Objectives: The decision to withdraw treatment in patients with metastatic cancer is a complex and emotionally charged process influenced by multiple interrelated factors. Despite its significant clinical and ethical implications, this phenomenon remains insufficiently explored through qualitative inquiry. This study aimed to explore the factors influencing decisions to withdraw treatment among patients with metastatic cancer. Methods: A qualitative study using conventional content analysis was conducted. Fourteen patients with metastatic cancer were purposively selected. Data were collected through in-depth, semi-structured interviews and analyzed using the qualitative content analysis approach proposed by Graneheim and Lundman. Data organization was facilitated using MAXQDA software. Results: The analysis yielded 1 main theme (“Finding the meaning of life, and freedom from cycles of suffering”), 4 categories, and 15 subcategories. The overarching theme suggests that understanding life’s meaning enables patients to situate their illness within a broader existential purpose, thereby affirming life’s intrinsic value beyond mere physical survival. The 4 categories were social and family influences, physical health factors, psychological determinants, and divine and spiritual beliefs. Conclusions This study outlines a multilevel approach to improving end-of-life care. At the clinical level, holistic nursing assessments are needed to guide transitions to palliative care. At the institutional level, implementing structured protocols with multidisciplinary support and financial counselling is essential. At the national level, policies should ensure universal health coverage and promote cultural acceptance of dignified treatment withdrawal. These findings provide actionable insights for healthcare administrators and policymakers and offer a foundation for strategies aimed at reducing barriers and improving access to supportive care services.

Objectives: Patients undergoing hemodialysis encounter a wide range of complex challenges, underscoring the essential role of self-care in disease management. The present study aimed to examine the effectiveness of an educational intervention grounded in Orem’s self-care model for enhancing treatment adherence, self-care behaviors, and quality of life among hemodialysis patients in southern Iran. Methods: This single-blind randomized controlled trial included 120 hemodialysis patients who met the predetermined eligibility criteria. Data were collected between April 2023 and August 2023 at 2 university-affiliated teaching hospitals located in southern Iran. After providing informed consent, participants were randomly allocated to either the intervention group (n=60) or the control group (n=60) through a simple randomization procedure. Three psychometrically robust instruments were used to collect data: the End-Stage Renal Disease Adherence Questionnaire, the Kidney Disease Quality of Life Short Form, and the Self-Management Behavior Scale. Statistical analyses were performed using SPSS version 23, and p-values<0.05 were considered statistically significant. Results: At baseline, no statistically significant differences were observed between the intervention and control groups in the mean scores of the measured variables. However, immediately following the intervention and at the 3-month follow-up, the intervention group demonstrated statistically significant improvements across all 3 variables. Conclusions The findings underscore the effectiveness of an educational program based on Orem’s self-care model in significantly improving self-care behaviors, treatment adherence, and quality of life among hemodialysis patients.