title: Prognostication in advance cancer: nurses' perceptions of the dying process.
abstract: OBJECTIVE
  To determine how experienced nurses describe the dying process of patients with advanced cancer.
  
  
  METHODS
  Fifteen nurses, experienced in the care of patients with advanced cancer, employed by a midsize midwestern hospice or academic inpatient oncology unit.
  
  
  METHODS
  Individual interviews using structured and semi-structured questions. Responses were content-analyzed using Krippendorff's techniques.
  
  
  METHODS
  Dying process in cancer.
  
  
  RESULTS
  Nurses view the dying process as a weeks-to-months-long, multidimensional process that encompasses physical, psychosocial, and spiritual/existential domains. Impending death is recognized and monitored. Common clinical signs include declining interest in life, increased weakness, somnolence, and changes in respiratory, circulatory, and cognitive status.
  
  
  CONCLUSIONS
  Active (or acute) dying processes are recognized and monitored by nurses; the complexities and patterns of the phenomenon remain unarticulated.
  
  
  CONCLUSIONS
  Future research could explore both empirical and contextual aspects of acute dying processes. Nurses are in a position to develop useful knowledge about acute dying processes in cancer.
authors.affiliation: University of Wisconsin, Milwaukee, WI, USA. ndendaas@uwm.edu
authors.forename: Nancy R
authors.initials: NR
authors.lastname: Dendaas
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing* / Q000503:physiopathology; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology*; D011379:Prognosis