Palliative and Supportive Care Service, Lausanne University Hospital, University of Lausanne, Lausanne, Vaud, Switzerland.
La Source School of Nursing, HES-SO, Lausanne, Switzerland.
Palliat Med. 2024 Jan;38(1):110-120. doi: 10.1177/02692163231207495. Epub 2023 Nov 9.
Empirical studies suggest that gratitude positively influence the quality of life of palliative patients and relatives. However, the literature is marked by a lack of conceptual clarity about what gratitude is and whether it can bring about individual and social benefits.
This paper explores how palliative care patients and relatives understand gratitude, how discursive representations of gratitude may affect their positions, perceptions and relations, and how to conceptualise gratitude in the palliative context.
We examine 33 gratitude letters written by patients and relatives and 25 semi-structured interviews conducted as part of a pilot gratitude intervention study. We use a qualitative approach, thematic analysis, within a conceptual framework of discourse analysis.
SETTINGS/PARTICIPANTS: Data were collected from 23 patients and 13 relatives recruited through three hospital palliative care services in French-speaking Switzerland.
Participants articulate gratitude in five ways: (1) appreciating others; (2) love; (3) need to reciprocate; (4) appreciating the little things; (5) solace amid serious illness. While some of these representations are sources of positive emotions and outlook, wellbeing and hope, others may confirm self-perceptions of powerlessness and burden. These results support a tridimensional conceptualisation of gratitude in palliative care as source of individual benefits, valuing closest relationships and moral obligation.
Our study suggests that gratitude is a key to a good (end of) life, whilst highlighting potential negative effects. It could help healthcare professionals to better understand what gratitude means to patients and relatives, which may facilitate awareness and fostering of gratitude in palliative care.
实证研究表明，感恩会对姑息治疗患者及其家属的生活质量产生积极影响。然而，文献中对于感恩的概念以及它是否能带来个人和社会效益存在着概念上的模糊。
本文探讨了姑息治疗患者及其家属如何理解感恩，感恩的话语表达如何影响他们的立场、认知和关系，以及如何在姑息治疗背景下对感恩进行概念化。
我们分析了 33 封由患者和家属撰写的感谢信和 25 次半结构式访谈，这些数据来自瑞士法语区三家医院姑息治疗服务机构的一项试点感恩干预研究。我们采用定性方法，主题分析，并在话语分析的概念框架内进行。
地点/参与者：数据来自 23 名患者和 13 名家属，他们是通过瑞士法语区三家医院姑息治疗服务机构招募的。
参与者以五种方式表达感恩：（1）欣赏他人；（2）爱；（3）需要回报；（4）欣赏小事；（5）在重病中得到安慰。虽然这些表达中的一些是积极情绪和人生观、幸福感和希望的源泉，但另一些可能会证实自己无力和负担过重的认知。这些结果支持将姑息治疗中的感恩概念化为个体受益、珍视最亲密关系和道德义务的三维概念。
我们的研究表明，感恩是美好生活的关键，同时也强调了潜在的负面影响。它可以帮助医疗保健专业人员更好地理解感恩对患者及其家属的意义，这有助于他们在姑息治疗中意识到并培养感恩。
