Health promotion in palliative care: the patients' perception of therapeutic interaction with the palliative nurse in the primary care setting

AIMS: To identify and describe palliative patients' perception of factors within the interaction with the community palliative care nurse that enhance feelings of health and well-being, and to begin to define health promotion in relation to palliative nursing in the primary care setting. BACKGROUND: Health promotion may seem to be of little relevance in palliative care and for patients within its remit, and there is no definition of health promotion in relation to palliative care, yet therapeutic 'new' nursing, and its core elements of holism, egalitarianism and a humanistic approach accord with the philosophy of palliative care and are recognised as health promoting nursing practice. DESIGN/METHODS: A qualitative methodology was used. Information was obtained from 12 patients by a qualitative semi-structured interview. Data were organised and analysed using recognised guidelines for phenomenological analysis. FINDINGS: The patients identified two types of therapeutic interaction with the nurse, which enhanced feelings of health and well-being in different ways. Psychological well-being was enhanced by the humanistic and egalitarian personal interaction with the nurse, and the professional interaction focused on the disease and addressed physical problems. Although recognizing the nurses' role in the relief of physical symptoms, the patients' perception of 'feeling better' generally focussed on enhancement of psychological health and well-being. CONCLUSION: For the patients, a combination of 'new' (therapeutic) nursing and a more traditional expert-led approach resulted in the promotion of an enhanced sense of physical and psychological health and well-being, and was an integral part of community palliative care nursing. Based on the study findings, the researcher offers a definition of health promotion relevant to palliative nursing in the primary care setting, which identifies that for the patients (but with caveats related to generalizability), the practice of holistically therapeutic palliative nursing is the ideal.