Skip to main content
Top
Published in: Supportive Care in Cancer 3/2017

01-03-2017 | Original Article

A good death from the perspective of palliative cancer patients

Authors: Lisa Kastbom, Anna Milberg, Marit Karlsson

Published in: Supportive Care in Cancer | Issue 3/2017

Login to get access

Abstract

Purpose

Although previous research has indicated some recurrent themes and similarities between what patients from different cultures regard as a good death, the concept is complex and there is lack of studies from the Nordic countries. The aim of this study was to explore the perception of a good death in dying cancer patients in Sweden.

Methods

Interviews were conducted with 66 adult patients with cancer in the palliative phase who were recruited from home care and hospital care. Interviews were analysed using qualitative content analysis.

Results

Participants viewed death as a process. A good death was associated with living with the prospect of imminent death, preparing for death and dying comfortably, e.g., dying quickly, with independence, with minimised suffering and with social relations intact. Some were comforted by their belief that death is predetermined. Others felt uneasy as they considered death an end to existence. Past experiences of the death of others influenced participants’ views of a good death.

Conclusions

Healthcare staff caring for palliative patients should consider asking them to describe what they consider a good death in order to identify goals for care. Exploring patients’ personal experience of death and dying can help address their fears as death approaches.
Literature
1.
go back to reference Steinhauser KE, Christakis NA, Clipp EC et al (2001) Preparing for the end of life: preferences of patients, families, physicians, and other care providers. J Pain Symptom Manag 22(3):727–737CrossRef Steinhauser KE, Christakis NA, Clipp EC et al (2001) Preparing for the end of life: preferences of patients, families, physicians, and other care providers. J Pain Symptom Manag 22(3):727–737CrossRef
2.
go back to reference Payne SA, Langley-Evans A et al (1996) Perceptions of a “good” death: a comparative study of the views of hospice staff and patients. Palliat Med 10(4):307–312CrossRefPubMed Payne SA, Langley-Evans A et al (1996) Perceptions of a “good” death: a comparative study of the views of hospice staff and patients. Palliat Med 10(4):307–312CrossRefPubMed
3.
go back to reference Granada-Cameron C, Houldin A (2012) Concept analysis of good death in terminally ill patients. Am J Hosp Palliat Med 29(8):632–639CrossRef Granada-Cameron C, Houldin A (2012) Concept analysis of good death in terminally ill patients. Am J Hosp Palliat Med 29(8):632–639CrossRef
4.
go back to reference Mak JM, Clinton M (1999) Promoting a good death: an agenda for outcomes research—a review of the literature. Nurs Ethics 6(2):97–106CrossRefPubMed Mak JM, Clinton M (1999) Promoting a good death: an agenda for outcomes research—a review of the literature. Nurs Ethics 6(2):97–106CrossRefPubMed
5.
go back to reference Patrick DL, Engelberg RA et al (2001) Evaluating the quality of dying and death. J Pain Symptom Manag 22(3):717–726CrossRef Patrick DL, Engelberg RA et al (2001) Evaluating the quality of dying and death. J Pain Symptom Manag 22(3):717–726CrossRef
6.
go back to reference Steinhauser KE, Christakis NA, Clipp EC et al (2000) Factors considered important at the end of life by patients, family, physicians, and other care providers. JAMA 284(19):2476–2482CrossRefPubMed Steinhauser KE, Christakis NA, Clipp EC et al (2000) Factors considered important at the end of life by patients, family, physicians, and other care providers. JAMA 284(19):2476–2482CrossRefPubMed
7.
go back to reference Kehl KA (2006) Moving toward peace: an analysis of the concept of a good death. Am J Hosp Palliat Med 23(4):277–286CrossRef Kehl KA (2006) Moving toward peace: an analysis of the concept of a good death. Am J Hosp Palliat Med 23(4):277–286CrossRef
8.
go back to reference Singer PA, Martin DK et al (1999) Quality end-of-life care: patients’ perspectives. JAMA 281(2):163–168CrossRefPubMed Singer PA, Martin DK et al (1999) Quality end-of-life care: patients’ perspectives. JAMA 281(2):163–168CrossRefPubMed
