The use of personal narratives in hospital-based palliative care interventions: An integrative literature review

Roikjær, Stine Gundtoft; Missel, Malene; Bergenholtz, Heidi; Schønau, Mai Nanna; Timm, Helle Ussing

doi:10.1177/0269216319866651

Cited by 22 publications

(21 citation statements)

References 44 publications

(387 reference statements)

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“…Our study showed that what was expected from the HP was related to the disease and its treatment, rather than an actual EOL conversation. A recent review [ 35 ] indicates that the use of personal narratives can relieve psychosocial and existential suffering in a hospital setting, but that a flexible intervention is required that is adjusted to both the setting and individual needs. Findings from this study reveal that the HPs might have to address EOL issues in another way – a way that embraces the position of the patient at that moment, as well as being sensitive to the fact that the patients and their spouses may not be at the same page.…”

Section: Discussionmentioning

confidence: 99%

Talking about death and dying in a hospital setting - a qualitative study of the wishes for end-of-life conversations from the perspective of patients and spouses

2020

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Background End-of-life (EOL) conversations are highly important for patients living with life-threatening diseases and for their relatives. Talking about the EOL is associated with reduced costs and better quality of care in the final weeks of life. However, there is therefore a need for further clarification of the actual wishes of patients and their relatives concerning EOL conversations in an acute hospital setting. Aim The purpose of this study was to explore the wishes of patients and their relatives with regard to talking about the EOL in an acute hospital setting when living with a life-threatening disease. Methods This study is a qualitative study using semi-structured in-depth interviews. A total of 17 respondents (11 patients and six spouses) participated. The patients were identified by the medical staff in a medical and surgical ward using SPICT™. The interview questions were focused on the respondents’ thoughts on and wishes about their future lives, as well as on their wishes regarding talking about the EOL in a hospital setting. Results This study revealed that the wish to talk about the EOL differed widely between respondents. Impairment to the patients’ everyday lives received the main focus, whereas talking about EOL was secondary. Conversations on EOL were an individual matter and ranged from not wanting to think about the EOL, to being ready to plan the funeral and expecting the healthcare professionals to be very open about the EOL. The conversations thus varied between superficial communication and crossing boundaries. Conclusion The wish to talk about the EOL in an acute hospital setting is an individual matter and great diversity exists. This individualistic stance requires the development of conversational tools that can assist both the patients and the relatives who wish to have an EOL conversation and those who do not. At the same time, staff should be trained in initiating and facilitating EOL discussions.

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Section: Discussionmentioning

confidence: 99%

Talking about death and dying in a hospital setting - a qualitative study of the wishes for end-of-life conversations from the perspective of patients and spouses

2020

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“…The purpose of this review was to evaluate the literature on the use of personal narratives in hospital-based palliative care interventions and determine if they have feasible and acceptable clinical application 4. A systematic integrative review method of primary research with qualitative analysis and narrative synthesis was executed.…”

Section: Methodsmentioning

confidence: 99%

The integration of personal narratives into hospital-based palliative care can relieve patient psychosocial and existential suffering

Acorn

2019

Evid Based Nurs

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“…[17][18][19] However, it is not easy to apply the resource-intensive reminiscence-based narrative in the fast-moving hospital setting. [17][18][19] The S' approach 20 was developed by Ternestedt and her team to operationalise PC in a clinical setting by exploring needs and resources in the dimensions of symptom control, self-image, self-determination, social relationships, strategy for the future and sense of coherence. 20 21 Based on the idea of narratives as a method to provide meaningful patterns, the S' approach aims to integrate patient and professional perspectives in PC.…”

Section: The Narrative S' Approachmentioning

confidence: 99%

“…On the basis of current research 17 exploring the need for 8 and lack of knowledge of PC in a general hospital setting, an intervention was designed and implemented alongside the standard treatment provided by a general outpatient HF clinic at a hospital in Denmark.…”

Section: A Pc Intervention For Hfmentioning

confidence: 99%

Qualitative study to explore what patients with heart failure find significant during integrated palliative care sessions in a Danish clinic

2020

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ObjectiveIn the field of palliative care (PC) as it is integrated into heart failure (HF) treatment, it is essential to explore the patient experience and build on this knowledge for the further development of PC practice and policy. Based on an intervention study, this paper explores what patients with HF find significant in integrated sessions using a narrative S’ approach.DesignWe conducted a semistructured interview study with a qualitative analysis focused on meaning making. The study follows the guidelines of Consolidated Criteria for Reporting Qualitative Research.Participants and settingThe inclusion criteria for the PC intervention were (1) a new diagnosis of HF, (2) follow-up treatment at this local Danish HF clinic and (3) informed consent to participate in the integrated PC intervention. The only exclusion criterion was if the patient was already engaged in a PC programme. 20 patients agreed to participate in the intervention, and 12 of these completed the S’ approach sessions and participated in this interview study.ResultsOverall, the analysis showed that the integrated S’ approach sessions were successful in joining an embodied patient perspective with a medical perspective. The thematic analysis resulted in three themes supporting the overall findings: sessions bring comfort, telling your story provides a sense of meaningfulness, and integrating perspectives of HF into everyday life.ConclusionThe method using the S’ approach in integrated PC and HF sessions was significant in various ways. First, patients experienced a calm and safe atmosphere and perceived that the nurse was truly interested in them. Second, the integrated sessions based on the S’ approach were able to bring comfort to lived physical, psychosocial and existential issues. Last, it allowed patients to combine their embodied understanding of HF with a medical perspective, thereby finding meaning in the sense of how everything is connected.

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The use of personal narratives in hospital-based palliative care interventions: An integrative literature review

Cited by 22 publications

References 44 publications

Talking about death and dying in a hospital setting - a qualitative study of the wishes for end-of-life conversations from the perspective of patients and spouses

Talking about death and dying in a hospital setting - a qualitative study of the wishes for end-of-life conversations from the perspective of patients and spouses

The integration of personal narratives into hospital-based palliative care can relieve patient psychosocial and existential suffering

Qualitative study to explore what patients with heart failure find significant during integrated palliative care sessions in a Danish clinic

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