Towards a conceptual evaluation of transience in relation to palliative care

J Adv Nurs. 2007 Jul;59(1):86-96. doi: 10.1111/j.1365-2648.2007.04311.x. Epub 2007 Jun 3.


Aim: This paper is a report of a concept evaluation of transience and its relevance to palliative care.

Background: A qualitative study into palliative care patients' experiences of transition revealed a gap between current definitions of transition and their expression of the palliative care experience. Transience appears to offer a better definition but remains conceptually weak, with limited definition in a healthcare context.

Methods: A qualitative conceptual evaluation of transience was undertaken using two case examples, interview data and the literature. Multiple sources were used to identify the literature (1966-2006), including a search on Cumulative Index to Nursing and Allied Health Literature Medline, and Ovid and Arts and Humanities Index using the keywords 'transience' and 'palliative care'. Thirty-one papers related to transience were retrieved. Analysis and synthesis formulated a theoretical definition of transience relative to palliative care.

Findings: Transience is a nascent concept. Preconditions and outcomes of transience appear contextually dependent, which may inhibit its conceptual development. Transience depicts a fragile emotional state related to sudden change and uncertainty at end-of-life, exhibited as a feeling of stasis. Defining attributes would seem to include fragility, suddenness, powerlessness, impermanence, time, space, uncertainty, separation and homelessness.

Conclusions: Transience is potentially more meaningful for palliative care in understanding the impact of end-of-life experiences for patients than current conceptualizations of transition as a process towards resolution. As a nascent concept, it remains strongly encapsulated within a framework of transition and further conceptual development is needed to enhance its maturity and refinement.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude to Death*
  • Attitude to Health*
  • Existentialism / psychology
  • Female
  • Health Services Needs and Demand
  • Hospices / standards
  • Humans
  • Male
  • Middle Aged
  • Palliative Care / psychology*
  • Quality of Life / psychology*
  • Terminally Ill / psychology*