Congress Abstracts 2005

48

APPROACHING DEATH: A PHENOMENOLOGICAL STUDY. Patricia Ryan, RN, PhD, AOCN^®, University of Kentucky, Lexington, KY.

An understanding of the end-of-life experience from the patient’s perspective is limited. It is important that care be based on understanding; not merely healthcare professional’s assumption or caregiver’s retrospective reports.

Knowledge developed directly from the patient’s perspective is needed in order to design meaningful care. The purpose of this study was to explore the lived experience of approaching death among elderly persons with advanced cancer.

A qualitative design with a phenomenological approach was used with five purposively selected participants. Multiple in-depth interviews were conducted over time in the homes of the participants or in a private hospital room. A set of open-ended questions designed by the researcher were used as a general guide for the interviews.

Each taped interview was repeatedly reviewed following its completion. The tapes were transcribed by the researcher verbatim. The material was subjected to a process Munhall (2001) refers to as contextual processing. This activity occurs parallel to the inquiry. This process provides a departure from generating themes and categories and allows for the composition of a narrative that reflects one person’s description of the experience within his or her situated context.

Five insightful and compelling narratives of these individuals’ experiences suggest that genuine caring, compassionate honesty from trusted healthcare professionals, cautious hopefulness maintained by the individual and their loved ones, unquestioned faith, an involvement in desired life activities, and positive interactions within the healthcare system and in their personal relationships were meaningful to this experience. As we look beyond the diagnosis and consider the lived experience, we get a more viivd picture of the whole person and the meaning the experience holds for them and those who love them. Knowledge of this experience allows healthcare professionals to honor the remaining “precious moments” of these individuals lives by respecting their humanity, preserving their dignity, ensuring their comfort, and advocating for the highest quality of palliative care. Such knowledge can enable healthcare professionals and others providing care to assist individuals approaching death and their families to do so in a way that is meaningful rather than merely tolerable.