9.
go back to reference Miyashita M, Sanjo M, Morita T et al (2007) Good death in cancer care: a nationwide quantitative study. Ann Oncol 18:1090–1097CrossRefPubMed Miyashita M, Sanjo M, Morita T et al (2007) Good death in cancer care: a nationwide quantitative study. Ann Oncol 18:1090–1097CrossRefPubMed
10.
go back to reference Hirai K, Miyashita M et al (2006) Good death in Japanese cancer care: a qualitative study. J Pain Symptom Manag 31(2):140–147CrossRef Hirai K, Miyashita M et al (2006) Good death in Japanese cancer care: a qualitative study. J Pain Symptom Manag 31(2):140–147CrossRef
11.
go back to reference Steinhauser KE, Clipp EC et al (2000) In search of a good death: observations of patients, families and providers. Ann Intern Med 132(10):825–832CrossRefPubMed Steinhauser KE, Clipp EC et al (2000) In search of a good death: observations of patients, families and providers. Ann Intern Med 132(10):825–832CrossRefPubMed
12.
go back to reference Goldsteen M, Houtepen R et al (2006) What is a good death? Terminally ill patients dealing with normative expectations around death and dying. Patient Educ Couns 64:378–386CrossRefPubMed Goldsteen M, Houtepen R et al (2006) What is a good death? Terminally ill patients dealing with normative expectations around death and dying. Patient Educ Couns 64:378–386CrossRefPubMed
13.
go back to reference Hughes T, Schumacher M et al (2008) Confronting death: perceptions of a good death in adults with lung cancer. Am J Hosp Palliat Med 25(1):39–44CrossRef Hughes T, Schumacher M et al (2008) Confronting death: perceptions of a good death in adults with lung cancer. Am J Hosp Palliat Med 25(1):39–44CrossRef
14.
go back to reference Vig EK, Davenport NA, Pearlman RA (2002) Good deaths, bad deaths, and preferences for the end of life: a qualitative study of geriatric outpatients. J Am Geriatr Soc 50:1541–1548CrossRefPubMed Vig EK, Davenport NA, Pearlman RA (2002) Good deaths, bad deaths, and preferences for the end of life: a qualitative study of geriatric outpatients. J Am Geriatr Soc 50:1541–1548CrossRefPubMed
15.
go back to reference Vig EK, Pearlman RA (2004) Good and bad dying from the perspective of terminally ill men. Arch Intern Med 164(9):977–981CrossRefPubMed Vig EK, Pearlman RA (2004) Good and bad dying from the perspective of terminally ill men. Arch Intern Med 164(9):977–981CrossRefPubMed
16.
go back to reference Proulx K, Jacelon C (2004) Dying with dignity: the good patient versus the good death. Am J Hosp Palliat Med 21(2):116–120CrossRef Proulx K, Jacelon C (2004) Dying with dignity: the good patient versus the good death. Am J Hosp Palliat Med 21(2):116–120CrossRef
17.
go back to reference Van der Geest S (2004) Dying peacefully: considering good death and bad death in Kwahu-Tafo, Ghana. Social Science & Medicine 58:899–911CrossRef Van der Geest S (2004) Dying peacefully: considering good death and bad death in Kwahu-Tafo, Ghana. Social Science & Medicine 58:899–911CrossRef
19.
go back to reference Karlsson M, Milberg A, Strang P (2011) Dying cancer patients´ own opinions on euthanasia: an expression of autonomy? A qualitative study. Palliat Med 26(1):34–42CrossRefPubMed Karlsson M, Milberg A, Strang P (2011) Dying cancer patients´ own opinions on euthanasia: an expression of autonomy? A qualitative study. Palliat Med 26(1):34–42CrossRefPubMed
20.
go back to reference Karlsson M, Milberg A, Strang P (2012) Suffering and euthanasia: a qualitative study of dying patients´ perspectives. Support Care Cancer 20:1065–1071CrossRefPubMed Karlsson M, Milberg A, Strang P (2012) Suffering and euthanasia: a qualitative study of dying patients´ perspectives. Support Care Cancer 20:1065–1071CrossRefPubMed
21.
go back to reference Kvale S (1996) InterViews: an introduction to qualitative research interviewing. Sage Publications, Thousand Oaks Kvale S (1996) InterViews: an introduction to qualitative research interviewing. Sage Publications, Thousand Oaks
22.
