Longing for ground in a ground(less) world : a qualitative inquiry of existential suffering
Date
2011-01-27
Authors
Bruce, Anne
Schreiber, Rita
Petrovskaya, Olga
Boston, Patricia
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Background: Existential and spiritual concerns are fundamental issues in palliative care and patients frequently
articulate these concerns. The purpose of this study was to understand the process of engaging with existential
suffering at the end of life.
Methods: A grounded theory approach was used to explore processes in the context of situated interaction and
to explore the process of existential suffering. We began with in vivo codes of participants’ words, and clustered
these codes at increasingly higher levels of abstractions until we were able to theorize.
Results: Findings suggest the process of existential suffering begins with an experience of groundlessness that
results in an overarching process of Longing for Ground in a Ground(less) World, a wish to minimize the
uncomfortable or anxiety-provoking instability of groundlessness. Longing for ground is enacted in three
overlapping ways: by turning toward one’s discomfort and learning to let go (engaging groundlessness), turning
away from the discomfort, attempting to keep it out of consciousness by clinging to familiar thoughts and ideas
(taking refuge in the habitual), and learning to live within the flux of instability and unknowing (living in-between).
Conclusions: Existential concerns are inherent in being human. This has implications for clinicians when
considering how patients and colleagues may experience existential concerns in varying degrees, in their own
fashion, either consciously or unconsciously. Findings emphasize a fluid and dynamic understanding of existential
suffering and compel health providers to acknowledge the complexity of fear and anxiety while allowing space for
the uniquely fluid nature of these processes for each person. Findings also have implications for health providers
who may gravitate towards the transformational possibilities of encounters with mortality without inviting space
for less optimistic possibilities of resistance, anger, and despondency that may concurrently arise.
Description
BioMed Central
Keywords
Citation
Bruce et al.: Longing for ground in a ground(less) world: a qualitative inquiry of existential suffering. BMC Nursing 2011 10:2.