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Liang HJ, Xiong Q, Lin PC, Tsai JH, Preston N. 'A good ending but not the end': Exploring family preparations surrounding a relative's death and the Afterlife - A qualitative study. Palliat Med 2024:2692163241280016. [PMID: 39340161 DOI: 10.1177/02692163241280016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2024]
Abstract
BACKGROUND Adequate death preparation positively influences families' experience before death and during bereavement. However, how to prepare families in non-Western cultures has received scant attention. AIM To explore family caregivers' experiences in preparing for a relative's death in specialist palliative care in Taiwan. DESIGN A qualitative study employing reflexive thematic analysis of data collected from semi-structured interviews was conducted. SETTING/PARTICIPANTS Twenty-two family caregivers from seven hospitals participated. RESULTS The overarching theme was 'getting everything right to have no regrets between the dead and the living'. We developed two themes to explain preparations for the time surrounding and after the death, including the deceased' afterlife: (1) 'having a good ending but not the end of the relationship', which addresses preparations for the death itself, the funeral, the afterlife and maintaining connections and (2) 'using religious beliefs and cultural norms to guide preparation', which explores perceptions of a good death, including refrain from strong emotions before and after the death. CONCLUSION Funeral arrangements, enhancing the deceased's afterlife and maintaining connections to the deceased are crucial for families' experiences which can be impacted by actions they take as they prepare for the death. A culturally appropriate death is beneficial for the dying relative which includes preparing to not show strong emotions during and after the death. These insights inform the importance of the cultural context in death preparation in Taiwan and provide perspectives for palliative care beyond Western culture, potentially benefiting Chinese populations, predominantly East Asian and Buddhist societies.
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Affiliation(s)
- Hui-Ju Liang
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Health Innovation One, Lancaster, UK
| | - Qian Xiong
- Centre for Ageing Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Peng-Chan Lin
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Centre for Hospice Palliative Shared Care, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jui-Hung Tsai
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Centre for Hospice Palliative Shared Care, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nancy Preston
- International Observatory on End of Life Care, Division of Health Research, Lancaster University, Lancaster, UK
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Breitsameter C. When dying does not go well: a qualitative study. BMC Palliat Care 2024; 23:69. [PMID: 38461270 PMCID: PMC10924395 DOI: 10.1186/s12904-024-01379-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 02/06/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND Several studies deal with the question of what constitutes a "satisfactory death". A smaller number of studies deal with unsatisfactory dying processes. And only a few shed light on unsatisfactory deaths that take place in hospices and palliative care units, which see themselves as places conducive to a "good" death. What also remains largely undiscussed are the ethical aspects that accompany the observation of an unsatisfactory course of death. METHOD The research was carried out as an exploratory and qualitative study. The data collection and analysis were based on the methods of the "grounded theory". RESULTS Notions of a bad death are articulated here, though hardly by the affected persons and their relatives themselves, but rather by the professionals. Principally, descriptions of unsatisfactory dying processes refer to deficient success in symptom control, whereby the principle of autonomy is of particular importance. The focus here is not only on the needs of patients, but also on the needs of staff. The manifestation of such notions is related to the requirements arising from a practice that apparently evokes a need for accountability in the form of communicative reassurance. CONCLUSION An idealised definition of "dying well" is in danger of losing sight of the contextual specifics of the practice involved, which can lead to ethically problematic situations.
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Affiliation(s)
- Christof Breitsameter
- Lehrstuhl für Moraltheologie, Katholisch-Theologische Fakultät, Ludwig-Maximilians-Universität München, Geschwister-Scholl-Platz 1, 80539, Munich, Germany.
