Abstract
In today's industrial societies, many people die receiving professional care. Although specialist palliative and hospice care have often been identified as ideal care approaches to promote good dying, more people die receiving generalist palliative care. This integrative review examines how professional caregivers providing generalist palliative care in hospitals, nursing or private homes define good dying. Furthermore, through comparative analysis of existing empirical studies, it explores conceptual aspects in researching good dying that better reflect the social complexity of this phenomenon. Three databases (Scopus, MEDLINE, and CINAHL) were searched for peer-reviewed studies published between January 2000 and April 2020. Studies were selected if they presented original empirical findings from qualitative or quantitative studies on the perspective of professional caregivers in generalist palliative care (nurses, physicians, surgeons, clergy, and other staff) on good dying or related concepts (e.g., good death, dignity in dying, or quality of life at the end of life). 42 studies were included in the review. They identified good dying as expected, accepted and prepared dying, as free from pain and suffering, as socially embedded, as being at peace with one's life and situation, as supported with individualised and holistic care, as based upon professional cooperation and communication, and as in a peaceful and private environment. The paper concludes that the perspective of professional caregivers in generalist palliative care shares many elements of good dying with societal and specialist palliative care discourses around good dying. Through comparing the different studies, the review found that studies that explicated who benefitted from ideals and practices of good dying, questioned the dichotomous categorisation of good/bad dying, or discussed the compatibility of elements of good dying, provided more nuanced perspectives on this topic. Thus, the review calls for a more systematic analysis of these aspects in research of good dying.
Highlights
Social meaning and practices of dying and good dying are socially contingent (Kellehear, 2007)
We analysed 43 peer-reviewed articles dealing empirically with the perspectives of professional caregivers not working in specialised palliative or hospice care on good dying
Good dying in generalist palliative care: commonalities and nontopics
Summary
Social meaning and practices of dying and good dying are socially contingent (Kellehear, 2007). Research on good dying has been conducted to improve our understanding of society, and to inform care policy and practices by identifying needs and values of those involved in and affected by end-of-life care situations (Asano et al, 2019; Meier et al, 2016). As in specialised hospice and palliative care, pro fessionals working in generalist palliative care – together with families, relatives, or community members – strive for accomplishing good care, the well-being of the patient, and good dying. Their values and beliefs, as well as their work experiences and practices, are impor tant aspects in creating the conditions, social interactions, and meanings related to good dying
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