Death acceptance from a Thai Buddhist perspective: A qualitative study

Navigating toward acceptance of death: Home-dwelling patients in the palliative phase

BACKGROUND

As global life expectancy increases, the need for palliative care grows. Recognizing the deeply personal and diverse nature of individuals' end-of-life experiences, palliative care for home-dwelling patients requires a flexible and person-centered approach. This study explores the complex process of death acceptance as experienced by patients receiving palliative care at home.

METHODS

Utilizing a qualitative, explorative, and descriptive design grounded in hermeneutic methodology, this study incorporates a secondary analysis of data derived from 13 in-depth interviews with home-dwelling patients in the palliative phase.

RESULTS

The findings reveal that patients consider relationships with family and healthcare professionals crucial in their journey toward accepting death. While strong, supportive relationships provided peace and meaningfulness, they could also introduce emotional complexity. Trust, honesty, and supportive care were fundamental for patients to find meaning and maintain quality of life during this challenging process. Staying in familiar environments, particularly at home, increased patients' likelihood of accepting their mortality. Participants noted that achieving peace and reconciling with death required balancing hope for life with acceptance of death.

CONCLUSION

This study highlights the complex process of death acceptance as experienced by patients receiving palliative care at home. Healthcare professionals can provide vital support by facilitating open conversations about fears and preferences related to death. Further research is needed to explore how end-of-life care can best support this intricate process.

Lived Experiences of Self-Care in Older Adults with Lymphoma Undergoing Chemotherapy Treatments During the COVID-19 Pandemic

Background: To be diagnosed and treated for cancer can be a distressing experience, and it can require individuals to engage in self-care strategies to cope with the situation. The self-care experiences of older adults with lymphoma undergoing chemotherapy during the COVID-19 pandemic in Thailand remain rarely studied. This study aimed to explore the lived experiences of self-care among older adults with lymphoma undergoing chemotherapy during the COVID-19 pandemic. Methods: A hermeneutic phenomenology research design was used. It involved in-depth interviews with nine older adults with lymphoma undergoing chemotherapy. Data analysis utilized van Manen's approach, and trustworthiness was ensured by adhering to Lincoln and Guba's criteria. Results: This study revealed that the lived experience of self-care among older adults with lymphoma receiving chemotherapy during the COVID-19 pandemic encompasses five lifeworlds within the lived body, addressing aspects of (1) thumjai and (2) continuing to fight cancer. Lived relations means trusting healthcare providers and holding on together. Lived time reflects being aware of the natural path of life. The concept of lived space encompasses staying safe at home and staying cautious. Lived things reflect (1) accepting one's own karma and (2) living economically. Conclusions: The findings enhance the understanding of self-care experiences among older adults with lymphoma undergoing chemotherapy during the COVID-19 pandemic in an Asian context. The findings can inform the development of a person-centered nursing intervention tailored for older persons that emphasizes cultural aspects.

Geriatric Nursing: Relationship Among Death Attitude, Meaning in Life, and Career Choice Motivation

BACKGROUND

Aging populations require higher quality care. However, few undergraduate nursing students choose careers in aged care. Negative death attitudes and loss of meaning in life may reduce motivation to choose geriatric nursing (GN) as a career. The relationships among these variables have yet to be clarified in the literature.

PURPOSE

The purpose of this study was to investigate the relationships among death attitude, meaning in life, and motivation to choose a career in GN among undergraduate nursing students in China.

METHODS

This cross-sectional study was conducted using an online survey. Five hundred ninety-five final-year undergraduate nursing students in four nursing schools completed the Career Choice Motivation Questionnaire for Geriatric Nursing, Death Attitude Profile-Revised, and Meaning in Life Questionnaire. A t test, analysis of variance, Pearson's correlation, and multiple linear regression model were used to analyze the data using SPSS Version 22.0.

RESULTS

The mean Career Choice Motivation Questionnaire for Geriatric Nursing item score was 3.15 ( SD = 0.49; 1-5 points), indicating the participants were moderately motivated to choose GN as a career. The multiple linear regression revealed statistically significant associations among death attitude, meaning in life, and motivation to care for older adults, explaining 14.5% of the total variance ( R2 = .15, F = 9.01, p < .001). Perceiving meaning in life, having escape acceptance, and having approach acceptance were each shown to be positively associated with choosing a career in GN. Conversely, fear of death and death avoidance were found to be negatively associated with choosing this career path.

