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Borovečki A, Nikodem K, Ćurković M, Braš M, Palić-Kramarić R, Špoljar D, Matulić T, Grosek Š, Tonković D. What Constitutes a "Good Death"?-A Representative Cross-Sectional Survey Among the General Public in Croatia. OMEGA-JOURNAL OF DEATH AND DYING 2023; 86:1415-1431. [PMID: 33940964 DOI: 10.1177/00302228211010597] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Understanding the attitudes of a particular society on a "good death" is important when it comes to end-of-life decision-making and palliative care. In the Republic of Croatia no systematic research has been done on the attitudes of the general population about the concept of a "good death". This cross sectional survey was conducted on a three-stage random sample, stratified by regions, counties and locations within those counties (N = 1203) during November and December, 2019. ANOVA, to determine differences, factor analysis and multiple regression analysis were used. The most important characteristics of a good death outlined by the respondents were: the absence of pain, the presence and unencumberedness of family and loved ones, the importance of a sense of fulfilment and meaning in life in this regard, reconciliation with God, the presence of awareness and sobriety, and the possibility of treatment.
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Affiliation(s)
- Ana Borovečki
- School of Medicine, Andrija Stampar School of Public Health, University of Zagreb, Zagreb, Croatia
| | - Krunoslav Nikodem
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Marko Ćurković
- School of Medicine, University Psychiatric Hospital Vrapče, University of Zagreb, Zagreb, Croatia
| | - Marijana Braš
- Centre for Palliative Medicine, Medical Ethics and Communication Skills, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ružica Palić-Kramarić
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University, Osijek, Croatia
| | - Diana Špoljar
- School of Medicine, University Hospital Dubrava, University of Zagreb, Zagreb, Croatia
| | - Tonči Matulić
- Catholic Faculty of Theology, University of Zagreb, Zagreb, Croatia
| | - Štefan Grosek
- Neonatology Department, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Department of Perinatology, Division of Obstetrics and Gynaecology, University Medical Centre, Ljubljana, Slovenia.,Department of Paediatric Intensive Therapy, Division of Surgery, University Medical Centre, Ljubljana, Slovenia
| | - Dinko Tonković
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Zagreb, Zagreb, Croatia
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A good death from the perspective of healthcare providers from the internal medicine department in Shanghai: A qualitative study. Int J Nurs Sci 2021; 9:236-242. [PMID: 35509698 PMCID: PMC9052265 DOI: 10.1016/j.ijnss.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/07/2021] [Accepted: 11/18/2021] [Indexed: 11/21/2022] Open
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Rushton C, Edvardsson D. A genealogy of what nurses know about 'the good death': A socio-materialist perspective. Nurs Philos 2021; 22:e12365. [PMID: 34428347 DOI: 10.1111/nup.12365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/30/2021] [Accepted: 07/06/2021] [Indexed: 11/29/2022]
Abstract
In this article, we report the outcome of a sociological inquiry into nursing knowledge of death and dying, specifically 'the good death'. A genealogical approach informed by actor-network theory and appreciative inquiry were used to compose a broad socio-material account of how nurses concern themselves with the care of the dying and end-of-life care. Our enquiry revealed similarly to other studies, that there was no shared or overarching model of care. Key themes derived from nurses' translations of 'the good death' were re-presented pictorially as six pillars and two processes to comprise a new diagram of The Personalised Ideal Death.
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Affiliation(s)
- Carole Rushton
- School of Nursing and Midwifery, College of Science, Health and Engineering, Latrobe University, Melbourne, Victoria, Australia
| | - David Edvardsson
- School of Nursing and Midwifery, College of Science, Health and Engineering, Latrobe University, Melbourne, Victoria, Australia
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Gourdji I, Mcvey L, Purden M. A Quality end of Life from A Palliative Care Patient's Perspective. J Palliat Care 2018. [DOI: 10.1177/082585970902500105] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This qualitative study explored the meaning of quality of life (QOL) from the perspective of palliative care patients by examining their lived experiences and their perceptions of what contributes to their QOL. Ten in-patients — five women and five men — took part in in-depth, semi-structured interviews. When asked about their QOL, they spoke about three distinct aspects: the meaning of a quality life at this stage in their illness trajectory, the experience of living with the illness, and factors that contributed to their QOL. Patients’ approach to life, illness life, and ideal quality life were found to create a sphere of influence that shaped their end-of-life experience. At the heart of living a quality end of life for these patients was their ability to “do the things that I usually do,” “be helpful to others,” and “live in a caring environment,” The findings highlight the importance of understanding each of these factors: patients’ approach to life, illness life, and ideal quality of life, and what they mean to patients in order to tailor interventions to enhance their QOL.
