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Patients' and Families' Experience of Their Relationship With Professional Healthcare Providers in Hospital End-of-Life Care: An Interpretive Phenomenological Study

Spichiger, Elisabeth RN, PhD

Journal of Hospice & Palliative Nursing: May-June 2010 - Volume 12 - Issue 3 - p 194-202
doi: 10.1097/NJH.0b013e3181d4c20b
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The aim of this study was to describe the experiences of patients with a terminal illness and their families of their relationships with healthcare providers in a Swiss tertiary care hospital. A qualitative approach, interpretive phenomenology, was used. Ten patients and their closest family members participated. Data were collected through repeated participant observations, conversations with patients, and interviews with family members. Patients and families experienced relationships with care providers mainly in the latter's commitment or lack of commitment to caring for them. Patients and families appreciated friendly, cheerful, and well-mannered providers who showed empathy, consideration, and respect. A lack of this stance was experienced as problematic. Patients and families were aware of their influence on interactions with providers; as dependent partners, they tried to improve and not to damage their relationships with providers. Patients' and families' experiences showed that professionals can decisively influence the quality of hospital end-of-life care through their relationships with patients and family members. The study participants felt best cared for when the providers showed their recognition and concern; informal conversations were welcomed. Situations that were experienced as problematic were related to providers who distanced themselves and tended to ignore patients and family members as persons.

Author Affiliations: Elisabeth Spichiger, RN, PhD, is Lecturer, Institute of Nursing Science, University of Basel, and Scientific Collaborator, Inselspital Bern University Hospital, Switzerland.

Funding of the author's studies from the following sources is gratefully acknowledged: Regents Fellowship and Nonresident Tuition Scholarship, University of California San Francisco; Bernese Cancer League's Grant, Inselspital and Lindenhof, Bern, Switzerland.

Address correspondence to Elisabeth Spichiger, RN, PhD, Institute of Nursing Science, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland (Elisabeth.spichiger@unibas.ch).

© 2010 The Hospice and Palliative Nurses Association