Although several models attempt to account for how individuals cope with a life-threatening illness, the task-based approach is the model most commonly used.[1] Several significant, limiting factors have been ascribed to the older model, a stage theory based on the original work of Elizabeth Kubler-Ross,[2] including the actual existence of these five stages (denial, anger, bargaining, depression, and acceptance). There is no evidence that all individuals experience these stages or that movement from one stage to another occurs sequentially. Further, the sole analysis of this theory was flawed by limitations in the research methodology.[1]

The task-based model does not imply any order or sequence and is therefore viewed as a more flexible, fluid model that helps to empower the patient and his or her family and significant others. Four phases, or segments, of a life-threatening illness have been identified: prediagnostic, acute, chronic, and recovery or death. A task-based concept has been applied to explain how individuals confront each phase.[3]

The prediagnostic phase of a life-threatening illness is the time before the diagnosis of illness during which an individual recognizes symptoms or risk factors that make him or her prone to illness and during which diagnostic studies are performed. This is not a single moment but may culminate in one moment when the diagnosis is first spoken.

The acute phase centers on the crisis of diagnosis in which a person is forced to understand the diagnosis and make a series of decisions regarding his or her medical care.

The chronic phase of an illness is the period of time between the diagnosis and outcome.[3] Individuals attempt to cope with the demands of life while simultaneously striving to comply with treatments and deal with side effects. Until recently, the period between a cancer diagnosis and death was typically measured in months, most of which were spent in the hospital. Today people can live for years after the diagnosis of cancer.

Persons may experience recovery from their disease and thus deal with the psychological, social, physical, spiritual, and financial after-effects of cancer.

Other individuals encounter a final phase, or terminal phase, of illness when death is no longer just possible but is inevitable. At this time, medical goals change from curing illness or prolonging life to providing comfort and focusing on palliative care. The tasks during this final phase reflect this transition and often focus on spiritual and existential concerns.

References

1. Corr CA, Nabe CM, Corr DM: Death and Dying, Life and Living. 2nd ed. Pacific Grove, Calif: Brooks/Cole Publishing Company, 1997. 
   
   
2. Kubler-Ross E: On Death and Dying. New York: Macmillan Publishing Company Inc.,1969. 
   
   
3. Doka KJ: Living with Life-Threatening Illness: A Guide for Patients, Their Families, and Caregivers. New York: Lexington Books, 1993. 
   
   

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