Prognostication in Advanced Cancer: Nurses' Perceptions of the Dying Process

Purpose/Objectives: To determine how experienced nurses describe the dying process of patients with advanced cancer.

Sample/Setting: 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.

Main Research Variable: Dying process in cancer.

Findings: 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.

Implications for Nursing: 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.