The caregiving relationship : palliative caregivers' relationships with patients and families
The purpose of this study was to investigate the relationship- and communication experiences of hospice caregivers with patients and families. Two research questions were addressed: 1. How do caregivers experience these relationships and what is the nature of this relationship?, and 2. what role does communication play in the development and maintenance of these relationships? The study was designed as a field study using in-depth interviewing as the principal data collection strategy and a phenomenological-psychologicaal pproach as an analytical technique. The research inquiry consisted of three separate but linked parts: a pilot study with ten participants at a hospice in Great Britain, a subsequent focus group interview with seven of these ten caregivers at the same site, and a followup study with twenty-six participants at four different hospices in Great Britain. A total of thirty-six individual interviews were conducted using a long-interview design. The analyses of the data in this study suggested that the relationship experiences of hospice caregivers with patients and families are grounded in a particular mode of relating or relationship conduct characterized by a display of feelings, closeness, and solicitude. This conduct is the basis on which the caregiving relationship develops. The development and maintenance of this relationship also depends on caregivers' ability and willingness to involve themselves in the total situation of patients and families, to keep essential boundaries intact, and to find the right balance between distance and closeness. The themes of communication that were identified in this study (communicating about diagnosis and prognosis, telling and accepting the truth, facing and accepting death) - as well as the subthemes (finishing "unfinished business", resolving unresolved conflicts, "letting go"), and the communication problems that arise in this context - are all part of the meta-theme of preparing the patient/family unit for the occurrence of death.