Prognostication in advance cancer: nurses' perceptions of the dying process.
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.
Dendaas
Nancy R
NR
University of Wisconsin, Milwaukee, WI, USA. ndendaas@uwm.edu
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