Gratitude at the End of Life: A Promising Lead for Palliative Care

Althaus, Betty; Borasio, Gian Domenico; Bernard, Mathieu

doi:10.1089/jpm.2018.0027

Cited by 23 publications

(29 citation statements)

References 57 publications

(45 reference statements)

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“…One highlights positive links between growth and end of life dreams and visions (Levy et al, 2020). The other, conducted by our research team, found positive associations between gratitude and growth (Althaus et al, 2018). However, key questions of PTG prevalence and associations with psychological distress and quality of life in palliative patients remain unanswered.…”

Section: Introductionmentioning

confidence: 80%

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Posttraumatic growth in palliative care patients and its associations with psychological distress and quality of life

et al. 2022

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Objectives Posttraumatic growth (PTG) refers to positive psychological changes resulting from individuals’ inner struggles with traumatic events such as life-threatening illness. Although palliative care patients are confronted with their own mortality, little is known about their PTG experience. This study investigates whether PTG is an empirically relevant concept for palliative patients by assessing the prevalence and areas of growth, and examining associations with psychological distress and quality of life. Methods Participants were recruited in Switzerland. Using validated questionnaires, we assessed PTG (Posttraumatic Growth Inventory, PTGI), psychological distress (Hospital Anxiety and Depression Scale), and quality of life (McGill-Quality of Life Questionnaire – Revised). We performed descriptive analyses, Spearman correlations, and linear regressions. Results Fifty-five patients completed the PTGI, 44% of whom experienced no/low growth, 47% moderate growth, and 9% high/very high growth. Participants experienced the greatest positive changes in terms of appreciating life and relating to others. We found significant negative bivariate correlations between PTG and psychological distress (r = −0.33) and between PTG and depression (r = −0.47). Linear regressions showed that PTG is associated with depression (β = −0.468; p = 0.000), but not with anxiety or quality of life (adjusted R2 = 0.219). Significance of results Over half of our patients experienced moderate to very high growth, indicating that PTG is an empirically relevant psychological process in palliative care. PTG is associated with lower levels of depression, possibly as those experiencing growth are more able to process past traumas and build a more positive outlook on one's life and self. By contrast, the relative independence of anxiety and PTG points to the likely coexistence of positive and negative psychological responses to trauma. The lack of association between PTG and quality of life points to the uniqueness of the PTG concept in capturing how people access deeper meaning and greater appreciation of life along the path toward posttraumatic self-reconstruction.

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Section: Introductionmentioning

confidence: 80%

“…This cross-sectional study deployed standardized, validated questionnaires to collect quantitative data about palliative care patients, as part of a wider research project examining gratitude at the end of life (Althaus et al, 2018).…”

Section: Methodsmentioning

confidence: 99%

Posttraumatic growth in palliative care patients and its associations with psychological distress and quality of life

et al. 2022

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“…Articles included in this meta-narrative often focus on gratitude benefits as a factor that could be used instrumentally to inform care interactions. Althaus et al (2018) conclude that gratitude may have a positive impact on quality of life and reduce psychological distress in patients receiving palliative care in Switzerland. A thematic analysis of interviews with patients in a city in the United States who had suffered a traumatic spinal cord injury found that patients benefited from appraising adverse life experiences as positive through the lens of gratitude (Chun & Lee, 2013).…”

Section: Meta-narrative 4: Benefits Of Gratitudementioning

confidence: 85%

Gratitude in Health Care: A Meta-narrative Review

2020

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Research into gratitude as a significant sociological and psychological phenomenon has proliferated in the past two decades. However, there is little consensus on how it should be conceptualized or investigated empirically. We present a meta-narrative review that focuses on gratitude in health care, with an emphasis on research exploring interpersonal experiences in the context of care provision. Six meta-narratives from literatures across the humanities, sciences, and medicine are identified, contextualized, and discussed: gratitude as social capital; gifts; care ethics; benefits of gratitude; gratitude and staff well-being; and gratitude as an indicator of quality of care. Meta-narrative review was a valuable framework for making sense of theoretical antecedents and findings in this developing area of research. We conclude that greater attention needs to be given to what constitutes “evidence” in gratitude research and call for qualitative studies to better understand and shape the role and implications of gratitude in health care.

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“…In this way, perhaps the process of truly receiving gratitude can be conceptualized as a form of self-care. Gratitude may be a promising focus for interventions in health care due to its positive effect on the giver ( Althaus et al, 2018 ) and receiver.…”

Section: Discussionmentioning

confidence: 99%

“…More specifically, there is evidence that giving thanks or “practicing gratitude” can be beneficial for patients with advanced disease, resulting in an improved sense of quality of life and protection against psychosocial distress ( Althaus et al, 2018 ). Some studies also suggest that practicing gratitude helps to reduce burnout ( Chan, 2011 ; Lanham et al, 2012 ), and stress ( Krause, 2006 ; Tsui Pui, 2009 ; Wood et al, 2008 ), improves mood, self-esteem and sense of happiness ( Borgueta, 2012 ; Lee, 2017 ).…”

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confidence: 99%

Palliative Professionals’ Experiences of Receiving Gratitude: A Transformative and Protective Resource

et al. 2022

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Providing palliative care can be both challenging and rewarding. It involves emotionally demanding work and yet research shows that burnout is lower than in other fields of health care. Spontaneous expressions of gratitude from patients and family members are not uncommon and are highly valued. This study explored the experience of Spanish palliative professionals who received expressions of gratitude from their patients and families. A phenomenological approach was used to better understand the role of receiving gratitude in participants’ lives. Interviews were transcribed verbatim and a phenomenological approach to analysis was undertaken using macro-thematic and micro-thematic reflection. Two team members independently engaged in this reflection with an inductive approach. The analysis was shared and discussed at periodic meetings to identify the key themes and sub-themes of the gratitude experience. Ten palliative professionals were interviewed. Participants engaged in a process of recognizing, internalizing, and treasuring the expressions of gratitude which they then used for reflection and growth. These expressions were a powerful and deeply meaningful resource that the palliative professionals revisited over time. Receiving expressions of gratitude invited a stronger sense of the value of one’s self and one’s work that was motivational and protective, particularly during challenging times.

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Gratitude at the End of Life: A Promising Lead for Palliative Care

Abstract: Gratitude may act positively on QoL and may protect against psychological distress in the palliative situation. The next step will be the adaptation and implementation of a gratitude-based intervention.

Cited by 23 publications

References 57 publications

Posttraumatic growth in palliative care patients and its associations with psychological distress and quality of life

Posttraumatic growth in palliative care patients and its associations with psychological distress and quality of life

Gratitude in Health Care: A Meta-narrative Review

Palliative Professionals’ Experiences of Receiving Gratitude: A Transformative and Protective Resource

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