Towards a conceptual evaluation of transience in relation to palliative care.
OBJECTIVE
This paper is a report of a concept evaluation of transience and its relevance to palliative care.


BACKGROUND
A qualitative study into palliative care patients' experiences of transition revealed a gap between current definitions of transition and their expression of the palliative care experience. Transience appears to offer a better definition but remains conceptually weak, with limited definition in a healthcare context.


METHODS
A qualitative conceptual evaluation of transience was undertaken using two case examples, interview data and the literature. Multiple sources were used to identify the literature (1966-2006), including a search on Cumulative Index to Nursing and Allied Health Literature Medline, and Ovid and Arts and Humanities Index using the keywords 'transience' and 'palliative care'. Thirty-one papers related to transience were retrieved. Analysis and synthesis formulated a theoretical definition of transience relative to palliative care.


RESULTS
Transience is a nascent concept. Preconditions and outcomes of transience appear contextually dependent, which may inhibit its conceptual development. Transience depicts a fragile emotional state related to sudden change and uncertainty at end-of-life, exhibited as a feeling of stasis. Defining attributes would seem to include fragility, suddenness, powerlessness, impermanence, time, space, uncertainty, separation and homelessness.


CONCLUSIONS
Transience is potentially more meaningful for palliative care in understanding the impact of end-of-life experiences for patients than current conceptualizations of transition as a process towards resolution. As a nascent concept, it remains strongly encapsulated within a framework of transition and further conceptual development is needed to enhance its maturity and refinement.
Larkin
Philip J
PJ
Aras Moyola, Department of Nursing and Midwifery Studies, The National University of Ireland, Galway, Ireland. philip.larkin@nuigalway.ie
Dierckx de Casterlé
Bernadette
B
Schotsmans
Paul
P
D001293:Attitude to Death; D001294:Attitude to Health; D005086:Existentialism / Q000523:psychology; D005260:Female; D006301:Health Services Needs and Demand; D006738:Hospices / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D019452:Terminally Ill / Q000523:psychology*