Re-living trauma near death: an integrative review using grounded theory narrative analysis.

Johnston, Nikki; Chapman, Michael; Gibson, Jo; Paterson, Catherine; Turner, Murray; Strickland, Karen; Liu, Wai-Man; Phillips, Christine; Bail, Kasia

Abstract

Symptoms of emotional and physical stress near death may be related to previous experiences of trauma. The objective is to investigate current evidence regarding the following: (1) Is previous trauma identified in people who are dying, and if so, how? (2) How is previous trauma associated with the experience of death/dying in people with or without cognitive impairment? and (3) What palliative care interventions are available to people with previous trauma at the end of life? This integrative review was conducted per Whittemore and Knafl’s guidelines, which involves a stepped approach, specifically (1) problem identification, (2) literature search, (3) data evaluation, (4) data analysis and (5) presentation. This integrative review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Electronic databases were searched in August 2021 and updated in August 2023. The articles were quality appraised, and narrative data were analysed using Grounded Theory (GT). Of 1310 studies screened, 11 met the inclusion criteria (four qualitative and seven quantitative) conducted in Australia, Canada, Japan and the United States; and American studies accounted for 7/11 studies. Eight were focused on war veterans. Descriptive studies accounted for the majority, with only two publications testing interventions. Re-living trauma near death has additional features to a diagnosis of post-traumatic stress disorder alone, such as physical symptoms of uncontrolled, unexplained acute pain and this distress was reported in the last weeks of life. This study proposes that re-living trauma near death is a recognisable phenomenon with physical and psychological impacts that can be ameliorated with improved clinical knowledge and appropriate management as a new GT. Further research is needed to enable past trauma identification at the end of life, and trauma-informed safe interventions at the end of life are an urgent need.

Citation

JOHNSTON, N., CHAPMAN, M., GIBSON, J., PATERSON, C., TURNER, M., STRICKLAND, K., LIU, W.-M., PHILLIPS, C. and BAIL, K. 2024. Re-living trauma near death: an integrative review grounded theory narrative analysis. Palliative care and social practice [online], 18, pages 1-22. Available from: https://doi.org/10.1177/26323524241277851

• Journal Article Type: Review
• Acceptance Date: Aug 7, 2024
• Online Publication Date: Sep 28, 2024
• Publication Date: Dec 31, 2024
• Deposit Date: Oct 7, 2024
• Publicly Available Date: Oct 7, 2024
• Journal: Palliative care and social practice
• Electronic ISSN: 2632-3524
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 18
• Pages: 1-22
• DOI: https://doi.org/10.1177/26323524241277851
• Keywords: End-of-life care; Identifying past trauma; Increased suffering; Trauma; Trauma-informed palliative care
• Public URL: https://rgu-repository.worktribe.com/output/2515463