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Koh MYH, Gallardo MD, Khoo HS, Hum A. Burnout in Palliative Care - Difficult Cases: Qualitative Study. BMJ Support Palliat Care 2024; 13:e1383-e1389. [PMID: 35332027 DOI: 10.1136/bmjspcare-2021-003347] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 03/04/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Burnout is common among palliative care clinicians, occurring as a result of emotions experienced in caring for challenging patients or families. Awareness of these scenarios helps clinicians and teams appropriately manage their own emotions and prevent burnout. We studied challenging clinical situations and the emotions encountered by experienced palliative care clinicians which could potentially contribute to burnout. METHODS A qualitative study was conducted using semistructured interviews with purposive sampling of 18 palliative care clinicians-5 doctors, 10 nurses and 3 social workers who worked in various palliative care settings (hospital palliative care team, home hospice and inpatient hospice). The interviews were recorded verbatim, transcribed and analysed using a thematic analysis approach. RESULTS The mean age of the interviewees was 52 years old and the mean number of years practising palliative care was 15.7 years (ranging from 10 to 25 years). The following clinical situations were reported by our respondents as particularly challenging, potentially leading to burnout: (1) abusive patients and families, (2) 'bad deaths', (3) death of young patients, (4) complex cases, and (5) having multiple deaths or difficult cases at any one time. Emotions encountered in the course of care of these cases included: (1) feeling overwhelmed, (2) having a sense of helplessness and failure, as well as (3) a sense of injustice. CONCLUSION The challenging cases we described evoke strong emotional reactions from palliative care clinicians that need to be adequately addressed to prevent burnout.
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Affiliation(s)
| | | | - Hwee Sing Khoo
- Health Outcomes and Medical Education Research (HOMER), National Healthcare Group, Singapore
| | - Allyn Hum
- Palliative Medicine, Tan Tock Seng Hospital, Singapore
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Rawlings D, Winsall M, Miller-Lewis L, Tieman J. Natural Death Versus Known Date-Of-Death: A Qualitative Study of Views on Voluntary Assisted Dying in an Online Course About Death. OMEGA-JOURNAL OF DEATH AND DYING 2023; 86:1272-1290. [PMID: 33840272 DOI: 10.1177/00302228211008771] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The study aimed to describe views on Voluntary Assisted Dying (VAD), gleaned through qualitative analysis of participant responses to a set activity, run during the 2018 'Dying2Learn' Massive Open Online Course (MOOC). Data from 508 participants, most of whom identified as health professionals, were analysed using thematic content analysis, and themes generated. A large proportion of participants discussed their personal views related to VAD, specifically around choice, control, dignity, palliative care and dying at home, medical intervention, societal factors, the impact on those left behind, laws and regulations, dying 'naturally', advance care directives, and being in pain. In this study, participants had many different views on the act itself, often divisive, but also with common concepts such as respecting the choices and decisions of others.
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Affiliation(s)
- Deb Rawlings
- Palliative & Supportive Services, Flinders University, Bedford Park, Australia
| | - Megan Winsall
- Palliative & Supportive Services, Flinders University, Bedford Park, Australia
| | - Lauren Miller-Lewis
- School of Health, Medical and Applied Sciences, CQUniversity, Adelaide, Australia
| | - Jennifer Tieman
- Palliative & Supportive Services, Flinders University, Bedford Park, Australia
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McCune EK, Visser MR, Bamberger J. "Nobody Wants to Talk About It, Especially in This Building": A Qualitative Study of How People Living in Permanent Supportive Housing Approach End-Of-Life Care. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221114756. [PMID: 35815736 DOI: 10.1177/00302228221114756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Permanent supportive housing (PSH) is long-term affordable housing with onsite social services. End-of-life care (EOLC) involves a discussion about the type of medical care an individual hopes to receive at the end of their life. This qualitative study examines the goals, desires, and expectations for EOLC for people living in PSH. Semi-structured interviews were conducted with 17 formerly homeless residents in four PSH facilities in San Francisco, California and analyzed using the framework method. The interviews reveal how an individual's experience with housing precarity and with the PSH setting shape their preferences and expectations for the end of life. While PSH residents value social support in their final days, social isolation in PSH serves as a barrier to receiving such support. Results from this work can inform policies and programs to support people living in PSH in achieving their desired death.
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Affiliation(s)
- Emma K McCune
- University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - Megan R Visser
- Department of Social and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Joshua Bamberger
- Department of Family and Community Medicine, University of California, San Francisco, CA, USA
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Wilson DM, Anafi F, Roh SJ, Errasti-Ibarrondo B. A Scoping Research Literature Review to Identify Contemporary Evidence on the Incidence, Causes, and Impacts of End-of-Life Intra-Family Conflict. HEALTH COMMUNICATION 2021; 36:1616-1622. [PMID: 32519565 DOI: 10.1080/10410236.2020.1775448] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
When someone is terminally ill, it is often a very stressful time for the dying person and their family. It would not be unusual for intra-family conflict, involving one or more family members and even the dying person, to occur. However, this type of conflict has not been identified as an end-of-life issue needing to be noticed and addressed or prevented when possible. This lack of attention could be because it is not known how common or how impactful this type of conflict is. A scoping research literature review was conducted for available 2004-2019 evidence on the incidence or prevalence of intra-family conflict, factors contributing to it or causing it, and the outcomes or impact of it. A search for published peer-review articles identified 18 research reports for a scoping review. The 18 studies, all conducted in developed countries, revealed intra-family conflict is often present; and with a range of harmful effects for the dying person, the family as a whole or individual family members, and other persons and organizations. The identified factors contributing to or predisposing intra-family conflict were grouped into three categories: (a) family disagreements over curative treatment and/or end-of-life care and decisions, (b) previous family conflict and other family dynamic matters, and (c) the dying process itself. The evidence identified through this scoping review, although relatively minimal, should be useful for planning future research and for raising awareness of end-of-life intra-family conflict to improve social services and palliative programs or services.
