Change search
ReferencesLink to record
Permanent link

Direct link
Complexity in Non-Pharmacological Caregiving Activities at the End of Life: An International Qualitative Study
Umeå University, Faculty of Medicine, Department of Nursing.
Show others and affiliations
2012 (English)In: PLoS Medicine, ISSN 1549-1277, E-ISSN 1549-1676, Vol. 9, no 2, e1001173- p.Article in journal (Refereed) Published
Abstract [en]

Background: In late-stage palliative cancer care, relief of distress and optimized well-being become primary treatment goals. Great strides have been made in improving and researching pharmacological treatments for symptom relief; however, little systematic knowledge exists about the range of non-pharmacological caregiving activities (NPCAs) staff use in the last days of a patient's life. Methods and Findings: Within a European Commission Seventh Framework Programme project to optimize research and clinical care in the last days of life for patients with cancer, OPCARE9, we used a free-listing technique to identify the variety of NPCAs performed in the last days of life. Palliative care staff at 16 units in nine countries listed in detail NPCAs they performed over several weeks. In total, 914 statements were analyzed in relation to (a) the character of the statement and (b) the recipient of the NPCA. A substantial portion of NPCAs addressed bodily care and contact with patients and family members, with refraining from bodily care also described as a purposeful caregiving activity. Several forms for communication were described; information and advice was at one end of a continuum, and communicating through nonverbal presence and bodily contact at the other. Rituals surrounding death and dying included not only spiritual/religious issues, but also more subtle existential, legal, and professional rituals. An unexpected and hitherto under-researched area of focus was on creating an aesthetic, safe, and pleasing environment, both at home and in institutional care settings. Conclusions: Based on these data, we argue that palliative care in the last days of life is multifaceted, with physical, psychological, social, spiritual, and existential care interwoven in caregiving activities. Providing for fundamental human needs close to death appears complex and sophisticated; it is necessary to better distinguish nuances in such caregiving to acknowledge, respect, and further develop end-of-life care.

Place, publisher, year, edition, pages
San Francisco: Public Library of Science , 2012. Vol. 9, no 2, e1001173- p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:umu:diva-54141DOI: 10.1371/journal.pmed.1001173ISI: 000301222600006OAI: diva2:516917
Available from: 2012-04-20 Created: 2012-04-17 Last updated: 2012-08-09Bibliographically approved

Open Access in DiVA

fulltext(449 kB)254 downloads
File information
File name FULLTEXT02.pdfFile size 449 kBChecksum SHA-512
Type fulltextMimetype application/pdf

Other links

Publisher's full text

Search in DiVA

By author/editor
Lindqvist, OlavLundquist, GunillaHolritz Rasmussen, Birgit
By organisation
Department of NursingOncology
In the same journal
PLoS Medicine
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 254 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 182 hits
ReferencesLink to record
Permanent link

Direct link