Background of the study Promoting a peaceful death is one of the central purposes of palliative care. However, the concept is not clearly defined and research on terminally ill patients is above all directed on studying determinants of quality of life. In order to improve care to the dying more clarity about the dying process, the way symptoms affect the dying process and about factors that promote a peaceful death have to be obtained.
Method: In our prospective study on terminally ill cancer patients we gathered information about the last period of life of patients until their death through reports of physicians. Our interview and questionnaire focussed on the medical situation of the patient, the symptoms and their treatment, the disciplines involved in the treatment, possible wishes concerning end-of-life decisions and characteristics of dying. The last questionnaire was completed after the patient’s death. 85 patients were included.
Results: Results point out that the last months of their life patients are confronted with a large number of symptoms, which had increased before dying. Fatigue, loss of appetite, dependency and feeling unwell were the most prevalent symptoms. Despite suffering from diverse symptoms 73% patients died peacefully, 67% had said goodbye before dying and 58% were fully ready to die according to their attending physician. Multivariate analysis showed that psychosocial problems impeded the dying process and that being cared by loved ones contribute significantly to peaceful dying.
Conclusion: From this, we may conclude that, in order to promote a peaceful death it is essential to pay enough attention to psychosocial problems and to patients’ needs of social support earlier during the illness trajectory. In order to grasp the whole scope of ‘dying peacefully’ theoretical and methodological implications of these and of other studies will be presented.