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Understanding the concept of a “good death” among bereaved family caregivers of cancer patients in Singapore

Published online by Cambridge University Press:  01 March 2012

Geok Ling Lee ,
Ivan Mun Hong Woo  and
Cynthia Goh
Geok Ling Lee*
Affiliation:
Lien Centre for Palliative Care, Duke-National University of Singapore Graduate Medical School, Singapore
Ivan Mun Hong Woo
Affiliation:
Department of Social Work, National University of Singapore, Singapore
Cynthia Goh
Affiliation:
Department of Palliative Medicine, National Cancer Centre, Singapore
*
Address correspondence and reprint requests to: Geok Ling Lee, Department of Social Work, Faculty of Arts and Social Sciences, National University of Singapore, Blk AS3 Level 4, 3 Arts Link, Singapore 117570. E-mail: [email protected]
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Abstract

Objective:

The aim of this study was to examine the concept of a good death from the perspectives of both the dying person and the family caregiver, as perceived by bereaved family caregivers of advanced cancer patients.

Method:

The data were gathered from five focus group discussions and one face-to-face qualitative interview conducted over 8 months among 18 bereaved family caregivers recruited from a local hospice. The transcripts of the focus groups and the interview were entered into NVivo Version 8 and were analyzed using the thematic approach.

Results:

A good death may be understood as having the biopsychosocial and spiritual aspects of life handled well at the end of life. Five major themes were identified. These were preparation for death, family and social relationships, moments at or near death, comfort and physical care, and spiritual well-being. Differences were also noted in what is important at the end of life between the patients and caregivers. Having a quick death with little suffering was perceived to be good by the patient, but the family caregiver wanted to be able to say a final goodbye to the patient. Patients tend to prefer not to die in their children's presence but the children wished to be present for the final moment. In addition, family caregivers reported it was important for them to be able to give the patients permission to die, to feel recognized for the efforts made, and to have had a fulfilling caregiving experience.

Significance of results:

Whereas there are global attributes of a good death, our findings suggest that patients and family caregivers may define a good death differently. Therefore, there is a need to respect, address, and reconcile the differences, so that all parties may have a good experience at the end of a person's life.

Keywords

Good deathEnd-of-life carePalliative careBereaved family caregiversMulticultural society
Type
Original Articles
Information
Palliative & Supportive Care , Volume 11 , Issue 1 , February 2013 , pp. 37 - 46
Copyright
Copyright © Cambridge University Press 2012