go back to reference Krippendorff K (2004) Content analysis: an introduction to its methodology. Sage Publications, Thousand Oaks Krippendorff K (2004) Content analysis: an introduction to its methodology. Sage Publications, Thousand Oaks
23.
go back to reference Hsieh H-F, Shannon SE (2005) Three approaches to qualitative content analysis. Qual Health Res 15(9):1277–1288CrossRefPubMed Hsieh H-F, Shannon SE (2005) Three approaches to qualitative content analysis. Qual Health Res 15(9):1277–1288CrossRefPubMed
24.
go back to reference Graneheim UH, Lundman B (2004) Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 24:105–112CrossRefPubMed Graneheim UH, Lundman B (2004) Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 24:105–112CrossRefPubMed
25.
go back to reference Malterud K (2001) Qualitative research: standards, challenges, and guidelines. Lancet 358:483–488CrossRefPubMed Malterud K (2001) Qualitative research: standards, challenges, and guidelines. Lancet 358:483–488CrossRefPubMed
27.
go back to reference Kellehear A (2007) A social history of dying. Cambridge University Press Kellehear A (2007) A social history of dying. Cambridge University Press
28.
go back to reference Parker SM, Clayton JM, Hancock K et al (2007) A systematic review of prognostic/end-of-life communication with adults in the advanced stages of a life-limiting illness: patient/caregiver preferences for the content, style and timing of information. J Pain Symptom Manag 34(1):81–93CrossRef Parker SM, Clayton JM, Hancock K et al (2007) A systematic review of prognostic/end-of-life communication with adults in the advanced stages of a life-limiting illness: patient/caregiver preferences for the content, style and timing of information. J Pain Symptom Manag 34(1):81–93CrossRef
29.
go back to reference Slort W, Blankenstein AH et al. (2011) Facilitators and barriers for GP-patient communication in palliative care: a qualitative study among GPs, patients and end-of-life consultants. Br J Gen Pract :167–172 Slort W, Blankenstein AH et al. (2011) Facilitators and barriers for GP-patient communication in palliative care: a qualitative study among GPs, patients and end-of-life consultants. Br J Gen Pract :167–172
30.
go back to reference Benkel I, Wijk H, Molander U (2014) Challenging conversations with terminally ill patients and their loved ones: strategies to improve giving information in palliative care. SAGE Open Med Benkel I, Wijk H, Molander U (2014) Challenging conversations with terminally ill patients and their loved ones: strategies to improve giving information in palliative care. SAGE Open Med
31.
go back to reference Lundqvist G, Rasmussen BH, Axelsson B (2011) Information of imminent death or not: does it make a difference? J Clin Oncol 29:3927–3931CrossRef Lundqvist G, Rasmussen BH, Axelsson B (2011) Information of imminent death or not: does it make a difference? J Clin Oncol 29:3927–3931CrossRef
32.
go back to reference Johansen S, Holen JC, Kaasa S (2005) Attitudes towards, and wishes for, euthanasia in advanced cancer patients at a palliative medicine unit. Palliat Med 19:454–460CrossRefPubMed Johansen S, Holen JC, Kaasa S (2005) Attitudes towards, and wishes for, euthanasia in advanced cancer patients at a palliative medicine unit. Palliat Med 19:454–460CrossRefPubMed
33.
go back to reference Patton MQ (2002) Qualitative research and evaluation methods, 3rd edn. Sage Publications, Thousand Oaks Patton MQ (2002) Qualitative research and evaluation methods, 3rd edn. Sage Publications, Thousand Oaks
34.
go back to reference Patton MQ Enhancing the quality and credibility of qualitative analysis. Health Serv Res 34((5) Part II):1189–1208 Patton MQ Enhancing the quality and credibility of qualitative analysis. Health Serv Res 34((5) Part II):1189–1208
Metadata
Title
A good death from the perspective of palliative cancer patients
Authors
Lisa Kastbom
Anna Milberg
Marit Karlsson
Publication date
01-03-2017
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 3/2017
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-016-3483-9

Other articles of this Issue 3/2017

Supportive Care in Cancer 3/2017 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine