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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0045-1813024
Original Article

“A Lot Happens After Best Supportive Care”—Unbottling the Countertransference of Health-Related Suffering in a Community Cancer Palliative Care Setting: A Qualitative Case Study

Autoren

  • Vidya Viswanath 

    1   Department of Palliative Medicine, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
    2   School of Medicine, Cardiff University, Cardiff, United Kingdom

  • Ravuru Vamsi Pranai

    1   Department of Palliative Medicine, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India

  • Dolorosa Fernandes

    3   Department of Preventive Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India

  • Neeharika Alapati

    4   Department of Medical Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India

  • Ketireddi Sirisha

    1   Department of Palliative Medicine, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India

  • Alisha Karim

    5   Department of Clinical Psychology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India

  • Priyanshu Thakur

    1   Department of Palliative Medicine, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India

  • Samanasi Chaitanya Ram

    1   Department of Palliative Medicine, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India

  • Aaliya Khan

    1   Department of Palliative Medicine, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India

  • Geddam Bhavani

    1   Department of Palliative Medicine, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India

  • Suroj Shit

    1   Department of Palliative Medicine, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India

  • Duvvada Santha Kumari

    1   Department of Palliative Medicine, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India

  • Ravi Teja Miriyala

    6   Department of Radiation Oncology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India

Funding None.
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Abstract

Introduction

The Integrated Hospital-based Continuity of Care project at a government tertiary cancer hospital in the department of palliative medicine aimed to relieve serious health-related suffering and facilitate care along the continuum through home visits by a multidisciplinary team to patients on best supportive care. These patients transitioning through palliative care engender reciprocal feelings of suffering among the team members, impacting their well-being.

Countertransference includes the conscious and unconscious feelings experienced by the health care provider toward the patient. Accepted as appropriate and unavoidable, it is important to understand, recognize, and address the issues related to countertransference of health-related suffering. Following a debriefing session, the feelings documented by a downcast nurse, as a doodle, depicting the abandonment of a patient from her own home, formed the background for this study.

Objectives

This study aimed to explore the experiences of the palliative care team caring for patients with cervical cancer in the home care setting.

Materials and Methods

This qualitative case study method included the multidisciplinary team in the department of palliative medicine as participants. There were multiple sources of data like four sketches with captions depicting patients with cervical cancer at home drawn by the doctor and its interpretation by the team, reflective journaling notes, and transcripts from the focus group discussion. Following data familiarization and analysis, themes were derived.

Results

The first theme described the dejection felt by the participants as they witnessed patients with disfigurement, stigma, and neglect. These memories lingered and the second theme dealt with their deliberations as they navigated through self-doubt. The realization that home care is an invaluable experience was the third theme. The reflection that “every struggle is unique” and how art could help in training, learning, and catharsis was the fourth theme.

Conclusion

The results of our study resonate with the dual process model of grief; moving from the loss-oriented response as they witnessed suffering in patient's homes toward the restoration-oriented response where they felt gratitude and acknowledged the value of caring for the person at home. Art was the ice breaker in enabling this reflection.

Keywords

countertransference - home care services - palliative care - continuity of patient care - grief

Authors' Contributions

V.V. designed the study, conducted the research, analyzed the data, and wrote the manuscript. R.V.P., K.S., A.K., P.T., S.C.R., A.K., G.B., S.S., and D.S.K. participated in the study and reviewed and approved the data. D.F. and R.M. examined the data and assisted with the interpretation. D.F. and N.A. refined the final narrative and made critical contributions to the manuscript. All authors approved the final version. V.V. is the guarantor and corresponding author for this study. This manuscript is honest work which has been read and approved by all the authors.


Patient Consent

Patient consent is not required.


Supplementary Material



Publikationsverlauf

Artikel online veröffentlicht:
12. November 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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