THEORY IN COMPARISON

Nursing care at the end of life is concerned with assisting those dying through comfort measures on all levels – body, mind, and spirit – to allow them to gain a sense of peace and pass into the next realm with as much grace and dignity as possible. Nursing as a profession has focused holistically on the dying person’s experience. Nurses seek to promote a sense of well-being through environmental influences and social and spiritual support. Nursing theories assist in both clarifying nursing practice and guiding nursing interventions in meeting patient’s needs. (Keegan, 2011)

It is always useful to guide practice on the basis of a theoretical framework. Many theories work well with end-of-life care. The table below provided point of comparison of the major key concepts of the Peaceful End of Life Theory with other theories that tackle End of Life care.

	PEACEFUL END OF LIFE THEORY	PREPARE ME THEORY	TRANSPERSONAL CARING THEORY
Theorist	Cornelia Ruland and Shirley Moore	Carmencita Abaquin	Jean Watson
Person	Terminally ill patients, their families and all significant others	Terminally Ill patients (Cancer)	Clients dying of AIDS in the Center of Human Caring
Nursing	Critical in creating Peaceful End of Life Experience	Improve Quality of Life	Attends to the dignity of the person in the “caring occasion.”
Health	Maximize treatment, the best possible care provided through judicious use of technology and comfort measures	Theory talks more of cancer (Illness)	Subjective experience that is defined by the person. Health corresponds to the balance between mind, body, and spirit, and is influenced by how one perceives and experiences the situation and self.
Environment	Acute Care Setting	Home or Hospital	Physical space in which the caring occasion occurs and when the nurse and patient come together in a human transaction. The environment must be healing in all ways physically and non-physically, and attention is on wholeness, comfort, dignity, and peace
Key Concepts	Defined five major outcome standards that contribute to a peaceful EOL for terminally ill patients. (1). being free from pain, (2) experiencing comfort (3), experiencing dignity and respect, (4) being at peace and (5) experiencing a closeness to significant others or other caring person. This theory contributes the rich body of knowledge for nurses the need to provide end-of-life care. It provides insights and can contribute to increase knowledge about nursing interventions that provides peaceful end.	This theory provides a framework on non-pharmacologic, non-surgical approach of care to advanced cases of cancer patients. The focus is not on cure but on assisting the patient to explore her humanity and internal serenity as one is faced with the challenge of life and death. Nurses must be seen not as mere caregivers but facilitators of peaceful acceptance of condition.	Acknowledges unity of life and connections that move in concentric circles of caring-from individual, to others, to community, to world, to Planet Earth, to the universe.

References:

Alligood, M. & Tomey, A. (2010) Nursing Theorists and Their Work. Maryland Heights, MO: Mosby Elsevier.

Keegan, L. (2011) End of Life: Nursing Solutions for Death with Dignity. New York, NY: Springer Publishing Company

Group F N-207 UPOU-MAN 2013. Metaparadigms and Interventions. July 2013. Retrieved from http://upoun2072013.blogspot.com/p/metaparadigms.html