RESEARCH ARTICLE
Living in the Presence of Death: An Integrative Literature Review of Relatives’ Important Existential Concerns when Caring for a Severely Ill Family Member
Christina Melin-Johansson*, 1, Ingela Henoch2, 3, 6, Susann Strang4, 6, Maria Browall5, 6, 7
Article Information
Identifiers and Pagination:
Year: 2012Volume: 6
First Page: 1
Last Page: 12
Publisher ID: TONURSJ-6-1
DOI: 10.2174/1874434601206010001
PMID: 22371820
PMCID: PMC3282885
Article History:
Received Date: 1/8/2011Revision Received Date: 3/9/2011
Acceptance Date: 14/9/2011
Electronic publication date: 10/2/2012
Collection year: 2012

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
Abstract
Aim:
The aim of this study was to explore relatives’ existential concerns when caring for a seriously ill family member as well as to describe interventions that meet these concerns.
Methods:
In this integrative literature review we assessed and classified 17 papers, 12 qualitative and 5 quantitative. Literature was sought in the databases Cinahl, PubMed, Psykinfo and Web of Science in September 2009 and in March 2010. Search terms used in different combinations were: family, family caregiver, next of kin, relatives, palliative, palliative care, end-of-life care, existential, spirit*. Data were redrawn from the papers results/findings, and synthesized into a new descriptive content.
Results:
The results were categorized from 13 papers exploring relatives’ important existential concerns and 4 papers describing interventions aimed to support them in the existential area. A majority of the reviewed papers had been written in Sweden and concerned relatives of patients with cancer. One overarching theme, living in the presence of death, and three categories: responses to life close to death; support when death is near; and beyond the presence of death were created.
Conclusion:
There is an urgent demand for large-scale studies using accurate methodology, as well as a need to design qualified investigations regarding the effects of various interventions, and to determine which interventions are the most effective in supporting relatives who experience existential distress manifested physically and/or psychologically. There is also a considerable demand for educational interventions among professionals in various healthcare settings to increase their knowledge regarding existential concerns among relatives.