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Wilson DM, Underwood L, Errasti-Ibarrondo B. A scoping research literature review to map the evidence on grief triggers. Soc Sci Med 2021; 282:114109. [PMID: 34157614 DOI: 10.1016/j.socscimed.2021.114109] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 11/18/2022]
Abstract
Grief is understandably severe in the first days, if not weeks or months, following the death of a beloved person. Unless the mourner develops complicated grief, which is prolonged severe and impactful grief, the initial acute grief lessens in severity over time, although waves of significant grief will still occur with grief triggers. A scoping research literature review was undertaken in early 2021 to determine how often grief triggers occur, what the most common grief triggers are, the impact of triggered grief, and what can be done (by those not diagnosed with complicated grief) to manage grief triggers and mitigate the effect of them. Nine academic library databases were searched for English-language research reports using the keywords "grief trigger(s)" and "research": CINAHL, Directory of Open Access (online) Journals, Humanities Index, JSTOR, Medline (Ovid), Periodicals Index Online, PsychArticles, Scopus, and Web of Science. Six research papers relevant for review were published in the last two decades, with some evidence gained on how often grief triggers occur, what constitutes a grief trigger, and the impact of grief triggers. Major gaps in evidence were revealed, despite grief triggers being identified as a major consideration for grief in general and for grief recovery specifically.
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Affiliation(s)
- Donna M Wilson
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, T6G1C9, Canada.
| | - Leah Underwood
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, T6G1C9, Canada
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Abstract
Health care providers are coping with unprecedented deaths, decisions for which patient receives a lifesaving ventilator, and the personal fear of contracting a virus that presently has no known treatment protocol. This article discusses the concepts of moral injury; compassion fatigue; experiencing secondary stress associated with a continuous demanding daily work environment; and the idea of giving your patient a “good death” during a time when even if family and friends are present during the dying process, there is no touching, kissing, or ability to offer physical comfort. Suggestions for self-care for yourself and colleagues are discussed.
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9
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Borghi L, Menichetti J. Strategies to Cope With the COVID-Related Deaths Among Family Members. Front Psychiatry 2021; 12:622850. [PMID: 33716823 PMCID: PMC7946858 DOI: 10.3389/fpsyt.2021.622850] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/25/2021] [Indexed: 11/28/2022] Open
Abstract
The extraordinary circumstances of deaths during COVID-19 pandemic have been challenging for the deceased's families. This contribution aims to describe some spontaneous strategies that family members may adopt to cope with the loss of a relative for COVID-19. The present reflection derives from the experience of a clinical psychology unit of one of the biggest public hospital in Milan, Italy, which supported 246 families of COVID-19 victims in the 1st days after the loss. Spontaneous strategies used by family members to deal with such a unique mourning process involved: creating alternative good-bye rituals, normalizing the loss, addressing faith and hope, highlighting the perks of isolation, supporting others in need, and delivering the bad news to others. These observed strategies may suggest how to assess and support a "normal" bereavement process during the extraordinary COVID-19 circumstances, in order to prevent further psychological distress.
