Spiritual and existential meanings of death and dying : a palliative nursing care perspective.

Abstract

This study aimed to explore the ways palliative care nurses conceptualised the death and dying experiences of their patients. Spiritual and existential meaning-making was a particular focus, as well as the ways in which these intersected with Elisabeth Kübler-Ross’s (1969) five stages of dying. Ten palliative care nurses at a hospice facility in Johannesburg participated in the study. They were interviewed from 1 July to 20 August 2009. A semi-structured interview format was used. A thematic content analysis was used to analyse the data, with two broad themes emerging: experiences of death and dying, and meaning-making. Within the first theme, it was found that the five stages of dying, although identifiable, are found to be vacillating, and often occur simultaneously. The patients’ experiences themselves were perceived by nurses to be more complex and nuanced than the theory suggested, and some experiences did not conform to the stage model at all. Meaning-making was witnessed to occur regardless of patients’ level and type of religiosity. Existential meaning could be found through religion or without it. However, religion also served as a way to explain death, and when this failed, it could result in distress. The ways in which patients made meaning often directly influenced their emotional experiences, and thus intersections were common.