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Affiliation(s)
- Iris Gourdji
- Sir Mortimer B. Davis-Jewish General Hospital and School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Lynne Mcvey
- Sir Mortimer B. Davis-Jewish General Hospital and School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Margaret Purden
- Sir Mortimer B. Davis-Jewish General Hospital and School of Nursing, McGill University, Montreal, Quebec, Canada
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ulAin Q, Whiting TL. Is a "Good Death" at the Time of Animal Slaughter an Essentially Contested Concept? Animals (Basel) 2017; 7:E99. [PMID: 29240699 PMCID: PMC5742793 DOI: 10.3390/ani7120099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 12/07/2017] [Accepted: 12/13/2017] [Indexed: 11/16/2022] Open
Abstract
The phrase "essentially contested concept" (ECC) entered the academic literature in 1956 in an attempt to better characterize certain contentious concepts of political theory. Commonly identified examples of contested concepts are morality, religion, democracy, science, nature, philosophy, and certain types of creative products such as the novel and art. The structure proposed to identify an ECC has proven useful in a wide variety of deliberative discourse in the social, political, and religious arenas where seemingly intractable but productive debates are found. Where a strongly held moral position is contradicted by law, a portion of the citizenry see the law as illegitimate and do not feel compelled to respect it. This paper will attempt to apply the analytic structure of ECC to the concept of animal wellbeing at the time of slaughter specifically a "good death." The results of this analysis supports an understanding that the current slaughter debate is a disagreement in moral belief and normative moral theory. The parties to the dispute have differing visions of the "good." The method of slaughter is not an essentially contested concept where further discourse is likely to result in a negotiated resolution. The position statements of veterinary organizations are used as an example of current discourse.
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Affiliation(s)
- Qurat ulAin
- Manitoba Agriculture, 545 University Crescent, Winnipeg, MB R3T 5S6, Canada.
| | - Terry L Whiting
- Manitoba Agriculture, 545 University Crescent, Winnipeg, MB R3T 5S6, Canada.
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Abstract
The purpose of this concept analysis paper is to delineate the meaning of good death in long term care (LTC) settings and examine its implications for nursing. The Walker and Avant (2011) method was chosen for this analysis. An in depth literature review identifies uses of the concept and determines the defining attributes of the good death. This paper also illustrates case presentations, antecedents, consequences, empirical referents and implications for clinical practice to clarify the concept of 'good death' in this population. In LTC, death is experienced frequently and is considered the ultimate outcome for most admissions. Much of the existing research on end-of-life care has focused on community dwelling cancer patients whose death trajectory is predictable and who may remain cognitively intact until actively dying. In contrast, the LTC population is older and more likely to suffer from dementia and experience chronic illness for long periods prior to death, and they follow a less predictable death trajectory. In this century, death became the province of older people and the assurance of a good death became the responsibility of those caring for them.