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Affiliation(s)
- Lidia Borghi
- Clinical Psychology, Department of Health Sciences, University of Milan, Milan, Italy
| | - Julia Menichetti
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Levoy K, Tarbi EC, De Santis JP. End-of-life decision making in the context of chronic life-limiting disease: a concept analysis and conceptual model. Nurs Outlook 2020; 68:784-807. [PMID: 32943221 PMCID: PMC7704858 DOI: 10.1016/j.outlook.2020.07.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 06/26/2020] [Accepted: 07/10/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND Conceptual ambiguities prevent advancements in end-of-life decision making in clinical practice and research. PURPOSE To clarify the components of and stakeholders (patients, caregivers, healthcare providers) involved in end-of-life decision making in the context of chronic life-limiting disease and develop a conceptual model. METHOD Walker and Avant's approach to concept analysis. FINDINGS End-of-life decision making is a process, not a discrete event, that begins with preparation, including decision maker designation and iterative stakeholder communication throughout the chronic illness (antecedents). These processes inform end-of-life decisions during terminal illness, involving: 1) serial choices 2) weighed in terms of potential outcomes 3) through patient and caregiver collaboration (attributes). Components impact patients' death, caregivers' bereavement, and healthcare systems' outcomes (consequences). DISCUSSION Findings provide a foundation for improved inquiry into and measurement of the end-of-life decision making process, accounting for the dose, content, and quality the antecedent and attribute factors that collectively contribute to outcomes.
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Affiliation(s)
- Kristin Levoy
- NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, PA.
| | - Elise C Tarbi
- NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, PA
| | - Joseph P De Santis
- University of Miami School of Nursing and Health Studies, Coral Gables, FL
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Meeker MA, White D. Transition to comfort-focused care: Moral agency of acute care nurses. Nurs Ethics 2020; 28:529-542. [PMID: 34085584 DOI: 10.1177/0969733020952128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Moving into the last phase of life comprises a developmental transition with specific needs and risks. Facilitating transitions is an important component of the work of nurses. When curative interventions are no longer helpful, nurses enact key roles in caring for patients and families. AIM The aim of this study was to examine the experiences of registered nurses in acute care settings as they worked with patients and families to facilitate transition to comfort-focused care. RESEARCH DESIGN Sampling, data collection, and data analysis were guided by constructivist grounded theory, chosen because of its strength in identifying and explicating social processes. PARTICIPANTS AND CONTEXT A purposeful sample of 26 registered nurses working in acute care hospitals in one community in the northeastern United States participated in this study through semi-structured interviews. ETHICAL CONSIDERATIONS The study received approval from the university's Institutional Review Board for the Protection of Human Subjects. Participants provided informed consent. FINDINGS Nurses facilitated transition to comfort-focused care by enacting their moral commitments to patients and families. They focused on building relationships, honoring patient self-determination, and maintaining respect for personhood. In this context, they discerned a need for transition, opened a discussion, and used diverse strategies to facilitate achieving consensus on the part of patients, family members, and care providers. Regardless of how the process unfolded, nurses offered support throughout. DISCUSSION Achievement of consensus by all stakeholders is critical in the transition to comfort-focused care. This study deepens our understanding of how nurses as moral agents utilize specific strategies to assist progress toward consensus. It also offers an example of recognizing the moral agency of nurses through listening to their voices. CONCLUSION Increased understanding of effective nursing strategies for facilitating transition to comfort-focused care is essential for developing needed evidence for excellent care and strengthening end-of-life nursing education.
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Affiliation(s)
- Mary Ann Meeker
- 12292University at Buffalo, The State University of New York, USA
| | - Dianne White
- 12292University at Buffalo, The State University of New York, USA
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Engberink AO, Mailly M, Marco V, Bourrie D, Benezech JP, Chevallier J, Vanderhoeven S, Crosnier R, Bourrel G, Lognos B. A phenomenological study of nurses experience about their palliative approach and their use of mobile palliative care teams in medical and surgical care units in France. BMC Palliat Care 2020; 19:34. [PMID: 32197609 PMCID: PMC7085140 DOI: 10.1186/s12904-020-0536-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 03/02/2020] [Indexed: 11/28/2022] Open
Abstract
Background Despite a broad consensus and recommendations, numerous international reports or studies have shown the difficulties of implementing palliative care within healthcare services. The objective of this study was to understand the palliative approach of registered nurses in hospital medical and surgical care units and their use of mobile palliative care teams. Methods Qualitative study using individual in depth semi-structured interviews and focus group of registered nurses. Data were analyzed using a semiopragmatic phenomenological analysis. Expert nurses of mobile palliative care team carried out this study. 20 registered nurses from three different hospitals in France agreed to participate. Results Nurses recognize their role as being witnesses to the patient’s experience through their constant presence. This is in line with their professional values and gives them an “alert role” that can anticipate a patient-centered palliative approach. The physician’s positioning on palliative care plays a key role in its implementation. The lack of recognition of the individual role of the nurse leads to a questioning of her/his professional values, causing inappropriate behavior and distress. According to nurses, “rethinking care within a team environment” allows for the anticipation of a patient-centered palliative approach. Mobile Palliative Care Team highlights the major role of physicians-nurses “balance” while providing personal and professional support. Conclusions The Physician’s positioning and attitude toward palliative approach sets the tone for its early implementation and determines the behavior of different staff members within healthcare service. “Recognition at work”, specifically “recognition of the individual role of nurse” is an essential concept for understanding what causes the delay in the implementation of a palliative approach. Interprofessional training (physicians and nurses) could optimize sharing expertise. Registered nurses consider MPCT as a “facilitating intermediary” within the healthcare service improving communication. Restoring a balance in sharing care and decision between physicians and other caregivers lead care teams to an anticipated and patient-centered palliative approach according to guidelines.
