緩和ケアと医学

抽象的な

Confronting the Forthcoming Death: A Classic Grounded Theory

Carina Werkander Harstäde and Anna Sandgren

Objective: The aim of this study was to develop a classic grounded theory of patients in palliative care. Methods: A classic Grounded Theory methodology was used to conceptualize patterns of human behavior. Twenty-seven interviews with patients in palliative care and two autobiographies written by persons receiving palliative care were analyzed. Result: “Confronting the forthcoming death” emerged as the pattern of behavior through which patients deal with their main concern, living in uncertainty of a death foretold. The theory involves four strategies; Seeking concrete knowledge, Shielding off, Seeing things through, and Embracing life. Holding on to hope and Suffering are also ever present. Conclusion: The theory shows that there is no easy way straight ahead; patients strive to confront the situation as well as they can, both wanting and not wanting to know what lies ahead. For health professionals, knowledge about how patients use different strategies, which can be used in tandem or succession, or shifted back and forth between over time, to confront their imminent deaths, can create an awareness of how to encounter patients in this uncertainty.