Cargando…

Fear, Pain, Denial, and Spiritual Experiences in Dying Processes

PURPOSE: Approaching death seems to be associated with physiological/spiritual changes. Trajectories including the physical–psychological–social–spiritual dimension have indicated a terminal drop. Existential suffering or deathbed visions describe complex phenomena. However, interrelationships betwe...

Descripción completa

Detalles Bibliográficos
Autores principales: Renz, M., Reichmuth, O., Bueche, D., Traichel, B., Mao, M. Schuett, Cerny, T., Strasser, F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5794111/
https://www.ncbi.nlm.nih.gov/pubmed/28823175
http://dx.doi.org/10.1177/1049909117725271
_version_ 1783297062814613504
author Renz, M.
Reichmuth, O.
Bueche, D.
Traichel, B.
Mao, M. Schuett
Cerny, T.
Strasser, F.
author_facet Renz, M.
Reichmuth, O.
Bueche, D.
Traichel, B.
Mao, M. Schuett
Cerny, T.
Strasser, F.
author_sort Renz, M.
collection PubMed
description PURPOSE: Approaching death seems to be associated with physiological/spiritual changes. Trajectories including the physical–psychological–social–spiritual dimension have indicated a terminal drop. Existential suffering or deathbed visions describe complex phenomena. However, interrelationships between different constituent factors (e.g., fear and pain, spiritual experiences and altered consciousness) are largely unknown. We lack deeper understanding of patients’ inner processes to which care should respond. In this study, we hypothesized that fear/pain/denial would happen simultaneously and be associated with a transformation of perception from ego-based (pre-transition) to ego-distant perception/consciousness (post-transition) and that spiritual (transcendental) experiences would primarily occur in periods of calmness and post-transition. Parameters for observing transformation of perception (pre-transition, transition itself, and post-transition) were patients’ altered awareness of time/space/body and patients’ altered social connectedness. METHOD: Two interdisciplinary teams observed 80 dying patients with cancer in palliative units at 2 Swiss cantonal hospitals. We applied participant observation based on semistructured observation protocols, supplemented by the list of analgesic and psychotropic medication. Descriptive statistical analysis and Interpretative Phenomenological Analysis (IPA) were combined. International interdisciplinary experts supported the analysis. RESULTS: Most patients showed at least fear and pain once. Many seemed to have spiritual experiences and to undergo a transformation of perception only partly depending on medication. Line graphs representatively illustrate associations between fear/pain/denial/spiritual experiences and a transformation of perception. No trajectory displayed uninterrupted distress. Many patients seemed to die in peace. Previous near-death or spiritual/mystical experiences may facilitate the dying process. CONCLUSION: Approaching death seems not only characterized by periods of distress but even more by states beyond fear/pain/denial.
format Online
Article
Text
id pubmed-5794111
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-57941112018-02-12 Fear, Pain, Denial, and Spiritual Experiences in Dying Processes Renz, M. Reichmuth, O. Bueche, D. Traichel, B. Mao, M. Schuett Cerny, T. Strasser, F. Am J Hosp Palliat Care Original Articles PURPOSE: Approaching death seems to be associated with physiological/spiritual changes. Trajectories including the physical–psychological–social–spiritual dimension have indicated a terminal drop. Existential suffering or deathbed visions describe complex phenomena. However, interrelationships between different constituent factors (e.g., fear and pain, spiritual experiences and altered consciousness) are largely unknown. We lack deeper understanding of patients’ inner processes to which care should respond. In this study, we hypothesized that fear/pain/denial would happen simultaneously and be associated with a transformation of perception from ego-based (pre-transition) to ego-distant perception/consciousness (post-transition) and that spiritual (transcendental) experiences would primarily occur in periods of calmness and post-transition. Parameters for observing transformation of perception (pre-transition, transition itself, and post-transition) were patients’ altered awareness of time/space/body and patients’ altered social connectedness. METHOD: Two interdisciplinary teams observed 80 dying patients with cancer in palliative units at 2 Swiss cantonal hospitals. We applied participant observation based on semistructured observation protocols, supplemented by the list of analgesic and psychotropic medication. Descriptive statistical analysis and Interpretative Phenomenological Analysis (IPA) were combined. International interdisciplinary experts supported the analysis. RESULTS: Most patients showed at least fear and pain once. Many seemed to have spiritual experiences and to undergo a transformation of perception only partly depending on medication. Line graphs representatively illustrate associations between fear/pain/denial/spiritual experiences and a transformation of perception. No trajectory displayed uninterrupted distress. Many patients seemed to die in peace. Previous near-death or spiritual/mystical experiences may facilitate the dying process. CONCLUSION: Approaching death seems not only characterized by periods of distress but even more by states beyond fear/pain/denial. SAGE Publications 2017-08-21 2018-03 /pmc/articles/PMC5794111/ /pubmed/28823175 http://dx.doi.org/10.1177/1049909117725271 Text en © The Author(s) 2017 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Renz, M.
Reichmuth, O.
Bueche, D.
Traichel, B.
Mao, M. Schuett
Cerny, T.
Strasser, F.
Fear, Pain, Denial, and Spiritual Experiences in Dying Processes
title Fear, Pain, Denial, and Spiritual Experiences in Dying Processes
title_full Fear, Pain, Denial, and Spiritual Experiences in Dying Processes
title_fullStr Fear, Pain, Denial, and Spiritual Experiences in Dying Processes
title_full_unstemmed Fear, Pain, Denial, and Spiritual Experiences in Dying Processes
title_short Fear, Pain, Denial, and Spiritual Experiences in Dying Processes
title_sort fear, pain, denial, and spiritual experiences in dying processes
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5794111/
https://www.ncbi.nlm.nih.gov/pubmed/28823175
http://dx.doi.org/10.1177/1049909117725271
work_keys_str_mv AT renzm fearpaindenialandspiritualexperiencesindyingprocesses
AT reichmutho fearpaindenialandspiritualexperiencesindyingprocesses
AT bueched fearpaindenialandspiritualexperiencesindyingprocesses
AT traichelb fearpaindenialandspiritualexperiencesindyingprocesses
AT maomschuett fearpaindenialandspiritualexperiencesindyingprocesses
AT cernyt fearpaindenialandspiritualexperiencesindyingprocesses
AT strasserf fearpaindenialandspiritualexperiencesindyingprocesses