Abstract
This study was conducted to clarify how of nurses working in a Japanese hospice responded to dying patients and their imminent deaths, and to characterize the perception of death which gave form to these responses and their nursing practices. The subjects included 14 nurses working in a Japanese hospice. The data was collected through participant observation and semi-structured interviews, broken into a series of stages or meaningful units, and then classified into categories. Based on the categories thus determined, the following characteristics of the nurses' behavior and attitudes, their psychological reactions, and their way of conceptualizing death.
Yoi-mitori represents a shared ideal among the nurses on how the death of a patient should be handled. The nurses viewed yoi-mitori as a pattern of death they should work to attain, consisting of four points:(1) control of physical symptoms such as pain and vomiting until death and peace at the time of death;(2) maintenance of meaningful life until the point of death;(3) acceptance of death by the family; and (4) the presence of the family in the final hours. Yoi-mitori was the most prominent factor in guiding the actual practices of the nurses and the nurses' involvement in the approaches of the patients toward their own death. The nurses' emotional responses were also affected by whether yoi-mitori could be achieved or not: If yoi-mitori could not be achieved, the were overcome with negative feelings, and when they felt it could be achieved, their responses were positive. The nurses also demonstrated an unconscious hope that the patients achieve yoi-mitori.
