To get through to survive: Exploring the symptom cluster management process during oncological treatment from the perspective of patients with lung cancer - A grounded theory study.

Purpose: To explore the symptom cluster management process from the perspective of patients with lung cancer within the oncological care context.

Methods: We used a constructivist grounded theory methodology to collect and analyze rich data from 15 patients with lung cancer via individual interviews and a two-dimensional symptom assessment scale.

Results: A situational theoretical model describes the symptom cluster management process through the main category 'To get through to survive', with the category 'Handling symptom clusters' together with six sub-categories concerning the patients' management strategies and the category 'Living with symptom clusters,' together with two sub-categories describing the outcome in their daily life. Impacting conditions are incorporated in the model.

Conclusions: Patients often feel left to their own devices to deal with symptom clusters and may not understand or foresee problematic circumstances as they manage their situations on a day-to-day basis. When symptoms are normalized and accepted, patients do not ask for support, or support is not being offered to them. Healthcare professionals should consider the peril of normalizing symptoms and the patients' altered time perspective that stems from their approach of living one day at a time, in further development of nursing interventions and person-centered care for this population.