CONCLUSIONS

Death attitude and perceptions regarding the meaning of life are associated with the motivation of nursing students to care for older adults.

The perception of life and death in patients with end-of-life stage cancer: A systematic review of qualitative research

PURPOSE

This study aims to clarify the perceptions on life and death among patients with the end-of-life stage cancer through a systematic review.

METHODS

The search strategy combined MeSH terminology with free text searches, and was applied to the PubMed, CINAHL, Embase, and ICHUSHI (Japan Medical Abstracts Society) databases covering from 2010 to 5/2022. To ensure the quality of the research included, the Critical Appraisal Skills Program Qualitative Studies Checklist was used. Data relating to the perceptions of life and death of patients with the end-of-life stage cancer was extracted and analyzed with reference to qualitative meta-synthesis methods.

RESULTS

Ultimately, 50 studies were included. Five themes were derived based on the perceptions of life and death of patients with the end-of-life stage cancer: despair, making sense of death, how to live the rest of life, special feelings for loved ones, and fluctuation. By making sense of death in their own way, and reconciling it with their current situation, patients with the end-of-life stage cancer, even in despair over their impending death, look ahead into the future and their surroundings and consider how they would live the remaining time they have. During this time, the special feelings they have for their loved ones make an impact.

CONCLUSIONS

An important new finding from this study lies in the fact that the patients' desire to live as ordinary people who were not patients were expressed as a face that they hid from their families. Further research is needed in low-income countries/regions.

Describing Death Acceptance Among Thai Buddhists With Cancer

INTRODUCTION

Death acceptance (DA) is perceived in culturally specific ways. The purposes of this study were to describe DA among Thai Buddhists with cancer and to compare DA differences in demographic data.

METHODOLOGY

This research was a secondary data analysis. The participants were 363 Thai Buddhists with cancer, recruited using multistage sampling method. Data were collected using the Buddhist Death Acceptance Scale, reliability coefficient. .82. Data were analyzed using T-Tests and Two-Way ANOVA.

RESULTS

The participants had high levels of DA. Age and stage of cancer had main effects on DA.

DISCUSSION

This study highlighted the significant demographic differences with regard to DA levels among Thai Buddhists with cancer. Interventions include determining the patient's DA level, or offering patients and their families advance care plans. Nurses can then explore DA with patients, particularly those with life-limiting illnesses to ease their patients' lives and foster a good death.

Death Acceptance Process in Thai Buddhist Patients With Life-Limiting Cancer: A Grounded Theory

Cancer patients with life-limiting illnesses have varied levels of death acceptance pervarious scales. Nevertheless, the process of developing death acceptance in patients with life-limiting cancer remains unclear. This study explores the death acceptance process among patients with life-limiting cancer. We used grounded theory methodology. Data were collected through in-depth interviews of 13 patients with cancer in a palliative care setting, and researchers completed field notes. Data were analyzed using constant and comparative methods. Thai Buddhist patients with cancer in palliative care process death acceptance through three dynamic phases: engaging suffering, being open-minded about death, and adhering to Buddhist practices for increasing death consciousness. The death acceptance process described in this study could serve as a guideline to support death acceptance in Thai Buddhist patients with cancer, and other patients with cancer in palliative care, to improve peaceful life and attain good death.

Role of Equanimity on the Mediation Model of Neuroticism, Perceived Stress and Depressive Symptoms

Background: Equanimity is widely and commonly practiced, but few have investigated the concept in clinical research. While the mediation model of neuroticism, perceived stress and depression have been demonstrated, it remains unclear whether equanimity mediates the relationship of these variables in parallel, serial or moderated mediation models. This study aimed to investigate the role of equanimity among those models. Methods: In all, 644 general participants (74.2% female, mean age = 28.28 (SD = 10.6)) provided data on the 10-item Perceived Stress Scale (PSS), the Neuroticism Inventory (NI), depression subscale of the Core Symptom Index, and the equanimity subscale of the inner Strength-based Inventory. Mediation and moderation analyses with the 5000 bootstrapping method were applied. Results: Equanimity was shown to moderate the relationship between NI/PSS and depressive symptom. Statistical evaluation supported all parallel, serial and moderated mediation models. Equanimity as a moderator provided a higher amount of percent variance explained by depressive symptoms than parallel and serial mediation models. Conclusions: Results suggest that the effect of perceived stress and neuroticism on depression can be mitigated by increasing levels of equanimity. The results demonstrated one potential benefit from practicing equanimity; enabling its extension to mental health problems could constitute an interesting focus for future research.