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Exploring family relationships through associations of comfort, relatedness states, and life closure in hospice patients: A pilot study

Published online by Cambridge University Press:  24 April 2014

Dana M. Hansen ,
Patricia A. Higgins ,
Camille Beckette Warner  and
M. Murray Mayo
Dana M. Hansen*
Affiliation:
Kent State University College of Nursing, Kent, Ohio
Patricia A. Higgins
Affiliation:
Case Western Reserve University and Geriatric Research Education and Clinical Center, Cleveland Veterans Affairs Medical Center, Cleveland, Ohio
Camille Beckette Warner
Affiliation:
Assistant Professor, Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, Ohio
M. Murray Mayo
Affiliation:
Ursuline College, Breen School of Nursing, Cleveland, Ohio
*
Address correspondence and reprint requests to: Dana M. Hansen, Kent State University College of Nursing, 113 Henderson Hall, Room 372, P.O. Box 5190, Kent, Ohio 44242. E-mail: [email protected]
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Abstract

Objective:

Research at the end of life tends to focus on the dying patient's symptoms, often overlooking issues associated with family interactions. However, many families struggle just to maintain or initiate these valuable connections. The purpose of our pilot study was to explore family relationships at the end of life and investigate associations among perceived comfort, relatedness states, and life closure.

Method:

This descriptive study used a cross-sectional design, and a convenience sample (n = 30; 18 women; mean age = 71 years) was recruited from patients admitted to a large not-for-profit hospice in northeastern Ohio. In-person interviews using the Hospice Comfort Questionnaire, Relatedness States Visual Analog Scales, and the Life-Closure Scale provided data for analyses.

Results:

Family interactions that were not associated with the physical tasks of caregiving were related to life closure (r = 0.36, p = 0.001), and life closure and comfort were highly correlated (r = 0.69, p < 0.001). Participants residing in an inpatient setting had higher levels of involvement (t[18] = –2.07, p = 0.05) and comfort in relationships (t[28] = –2.06, p = 0.05) than those in the home setting.

Significance of Results:

This is the first known study investigating the associations among comfort, relatedness, and life closure at the end of life. The majority of participants had high levels of involvement and comfort in their relationships, and they preferred interactions that required minimal effort. Studies that focus on both patients' and family members' perceptions of relationships are needed as well as outcome studies that test simple interventions.

Keywords

ComfortLife closureRelatedness statesFamily relationships at the end of life
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 2 , April 2015 , pp. 305 - 311
Copyright
Copyright © Cambridge University Press 2014 

