Concept Analysis of Good Death in Terminally Ill Patients

Granda-Cameron, Clara; Houldin, Arlene D.

doi:10.1177/1049909111434976

Cited by 111 publications

(91 citation statements)

References 47 publications

(51 reference statements)

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“…6,7 This concept arose from the hospice movement and has been described as a multifaceted and individualized experience. 8 According to an Institute of Medicine report published 19 years ago, a good death is one that is “free from avoidable distress and suffering for patient, family, and caregivers, in general accord with the patient’s and family’s wishes, and reasonably consistent with clinical, cultural, and ethical standards.” 9 This concept has received some critique in several disciplines, including medicine, psychology, theology, sociology, and anthropology.…”

Section: Introductionmentioning

confidence: 99%

“…8 According to an Institute of Medicine report published 19 years ago, a good death is one that is “free from avoidable distress and suffering for patient, family, and caregivers, in general accord with the patient’s and family’s wishes, and reasonably consistent with clinical, cultural, and ethical standards.” 9 This concept has received some critique in several disciplines, including medicine, psychology, theology, sociology, and anthropology. 6 In particular, concern has been raised that there is no such thing as an external criterion of a good death and that it is more dependent on the perspectives of the dying individual. 10 …”

Section: Introductionmentioning

confidence: 99%

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Defining a Good Death (Successful Dying): Literature Review and a Call for Research and Public Dialogue

Meier¹,

Gallegos

Thomas³

et al. 2016

The American Journal of Geriatric Psychiatry

385

310

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There is little agreement about what constitutes good death or successful dying. The authors conducted a literature search for published, English-language, peer-reviewed reports of qualitative and quantitative studies that provided a definition of a good death. Stakeholders in these articles included patients, prebereaved and bereaved family members, and healthcare providers (HCPs). Definitions found were categorized into core themes and subthemes, and the frequency of each theme was determined by stakeholder (patients, family, HCPs) perspectives. Thirty-six studies met eligibility criteria, with 50% of patient perspective articles including individuals over age 60 years. We identified 11 core themes of good death: preferences for a specific dying process, pain-free status, religiosity/spiritualty, emotional well-being, life completion, treatment preferences, dignity, family, quality of life, relationship with HCP, and other. The top three themes across all stakeholder groups were preferences for dying process (94% of reports), pain-free status (81%), and emotional well-being (64%). However, some discrepancies among the respondent groups were noted in the core themes: Family perspectives included life completion (80%), quality of life (70%), dignity (70%), and presence of family (70%) more frequently than did patient perspectives regarding those items (35%–55% each). In contrast, religiosity/spirituality was reported somewhat more often in patient perspectives (65%) than in family perspectives (50%). Taking into account the limitations of the literature, further research is needed on the impact of divergent perspectives on end-of-life care. Dialogues among the stakeholders for each individual must occur to ensure a good death from the most critical viewpoint—the patient’s.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Defining a Good Death (Successful Dying): Literature Review and a Call for Research and Public Dialogue

Meier¹,

Gallegos

Thomas³

et al. 2016

The American Journal of Geriatric Psychiatry

385

310

View full text Add to dashboard Cite

show abstract

“…Mak und Clinton [19] zeigen, dass der Begriff des "guten Sterbens" am häufigsten verwendet wird. Eine Annäherung an das, was unter dem Begriff des "guten Sterbens" verstanden wird, ist durch eine Beschreibung der Attribute, die aus Sicht von Patienten und Versorgern ein gutes Sterben auszeichnen, zu erlangen [14]. …”

Section: Stand Der Forschungunclassified

Was ist „gutes Sterben“?

Hutter

Stößel

Meffert

et al. 2015

Dtsch med Wochenschr

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“…There is a growing body of evidence exploring end-of-life experience and the attributes of a ‘good death’ with general consensus being reached on the complexity of managing dying due to its multidimensional nature 1 2. Such complexity has been argued to result in care providers prioritising medical aspects of care over non-clinical aspects such as the social and psychological experience of dying, a critical issue that the study by Holdsworth seeks to address.…”

Section: Contextmentioning

confidence: 99%

What ‘a good death’ means for bereaved family carers

Papavasiliou

Bakogiannis

2015

Evid Based Nurs

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Commentary on: Holdsworth LM. Bereaved carers' accounts of the end of life and the role of care providers in a 'good death': a qualitative study. Palliat Med 2015;29:834-41. Implications for practice and research▪ Care providers are not always aware of the complex ways in which they can shape end-of-life experience.▪ Beyond good medical and nursing support, social aspects of care shaped by care providers can have a long-lasting effect on bereaved carers.▪ The interpersonal impact care providers can have on bereaved carers, especially when considering that care provision is terminated after the patient's death, needs to be further and more systematically explored. ContextThere is a growing body of evidence exploring end-of-life experience and the attributes of a 'good death' with general consensus being reached on the complexity of managing dying due to its multidimensional nature. 1 2 Such complexity has been argued to result in care providers prioritising medical aspects of care over non-clinical aspects such as the social and psychological experience of dying, a critical issue that the study by Holdsworth seeks to address. MethodsThe purpose of the study was to explore the way bereaved carers conceptualise 'good death' and the impact that care providers might have on shaping such conceptualisations. The study used in-depth interviews with bereaved family carers from a hospice population in the South East of England following a pragmatic, applied approach to qualitative inquiry as introduced by Snape and Spencer. 3 Out of a sample of 270 carers identified and invited by letter to take part in the study, 44 participated in the interviews. An interpretative thematic analysis using the framework approach was employed for data analysis. FindingsAttributes of a good death, as conceptualised by bereaved carers, were classified into six main themes. These themes comprised social engagement and connection to identity, carer provider characteristics and actions, carer's confidence and ability to care, preparation and awareness of death, presentation of the patient at death and support after death for protected grieving in all of which care providers were observed to play a key role. The findings suggest that the role of care providers in shaping end-of-life experience extends beyond medical and nursing support into more social aspects of care. CommentaryThis study focused on bereaved carers' accounts of what constitutes a 'good death' to determine the extent to which care providers can influence non-medical aspects of the dying experience. Although the impact of social support and the ways to improve such support for patients and carers have been systematically examined, research on the role of the care providers has largely focused on medical management with no explicit consideration of the role they can play in shaping social aspects of death. 4 5 This study indicates that the boundaries between care providers and the social network of patients and their families can be blurred as care providers are increasingly becom...

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Concept Analysis of Good Death in Terminally Ill Patients

Cited by 111 publications

References 47 publications

Defining a Good Death (Successful Dying): Literature Review and a Call for Research and Public Dialogue

Defining a Good Death (Successful Dying): Literature Review and a Call for Research and Public Dialogue

Was ist „gutes Sterben“?

What ‘a good death’ means for bereaved family carers

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