outcomes

Background: Sleep-wake disturbances are prevalent in patients with lung cancer yet are infrequently studied over time. This article reports on the qualitative results of a mixed-methods study of newly diagnosed patients' narratives over 6 months. Objective: The objective of this study was to gain an understanding of the treatment and illness trajectory related to sleep-wake disturbances as well as the beliefs and practices of patients while seeking optimal treatment outcomes. Methods: Longitudinal interview narratives of 26 patients' experiences with advanced lung cancer diagnosis (at baseline, pre-second and third treatment, and 6 months) were obtained from participants recruited from Veterans Administration Hospital Center and a Comprehensive Cancer Center in Northeast United States. Analysis of illness narratives used interpretive phenomenology based on Heideggarian hermeneutic traditions. Results: At diagnosis, participants described poor sleep such as trouble falling asleep and frequent awakenings. Over time, as the treatment worsened their sleep symptoms, these participants still maintained hope for more time with treatment. This focus enabled them to tolerate the sleep-wake disturbances and treatment adverse effects. As the treatment effectiveness declined, their focus changed to spiritual meanings for the future and to keep living life with a purpose. Conclusions: By explicating lung cancer patients' experiences with sleep-wake disturbances, nurses will gain insight into potential interventions to improve sleep and support effective outcomes as well as open a dialogue about hope. Implications for Practice: Findings offer insight for oncology nurses to provide opportunities for dialogue about treatment options and techniques to improve sleep, which will facilitate patients living their lives.