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References

REFERENCES

Anderson, F., Downing, G.M., Hill, J., et al. (1996). Palliative performance scale (PPS): A new tool. Journal of Palliative Care, 12, 5–11.Google Scholar
Bakitas, M.A., Lyons, K.D., Dixon, J., et al. (2006). Palliative care program effectiveness research: Developing rigor in sampling design, conduct, and reporting. Journal of Pain and Symptom Management, 31, 270–284.Google Scholar
Broom, A. & Kirby, E. (2012). The end of life and the family: Hospice patients' views on dying as relational. Sociology of Health & Illness, 28, 1–15.Google Scholar
Callahan, C.M., Unverzagt, F.W., Hui, S.L., et al. (2002). Six-item screener to identify cognitive impairment among potential subjects for clinical research. Medical Care, 40, 771–781.Google Scholar
Chochinov, H.M., Hassard, T., McClement, S., et al. (2009). The landscape of distress in the terminally ill. Journal of Pain and Symptom Management, 38, 641–649.Google Scholar
Dobratz, M.C. (1990). The Life-Closure Scale: A measure of psychological adaptation in death and dying. The Hospice Journal, 6, 1–15.CrossRefGoogle Scholar
Dobratz, M.C. (2004). The Life-Closure Scale: Additional psychometric testing of a tool to measure psychological adaptation in death and dying. Research in Nursing & Health, 27, 52–62.Google Scholar
Dobratz, M.C. (2006). Enriching the portrait: Methodological triangulation of life-closing theory. Advances in Nursing Science, 29, 260–270.Google Scholar
Dobratz, M.C. (2011). Toward development of a middle range theory of psychological adaptation in death and dying. Nursing Science Quarterly, 24, 4370–4376.CrossRefGoogle ScholarPubMed
Dowd, T., Kolcaba, K., Steiner, R., et al. (2007). Comparison of a healing touch, coaching and a combined intervention on comfort and stress in younger college students. Holistic Nursing Practice, 21, 194–202.Google Scholar
Downy, L., Engleburg, R.A., Curtis, J.R., et al. (2009). Shared priorities for the end of life period. Journal of Pain and Symptom Management, 37, 175–188.CrossRefGoogle Scholar
Graneheim, U.H. & Lundman, B. (2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105–112.Google Scholar
Haggerty, B.M.K, Lynch-Sauer, J., Patusky, K.L., et al. (1993). An emerging theory of human relatedness. IMAGE: Journal of Nursing Scholarship, 25, 291–296.Google Scholar
Ho, F., Lau, F., Downing, M.G., et al. (2008). A reliability and validity study of the palliative performance scale. BMC Palliative Care, 7, 1–10.Google Scholar
Keeley, M.P. (2007). Turning toward death together: The functions of messages during final conversations in close relationships. Journal of Social and Personal Relationships, 24, 225–253.CrossRefGoogle Scholar
Knight, S.J. & Emanuel, L. (2007). Processes of adjustment to end of life losses: A reintegration model. Journal of Palliative Medicine, 49, 86–92.Google Scholar
Kolcaba, K. (2003). Comfort theory and practice: A vision for holistic health care and research. New York: Springer.Google Scholar
Lau, F., Downing, G.M., Lesperance, M., et al. (2006). Use of palliative performance scale in end-of-life prognostication. Journal of Palliative Medicine, 9, 1066–1075.CrossRefGoogle ScholarPubMed
Lee, D. & Higgins, P. (2011). The role of relationships during chronic critical illness. Doctoral dissertation. Cleveland: Case Western University.Google Scholar
McPherson, C.J., Wilson, K.G. & Murray, M.A. (2007). Feeling like a burden: Exploring the perspectives of patients at the end of life. Social Science & Medicine, 64, 417–427.Google Scholar
McPherson, C.J., Wilson, K.G., Chyurlia, L., et al. (2010). The balance of give and take in caregiver–partner relationships: An examination of self-perceived burden, relationship equity and quality of life from the perspective of care recipients following stroke. Rehabilitation Psychology, 55, 194–203.Google Scholar
National Hospice and Palliative Care Organization (NHPCO) (2011). NHPCO facts and figures: Hospice care in America. Available from http://www.nhpco.org/files/public/statistics_research/2011_facts_figures.pdf.Google Scholar
Novak, B, Kolcaba, K., Steiner, R., et al. (2001). Measuring comfort in caregivers and patients during late end-of-life care. American Journal of Hospice & Palliative Care, 18, 170–180.Google Scholar
Prince-Paul, M. (2008). Relationships among communicative acts, social well-being, and spiritual well-being on the quality of life at the end of life in patients with cancer enrolled in hospice. Journal of Palliative Medicine, 11, 20–25.Google Scholar
Rosenbaum, E., Garlan, R.W., Hirschberger, N., et al. (2006). The life tape project: Increasing family social support and symbolic immortality with a brief existential intervention for cancer patients and their families. Omega (Westport), 53, 321–339.Google Scholar
Sheehan, D.K. & Draucker, C.B. (2011). Interaction patterns between parents with advanced cancer and their adolescent children. Psycho-Oncology, 20, 1108–1115.Google Scholar
Syren, S.M., Saveman, B.I. & Benzien, E.G. (2006). Being a family in the midst of living and dying. Journal of Palliative Care, 22, 26–32.Google Scholar
Wohleber, A.M., McKitrick, D.S. & Davis, S.E. (2012). Designing research with hospice and palliative care populations. American Journal of Hospice & Palliative Care, 29, 335–345.Google Scholar