Aims Effective symptom management is important part of end of life care. It is aimed at improving the quality of dying. The findings presented in this conference are taken from a larger project, the aim of which was to explore the experience of patients living with terminal cancer in southern, Thailand. This presentation reports on one of the main themes under this study's investigation; symptom management and its barriers.

Method A longitudinal qualitative study was conducted. Fifteen patients who had been diagnosed with terminal cancer and 20 caregivers were recruited. Series interviews and observations were employed. Content analysis was applied.

Findings The common symptoms perceived by patients as most burdensome and distressful were lack of energy, anorexia, pain and dry mouth. Family played a key role in managing symptoms for the dying patients. Symptom management strategies used by family caregivers focused not only on searching for cure by using complementary therapy, but also on managing everyday symptoms based on their beliefs and experiences. The barriers to manage symptoms consisted of attitude and concern about medication and its side effects, lack of knowledge about symptoms and symptom management, patients' wills to live, limited access due to the services system, and communication gaps among persons involved in care (doctor-care giver, care giver-care giver, patient-care giver).

Conclusion The finding from this research will provide a picture of experiences of patients with terminal advanced cancer. Awareness of effects of perceived barriers to symptom management will guide healthcare providers to develop effective interventions to improve quality of life among these patients.