Perceptions and experiences of gratitude among patients with advanced cancer in China: A descriptive phenomenological study

Objective: Gratitude has been demonstrated to be crucial for cancer patients' overall well-being and coping. However, the existing evidence on this topic is primarily from Western settings. This study aimed to explore how patients with advanced cancer in China perceive and experience gratitude. Methods: This descriptive phenomenological study involved semi-structured, face-to-face individual interviews with 15 patients with advanced cancer conducted by a research nurse in a tertiary-level hospital in Shanghai, China. Colaizzi's seven-step phenomenological method was used to analyze the data. Ethical approval was obtained from the hospital. Results: Four key themes emerged from the data: 1) The development of profound gratitude after cancer; 2) Gratitude deepened in shared struggles; 3) Gratitude that speaks without words; 4) The limits of gratitude. Conclusions: This qualitative study provided valuable insights into the conceptualization and experience of gratitude among Chinese patients with advanced cancer. It revealed that a cancer diagnosis shifted patients' priorities and values, and that cultural context shaped their expressions of gratitude. Despite their resilience, balancing gratitude with feelings of indebtedness highlighted the psychological burdens these patients face. It underscores the need for culturally sensitive nursing approaches and tailored interventions to enhance their wellbeing and coping strategies.