title: Communication about existential issues with patients close to death--nurses' reflections on content, process and meaning.
abstract: OBJECTIVE
  Encountering dying patients with implicit existential questions requires the nurses to have positive and comfortable attitude to talking about existential issues. This paper describes the nurses' reflections on existential issues in their communication with patients close to death.
  
  
  METHODS
  Nurses (n = 98) were recruited from a hospital, hospices and homecare teams. Each nurse participated in five group reflection sessions that were recorded, transcribed and analysed using qualitative content analysis.
  
  
  RESULTS
  Three domains and nine themes emerged. The content domain of the existential conversation covered living, dying and relationships. The process domain dealt with using conversation techniques to open up conversations, being present and confirming. The third domain was about the meaning of existential conversation for nurses. The group reflections revealed a distinct awareness of the value of sensitivity and supportive conversations.
  
  
  CONCLUSIONS
  This study supports the assertion that experience of talking about existential issues and supporting environment make nurses comfortable when counselling patients close to death. It was obvious from this study that having the courage to be present and confirming, having time and not trying to 'solve' every existential problem were the most important factors in conversations with the patients close to death.
authors: Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.
authors: Susann
authors: S
authors: Strang
authors: Ingela
authors: I
authors: Henoch
authors: Ella
authors: E
authors: Danielson
authors: Maria
authors: M
authors: Browall
authors: Christina
authors: C
authors: Melin-Johansson
mesh_terms: D000328:Adult; D003142:Communication; D005260:Female; D064946:Hospice and Palliative Care Nursing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology*; D036301:Qualitative Research; D012944:Social Support; D013727:Terminal Care; D055815:Young Adult
keywords: communication; counselling; end-of-life care; existential; hospice; nurse