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Affiliation(s)
- Agnès Oude Engberink
- University of montpellier CEPS platform, site Saint Charles, 34000, Montpellier, France. .,Maison de Santé Pluriprofessionnelle Universitaire Avicenne, 2 rue IBN Sinai dit Avicenne, 66330, Cabestany, France. .,Department of Palliative Care, CHU Montpellier, Montpellier, France.
| | - Maryse Mailly
- Mobile Palliative Care Team, CHU Montpellier, Montpellier, France
| | - Valerie Marco
- Department of General Medecine, University of Montpellier, avenue du Doyen Gaston Giraud, 34000, Montpellier, France
| | - Daniele Bourrie
- Department of General Medecine, University of Montpellier, avenue du Doyen Gaston Giraud, 34000, Montpellier, France
| | - Jean-Pierre Benezech
- Department of General Medecine, University of Montpellier, avenue du Doyen Gaston Giraud, 34000, Montpellier, France
| | | | - Sandrine Vanderhoeven
- Department of General Medecine, University of Montpellier, avenue du Doyen Gaston Giraud, 34000, Montpellier, France
| | - Remy Crosnier
- Mobile Palliative Care Team, CHU Montpellier, Montpellier, France
| | - Gérard Bourrel
- Maison de Santé Pluriprofessionnelle Universitaire Avicenne, 2 rue IBN Sinai dit Avicenne, 66330, Cabestany, France.,Department of Palliative Care, CHU Montpellier, Montpellier, France
| | - Béatrice Lognos
- University of montpellier CEPS platform, site Saint Charles, 34000, Montpellier, France.,Department of Palliative Care, CHU Montpellier, Montpellier, France
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Wilson DM, Cohen J, Eliason C, Deliens L, Macleod R, Hewitt JA, Houttekier D. Is the bereavement grief intensity of survivors linked with their perception of death quality? Int J Palliat Nurs 2019; 25:398-405. [DOI: 10.12968/ijpn.2019.25.8.398] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: Some people experience exceptionally severe bereavement grief, and this level of post-death grief could potentially be the result of a low quality dying process. Aims: A pilot study was conducted to determine if a relationship exists between perceived death quality and bereavement grief intensity. Methods: A questionnaire was developed and posted online for data on bereavement grief intensity, perceived death quality, and decedent and bereaved person characteristics. Data from 151 Canadian volunteers were analysed using bi-variate and multiple linear regression tests. Findings: Half had high levels of grief, and over half rated the death as more bad than good. Perceived death quality and post-death grief intensity were close to being negatively correlated. Conclusion: These findings indicate research is needed to explore possible connections between bereavement grief and the survivor's perceptions of whether a good or bad death took place. In the meantime, it is important for palliative care nurses to think of the quality of the dying process as being potentially very impactful on the people who will be left to grieve that death.
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Affiliation(s)
- Donna M Wilson
- Professor, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Joachim Cohen
- Professor, End-of-life Care Research Group, Vrije University Brussels and Ghent University, Belgium
| | - Cecilia Eliason
- Lecturer, School of Nursing and Midwifery, University of Ghana
| | - Luc Deliens
- Head, End-of-life Care Research Group, Vrije University Brussels and Ghent University
| | - Rod Macleod
- Palliative Care Professor, HammondCare and Conjoint Professor in Palliative Care, University of Sydney, Australia
| | | | - Dirk Houttekier
- End-of-life Care Research Group, Vrije University Brussels and Ghent University
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