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Affiliation(s)
- Preetha Krishnan
- Nurse Practitioner, Winnipeg Regional Health Authority, Winnipeg, Canada
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Wright DK, Brajtman S, Cragg B, Macdonald ME. Delirium as letting go: An ethnographic analysis of hospice care and family moral experience. Palliat Med 2015; 29:959-66. [PMID: 25855632 DOI: 10.1177/0269216315580742] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Delirium is extremely common in dying patients and appears to be a major threat to the family's moral experience of a good death in end-of-life care. AIM To illustrate one of the ways in which hospice caregivers conceptualize end-of-life delirium and the significance of this conceptualization for the relationships that they form with patients' families in the hospice setting. DESIGN Ethnography. SETTING/PARTICIPANTS Ethnographic fieldwork was conducted at a nine-bed, freestanding residential hospice, located in a suburban community of Eastern Canada. Data collection methods included 15 months of participant observation, 28 semi-structured audio-recorded interviews with hospice caregivers, and document analysis. RESULTS Hospice caregivers draw on a culturally established framework of normal dying to help families come to terms with clinical end-of-life phenomena, including delirium. By offering explanations about delirium as a natural feature of the dying process, hospice caregivers strive to protect for families the integrity of the good death ideal. CONCLUSION Within hospice culture, there is usefulness to deemphasizing delirium as a pathological neuropsychiatric complication, in favor of acknowledging delirious changes as signs of normal dying. This has implications for how we understand the role of nurses and other caregivers with respect to delirium assessment and care, which to date has focused largely on practices of screening and management.
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Granda-Cameron C, Houldin A. Concept Analysis of Good Death in Terminally Ill Patients. Am J Hosp Palliat Care 2012; 29:632-9. [DOI: 10.1177/1049909111434976] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The purpose of this concept analysis of good death was to examine the attributes of a good death and explore the changes of the concept over time and its impact on terminally ill patients. The method used for this analysis was the Rodgers’ evolutionary method. A literature search was completed using Medline Ovid and Journal Storage (JSTOR).The findings describe the evolution of the good death concept over time from the prehistoric era followed by premodern, modern, and postmodern times. In addition, information is presented about surrogate terms, attributes, antecedents, and consequences associated with good death followed by analysis and discussion of the findings. General attributes of a good death include pain and symptom management, awareness of death, patient’s dignity, family presence, family support, and communication among patient, family, and health care providers.
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Affiliation(s)
- Clara Granda-Cameron
- Coordinator Palliative Care Program, Joan Karnell Cancer Center at Pennsylvania Hospital, Doctor Nursing Practice Student, Drexel University, Philadelphia, PA, USA
| | - Arlene Houldin
- Associate Professor of Psychosocial Oncology, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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Fernández-Sola C, Granero-Molina J, Manrique GA, Castro-Sánchez AM, Hernández-Padilla JM, Márquez-Membrive J. New regulation of the right to a dignified dying in Spain: repercussions for nursing. Nurs Ethics 2012; 19:619-28. [PMID: 22323394 DOI: 10.1177/0969733011429016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Preserving dignity during the dying process requires reviewing the roles of those involved in the treatment, care methods and decision-making. This article examines the participation and responsibility assigned to nurses regarding decision-making in the final stages of life, as laid out in the Rights to and Guarantee of Dignity for the Individual During the Process of Death Act. This text has been analysed on the levels of socio-cultural practice and discourse practice, using the critical discourse analysis methodology. The results show that, although the law is another result of the social trend of patient empowerment, the responsibility of the nurses is not recognised, and they are left out of the decision-making process in the final stages of life.
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Liaschenko J, Peden-McAlpine C, Andrews GJ. Institutional geographies in dying: nurses' actions and observations on dying spaces inside and outside intensive care units. Health Place 2011; 17:814-21. [PMID: 21478045 DOI: 10.1016/j.healthplace.2011.03.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 03/06/2011] [Accepted: 03/10/2011] [Indexed: 12/18/2022]
Abstract
This paper articulates the geographies associated with intensive care nursing work with dying patients and their families. Six focus groups were conducted with 27 registered critical care nurses who practice in hospitals in a mid-western city in the United States. The analysis is structured by three emerging themes (i) the importance of a 'good' and 'sacred' place, (ii) the body as mapped by medical specialties, and (iii) problems with procedurally driven suspension of 'do not resuscitate' orders beyond intensive care units (ICUs). Recommendations describe the need for institutional recognition of the moral importance of strong relationships between nurses, clients, and their families, and nurses' wide-ranging roles in bridging the various spatial domains of intensive care.
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Affiliation(s)
- Joan Liaschenko
- University of Minnesota, Center for Bioethics and School of Nursing, 410 Church Street SE, Minneapolis, MN 55455, USA.
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