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References

REFERENCES

Carr, D. (2003). A “good death” for whom? Quality of spouse's death and psychological distress among older widowed persons. Journal of Health and Social Behavior, 44, 215–232.Google Scholar
Charmaz, K. (2006). Constructivist Grounded Theory: A Practical Guide through Qualitative Analysis. London: Sage.Google Scholar
Chochinov, H.M. (2006). Dying, dignity, and new horizons in palliative end-of-life care. Cancer Journal for Clinicians, 56, 84–103.Google Scholar
De Jong, J.D. & Clarke, L.E. (2009). What is a good death? Stories from palliative care. Journal of Palliative Care, 25, 61–67.Google Scholar
Denzin, N.K.L. & Lincoln, Y.S. (2005). Introduction: The discipline and practice of qualitative research. In The SAGE Handbook of Qualitative Research, 3rd ed.Denzin, N.K.L. & Lincoln, Y.S., (eds.), pp. 1–30. Thousand Oaks, CA: Sage.Google Scholar
Hirai, K., Miyashita, M., Morita, T., et al. (2006). Good death in Japanese cancer care: a qualitative study. Journal of Pain and Symptom Management, 31, 140–147.CrossRefGoogle ScholarPubMed
Ho, D.Y.F. (1995). Selfhood and identity in Confucianism, Taoism, Buddhism and Hinduism: Contrast with the West. Journal for the Theory of Social Behaviour, 25, 115–139.Google Scholar
Hughes, T., Schumacher, M., Jacobs–Lawson, et al. (2008). Confronting death: Perceptions of a good death in adults with lung cancer. American Journal of Hospice and Palliative Care, 25, 39–44.CrossRefGoogle ScholarPubMed
Kehl, K.A. (2006). Moving toward peace: An analysis of the concept of a good death. American Journal of Hospice and Palliative Care, 23, 277–286.Google Scholar
Leung, K.K., Liu, W.J., Cheng, S.Y., et al. (2009). What do laypersons consider as a good death. Supportive Care in Cancer, 17, 691–699.Google Scholar
Li, J. (2001). Chinese conceptualization of learning. Ethos, 29, 111–137.Google Scholar
Mak, J.M. & Clinton, M. (1999). Promoting a good death: An agenda for outcomes research–A review of the literature. Nursing Ethics, 6, 97–106.Google Scholar
Miyashita, M., Morita, T., Sato, K., et al. (2008a). Factors contributing to evaluation of a good death from the bereaved family member's perspective. Psychooncology, 17, 612–620.Google Scholar
Miyashita, M., Morita, T., Sato, K., et al. (2008b). Good death inventory: A measure for evaluating good death from the bereaved family member's perspective. Journal of Pain and Symptom Management, 35, 486–498.Google Scholar
Miyashita, M., Sanjo, M., Morita, T., et al. (2007). Good death in cancer care: A nationwide quantitative study. Annals of Oncology, 18, 1090–1097.Google Scholar
Murakawa, Y. & Nihei, Y. (2009). Understanding the concept of a ‘good death’ in Japan: Differences in the views of doctors, palliative and non-palliative ward nurses. International Journal of Palliative Nursing, 15, 282–289.Google Scholar
Patrick, D.L., Engelberg, R.A. & Curtis, J.R. (2001). Evaluating the quality of dying and death. Journal of Pain and Symptom Management, 22, 717–726.Google Scholar
Patton, M.Q. (2002). Qualitative Research and Evaluation Methods, 3rd ed.Thousand Oaks, CA: Sage.Google Scholar
Payne, S.A., Hillier, R., Langley-Evans, A., et al. (1996a). Impact of witnessing death on hospice patients. Social Science and Medicine, 43, 1785–1794.Google Scholar
Payne, S.A., Langley-Evans, A. & Hillier, R. (1996b). Perceptions of a ‘good’ death: A comparative study of the views of hospice staff and patients. Palliative Medicine, 10, 307–312.Google Scholar
Sanjo, M., Miyashita, M., Morita, T., et al. (2007). Preferences regarding end-of-life cancer care and associations with good-death concepts: A population-based survey in Japan. Annals of Oncology, 18, 1539–1547.CrossRefGoogle ScholarPubMed
Singer, P.A., Martin, D.K. & Kelner, M. (1999). Quality end-of-life care: Patients' perspectives. Journal of the American Medical Association, 281, 163–168.Google Scholar
Steinhauser, K.E., Christakis, N.A., Clipp, E.C., et al. (2000a). Factors considered important at the end of life by patients, family, physicians, and other care providers. Journal of the American Medical Association, 284, 2476–2482.Google Scholar
Steinhauser, K.E., Clipp, E.C., McNeilly, M., et al. (2000b). In search of a good death: Observations of patients, families, and providers. Annals of Internal Medicine, 132, 825–832.Google Scholar
Teno, J.M., Casey, V.A., Welch, L.C., et al. (2001). Patient-focused, family-centered end-of-life medical care: Views of the guidelines and bereaved family members. Journal of Pain and Symptom Management, 22, 738–751.Google Scholar
Tong, E., McGraw, S.A., Dobihal, E., et al. (2003). What is a good death? Minority and non-minority perspectives. Journal of Palliative Care, 19, 168–175.Google Scholar
Vig, E.K., Davenport, N.A. & Pearlman, R.A. (2002). Good deaths, bad deaths, and preferences for the end of life: A qualitative study of geriatric outpatients. Journal of the American Geriatrics Society, 50, 1541–1548.Google Scholar