Ongoing transitions: the impact of a malignant brain tumour on patient and family.

Although primary malignant brain tumours represent only 1.4% of all cancers, it is considered one of the most devastating types of cancers in adults. From the time of diagnosis, the patient and family embark on a "roller coaster" ride of uncertainty, fear and hope. Despite improved medical outcomes, patients often experience severe functional impairment, as well as behavioural and cognitive dysfunction. Subsequently, they suffer from greater dependency and hopelessness than other cancer patients. The family caregivers are faced with multiple demands such as taking on new roles within the family and caring for their loved one while grieving the loss of the person they knew. The role of the nurse is to support the patient and the family throughout the illness trajectory, identify and promote their strengths and mobilize the necessary resources to facilitate patient and family coping. The purpose of this paper is to present, via a detailed case study, the impact of a malignant brain tumour on the patient and the family. The nursing strategies used to help them make the necessary transitions throughout the illness trajectory are discussed.