Comfort experience in palliative care: a phenomenological study

Abstract

BackgroundPalliative care aims to provide maximum comfort to the patient. However it is unknown what factors facilitate or hinder the experience of comfort, from the perspective of inpatients of palliative care units. This lack of knowledge hinders the development of comfort interventions adjusted to these patients. The aim of this research is to describe the comfort and discomfort experienced by inpatients at palliative care units.MethodsA phenomenological descriptive study was undertaken. Ten inpatients were recruited from a Spanish palliative care unit and seven from a Portuguese palliative care unit. Data were collected using individual interviews and analysed following the method of Giorgi.ResultsFour themes reflect the essence of the lived experience: The Palliative Care as a response to the patient’s needs with advanced disease, attempt to naturalize advanced disease, confrontation with their own vulnerability, openness to the spiritual dimension.ConclusionsInformants revealed that they experience comfort through humanized care, differentiated environment, symptomatic control, hope and relationships. The discomfort emerges from the losses and powerlessness against their situation. Even if such findings may seem intuitive, documenting them is essential because it invites us to reflect on our convictions about what it means to be comfortable for these patients, and allows incorporating this information in the design of focused interventions to maximize the comfort experience.Electronic supplementary materialThe online version of this article (doi:10.1186/s12904-016-0145-0) contains supplementary material, which is available to authorized users.

Nurses’ perceptions of early person‐centred palliative care: a cross‐sectional descriptive study

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“…Specialised knowledge is very important, because many times, according to Kim and Hwang and Coelho et al. nurses have difficulties with regard to symptom management that may threaten the quality of care of persons with life‐threatening disease and accompanying disturbing symptoms. Furthermore, experts have concluded that there is still a lack of attention on how to deliver high‐quality knowledge in palliative care in undergraduate and postgraduate academic nursing programs .…”

A qualitative study about palliative care patients’ experiences of comfort: Implications for nursing diagnosis and interventions

“…The results highlight the experience of in-patients and add consistency to the evidence reported in other contexts and countries. [6,27,29,30] Thus, results give a comprehensive overview of comfort attributes throughout the perspective of palliative care patients, and open new perspectives to the operationalization of the comfort intervention.…”

“…However, and as reported in previous studies, comfort experience is frequently explored and understood through discomfort experiences or in the absence of comfort. [25][26][27] In this study, participants' experiences and views about comfort were represented in five main topics, regarding the physical, psychological, spiritual, social and environmental contexts. Findings highlight that participants experienced not only physical symptoms ("Me and what I feel") -such as pain, difficulty in resting, anorexia, asthenia and constipation -but also psychological ("Me and how I react") and spiritual problems ("Me and the meaning of my life"), such as lack of security, fear, sense of vulnerability, uncertainty, guilt and hopelessness.…”

Development of a guided imagery program for patients admitted to palliative care units

“…Thus, the literature on GI, including scripts suggested by renowned authors in this area (Apóstolo, 2007), and the literature about comfort, including Katherine Kolcaba's theory of comfort (1995), were analyzed. A qualitative phenomenological study (Coelho, Parola, Escobar-Bravo, & Apóstolo, 2016) was conducted to understand the comfort and discomfort experiences of patients admitted to PCU.…”