The power of consoling presence - hospice nurses’ lived experience with spiritual and existential care for the dying

BMC Nursing

Venke Sørlie¹  Kari Kvigne²  Lars J Danbolt³  Kirsten A Tornøe³ 

[1]Lovisenberg Diaconal University College, Oslo, Norway

[2]Department of Nursing and Mental Health, Hedmark University College, Elverum, Norway

[3]Center for the Psychology of Religion, Innlandet Hospital Trust, Ottestad, Norway

关键词: Phenomenological hermeneutical study;    Consolation;    Hospice nursing;    Spiritual and existential care;    Dying;   

Others  :  1090940
DOI  :  10.1186/1472-6955-13-25

 received in 2014-05-02, accepted in 2014-08-26,  发布年份 2014

【 摘 要 】

Background

Being with dying people is an integral part of nursing, yet many nurses feel unprepared to accompany people through the process of dying, reporting a lack of skills in psychosocial and spiritual care, resulting in high levels of moral distress, grief and burnout. The aim of this study is to describe the meaning of hospice nurses’ lived experience with alleviating dying patients’ spiritual and existential suffering.

Methods

This is a qualitative study.

Hospice nurses were interviewed individually and asked to narrate about their experiences with giving spiritual and existential care to terminally ill hospice patients. Data analysis was conducted using phenomenological hermeneutical method.

Results

The key spiritual and existential care themes identified, were sensing existential and spiritual distress, tuning inn and opening up, sensing the atmosphere in the room, being moved and touched, and consoling through silence, conversation and religious consolation.

Conclusions

Consoling existential and spiritual distress is a deeply personal and relational practice. Nurses have a potential to alleviate existential and spiritual suffering through consoling presence. By connecting deeply with patients and their families, nurses have the possibility to affirm the patients’ strength and facilitate their courage to live a meaningful life and die a dignified death.

【 授权许可】

   
2014 Tornøe et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Rushton C, Halifax J, Dossey B: Being with dying, contemplative practices for compassionate end-of-life care. Am Nurse Today 2007, 2(9):16-18.
• [2]Cody W: Bearing witness to suffering: participating in cotranscendence. Int J Human Caring 2007, 11(2):17.
• [3]Naef R: Bearing witness: a moral way of engaging in the nurse–person relationship. Nurs Philos 2006, 7(3):146-156.
• [4]Ariès P: The hour of our death. New York: Oxford University Press; 1991.
• [5]Ariès P, Ranum PM: Western attitudes toward death: from the Middle Ages to the present. Baltimore: Johns Hopkins University Press; 1974.
• [6]Halifax J: Being with Dying Contemplative approaches to working with dying people, for the death of America project. 1995. http://wwwwellcom/user/suscon/esalen/participants/Halifax/dyinghtml webcite
• [7]Arman M, Rehnsfeldt A: The ‘little extra’ that alleviates suffering. Nurs Ethics 2007, 14(3):372-384. discussion 384-376
• [8]Kræftpatientens verden-en undersøgelse af, hvad danske kræftpatienter har brug for (The cancer patient’s world - a study of what Danish cancer patients need) http://www.cancer.dk/dyn/resources/File/file/6/1606/1385430279/behovsundersogkort2006.pdf webcite
• [9]Christensen KH: Spiritual care perspectives of Danish registered nurses. J Holist Nurs 2008, 26(1):7-14.
• [10]McSherry W, Jamieson S: An online survey of nurses’ perceptions of spirituality and spiritual care. J Clin Nurs 2011, 20(11–12):1757-1767.
• [11]McSherry W, Jamieson S: The qualitative findings from an online survey investigating nurses’ perceptions of spirituality and spiritual care. J Clin Nurs 2013, 22(21–22):3170-3182.
• [12]Noble A, Jones C: Getting it right: oncology nurses’ understanding of spirituality. Int J Palliat Nurs 2010, 16(11):565-569.
• [13]Rushton CH, Sellers DE, Heller KS, Spring B, Dossey BM, Halifax J: Impact of a contemplative end-of-life training program: being with dying. Palliat Support Care 2009, 7(4):405-414.
• [14]Swinton J: Identity and resistance: why spiritual care needs ’enemies’. J Clin Nurs 2006, 15(7):918-928.
• [15]Pesut B, Fowler M, Taylor EJ, Reimer-Kirkham S, Sawatzky R: Conceptualising spirituality and religion for healthcare. J Clin Nurs 2008, 17(21):2803-2810.
• [16]Reimer-Kirkham S: Lived religion: implications for nursing ethics. Nurs Ethics 2009, 16(4):406-417.
• [17]Kalish N: Evidence-based spiritual care: a literature review. Curr Opin Support Palliat Care 2012, 6(2):242-246.
• [18]Bruce A, Stadjuhar KI: Spirituality in Nursing following Patients’ and families view of a good death. In Spirituality in hospice palliative care. Edited by Bramadat P, Coward HG, Stajduhar KI. Albany, N.Y: SUNY Press; 2013. VII, 206 s
• [19]Ricœur P: Interpretation theory: discourse and the surplus of meaning. Fort Worth, Tex: Texas Christian University Press; 1976.
• [20]Lindseth A, Norberg A: A phenomenological hermeneutical method for researching lived experience. Scand J Caring Sci 2004, 18(2):145-153.
• [21]Spidsberg BD, Sørlie V: An expression of love–midwives’ experiences in the encounter with lesbian women and their partners. J Adv Nurs 2012, 68(4):796-805.
• [22]Mishler EG: Research interviewing: context and narrative. Cambridge, Mass: Harvard University Press; 1986.
• [23]Van Manen M: Researching lived experience: human science for an action sensitive pedagogy. London, Ont: Althouse Press; 1997.
• [24]Riessman CK: Narrative analysis. Newbury Park, Calif: Sage; 1993.
• [25]Gadamer H-G: Truth and method. London: Sheed & Ward; 1989.
• [26]Ricœur P: Time and narrative. Chicago: University of Chicago Press; 1984.
• [27]Ricœur P, Thompson JB: Hermeneutics and the human sciences: essays on language, action and interpretation. Cambridge: Cambridge University Press; 1981.
• [28]Swinton J, Mowat H: Practical theology and qualitative research. London: SCM Press; 2006.
• [29]Creswell JW: Research design: qualitative, quantitative, and mixed methods approaches. SAGE: Los Angeles; 2009.
• [30]Lincoln YS, Guba EG: Naturalistic inquiry. Beverly Hills, Calif: Sage; 1985.
• [31]Covington H: Caring presence. Delineation of a concept for holistic nursing. J Holist Nurs 2003, 21(3):301-317.
• [32]Back AL, Bauer-Wu SM, Rushton CH, Halifax J: Compassionate silence in the patient-clinician encounter: a contemplative approach. J Palliat Med 2009, 12(12):1113-1117.
• [33]Norberg A, Bergsten M, Lundman B: A model of consolation. Nurs Ethics 2001, 8(6):544-553.
• [34]Miller GA, Wagner A, Britton TP, Gridley BE: A framework for understanding the wounding of healers. Couns Values 1998, 42(2):124-132.
• [35]Hart B, Sainsbury P, Short S: Whose dying? A sociological critique of the‘good death’. Mortal 1998, 3(1):65-77.
• [36]McNamara B: Good enough death: autonomy and choice in Australian palliative care. Soc Sci Med 2004, 58(5):929-938.