Evid Based Nurs 6:95 doi:10.1136/ebn.6.3.95
  • Qualitative

Patients with cancer often felt a need to conceal their distress to protect family, friends, and doctors

 QUESTION: How do patients respond to having cancer?


Qualitative study.


Hospital clinics and a day care at an associated hospice in the UK.


30 patients who were 37–88 years of age (median age 55 y, 60% women, 100% white). Patients had cancer of the breast (n=11), lung (n=4), bowel/anus (n=6), larynx/tonsil/neck (n=3), cervix (n=2), kidney/liver (n=2), and prostate (n=1). 1 patient had non-Hodgkin’s lymphoma. The time since treatment was ≤7 days for 4 patients, <1 year for 14 patients, and 1–19 years for 12 patients. 14 patients received curative treatment and 16 palliative treatment.


Patients were individually interviewed for 30–180 minutes (mean 65 min) about their experience of cancer. Open questions, prompts, and reflection were used to help patients describe personal changes and their experiences of others. Interviews were audiotaped and transcribed. An inductive thematic analysis was done.

Main findings

(1) Concealing distress. Almost all patients expressed the importance of concealing distress or unhappiness from others. Most often, the desire to conceal distress stemmed …

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