Palliation: A Concept Analysis.

Palliation is a term that is used in the literature to identify very different concepts. It is often used interchangeably with palliative care, symptom management, and hospice. While these concepts are indeed related, the distinctions are valuable to identify to impact patient care. A concept analysis of palliation was undertaken via Wilson's method to define, identify core attributes and suggest areas for further research related to palliation. The analysis resulted in the following definition of palliation: patient goal directed symptom relief from a non-curative intervention, administered via human presence. Clarification of the definition and attributes will facilitate continued efforts to design valid measures of palliation as a patient-centered outcome.Keywords: concept analysis; palliation; palliative care; symptom management; quality of life; hospiceAlthough there has been tremendous growth in the specialty of palliative care (PC) in recent years, there remains substantial confusion about PC and lack of awareness and understanding about it among health care professionals as well as the public (Hupcey, Penrod, & Fogg, 2009). Despite efforts to clarify and differentiate, the related terms of palliation, palliative care, hospice, and end-of-life (EOL) care are often used interchangeably (Corn et al., 2011). Although this linguistic confusion is usually attributed to lack of understanding among the recipients of care and colleagues of PC providers, in fact the extant literature from within the discipline also reflects some lack of precision in language and hence in conceptualization (Bolmsjo, Nilstun, & Lofmark, 2007; Holmes, 2011; Lofmark, Nilstun, & Bolmsjo, 2007).Clarity in language, both spoken and written, is particularly important in emerging specialties. To the extent that our language reflects our mental models, precise language requires clarity and precision in concepts. Without this, we will be hampered in efforts to communicate the purposes of PC and the potential benefits to patients and providers of palliation concurrent with disease-oriented treatment and will have difficulty in developing meaningful theoretical models.To address the goal of contributing to a more theoretically grounded understanding of PC, the most basic component-palliation-requires analysis. This article will present a concept analysis of palliation, using Wilson's method to clarify the definition, identify defining attributes, and suggest further areas for research related to palliation (Walker & Avant, 2011).DEFINITIONSA multidisciplinary literature review was undertaken to enhance understanding of palliation via PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychiatryOnline, PsycINFO, Sociological Collection, Social Science Citation Index, The Oxford English Dictionary, MLA International Bibliography, OhioLINK Library Catalog, and Humanities International Complete. Not surprisingly, the health literature, compared to other sources, spoke most frequently of palliation. However, even in that literature, there was a paucity of sources related specifically to the concept of palliation. Articles found speak of palliation in relation to very specific symptoms or diseases. For example, several articles discuss palliation of malignant bowel obstruction using various methods (Augustine & Pawlik, 2009; Englert et al., 2012; Gianotti et al., 2013). Other articles discuss palliation of dysphagia caused by esophageal cancer (Kapoor, Bansal, Kochhar, Kumar, & Sharma, 2012; Massey, 2011). Metastatic disease management literature also uses the term palliation for symptom relief (Ballweg et al., 2009; Kim et al., 2011; Majumder et al., 2012). Lastly, there is a significant amount of literature about the palliation of heart disease and heart failure (Corn et al., 2011; Cortis & Williams, 2007; Goodlin, 2005; Hupcey et al., 2009; Koziol et al., 2013; Law, Dreyer, Heinle, & Dickerson, 2007). …