A matter of definition – key elements identified in a discourse analysis of definitions of palliative care

Abstract

For more than 30 years, the term "palliative care" has been used. From the outset, the term has undergone a series of transformations in its definitions and consequently in its tasks and goals. There remains a lack of consensus on a definition. The aim of this article is to analyse the definitions of palliative care in the specialist literature and to identify the key elements of palliative care using discourse analysis: a qualitative methodology. The literature search focused on definitions of the term 'palliative medicine' and 'palliative care' in the World Wide Web and medical reference books in English and German. A total of 37 English and 26 German definitions were identified and analysed. Our study confirmed the lack of a consistent meaning concerning the investigated terms, reflecting on-going discussion about the nature of the field among palliative care practitioners. Several common key elements were identified. Four main categories emerged from the discourse analysis of the definition of palliative care: target groups, structure, tasks and expertise. In addition, the theoretical principles and goals of palliative care were discussed and found to be key elements, with relief and prevention of suffering and improvement of quality of life as main goals. The identified key elements can contribute to the definition of the concept 'palliative care'. Our study confirms the importance of semantic and ethical influences on palliative care that should be considered in future research on semantics in different languages.

Avaliação das decisões médicas durante o processo do morrer

“…It is noteworthy that withdrawal of futile therapies that only prolong the end of life, are part of the hospice care focus. (19,20) In this study it was found that WWT, excluding non-CRR, was more common in critically ill patients, highlighting that sedation and analgesia were maintained for all these patients. These are considered end of life palliative actions.…”

“…(4,(13)(14)(15) . Nowadays, chronic diseases are responsible for the majority of deaths, (16,(17)(18)(19)(20)(21) and acceptance of therapeutic limitation of cancer patients is more common. (22) Similar results were signaled in this work where it was found, that even in the ICU, where ideally patients with a recovery potential are admitted, 42.6% of admissions terminate in death.…”

Pratique basée sur la théorie des soins de fin de vie aux patients cancéreux : une exploration du modèle de soins infirmiers McGill

“…Elle milite en faveur du soutien à fournir aux proches des patients et de la considé-ration des personnes dans leur globalité. Le soin global de la personne exige qu'on intègre attentivement les dimensions physiques, psychologiques, sociales et spirituelles de la santé, de la maladie et du mourir (Pastrana, Junger, Ostgathe, Elsner & Radbruch, 2008).…”

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“…Mit der fortschreitenden Entwicklung der Palliativversorgung in ganz Europa stehen die Verantwortlichen nicht nur vor der Entscheidung, wo und wann Angebote der Palliativversorgung entwickelt werden sollen, sondern auch, wie diese umzusetzen und zu gestalten sind. tology", "Comfort Care", "Supportive Care" [11]. Überdies können verschiedene Begrifflichkeiten auf verschiedene kulturelle Hintergründe zurückgeführt werden.…”

“…In der deutschen Sprache gibt es z. B. kein Äquivalent für den Ausdruck "Palliative Care" und folglich wird der Ausdruck "Palliativmedizin" sowohl für "Palliative Care" als auch für "Palliative Medicine" verwendet [11]. Allerdings hat der synonyme Gebrauch von "Palliativmedizin" (Palliative Medicine) und Palliative Care in diesem Zusammenhang zu Bedenken hinsichtlich einer Medikalisierung der Palliativversorgung in Deutschland geführt [11].…”