'Bridging worlds': meeting the emotional needs of dying patients.

Aim: This paper is a report of a study to develop a grounded theory to explain how district nurses meet the emotional needs of dying patients in the community.
Background: There has been a policy commitment internationally to improve community services and enable people with terminal illnesses to die in their own homes. This increasing trend towards home deaths in the United Kingdom (UK) makes more demand on district nurses to provide emotional support for dying patients.
Methods: A 'classic' grounded theory study was conducted in the UK between 2002 and 2005. Unstructured observations and semi-structured interviews were conducted with a purposive sample of nine district nurses, nine patients and four family carers. A further theoretical sample of five books of authors' accounts of their dying experiences and three district nurses who were advanced practitioners were selected.
Findings: Five categories were identified in the data: 'outside world', 'dying world', 'entering dying world', 'maintaining connections' and the core category 'bridging worlds'. The theory of 'bridging worlds' indicated that dying patients experienced 'dying world' and 'outside world'. District nurses met dying patients' emotional needs by acting as a bridge between their two worlds, encouraging them to maintain connections with the outside world so that they did not become isolated in their dying world.
Conclusion: District nurses should ensure that they meet both the physical and emotional needs of dying patients. Nursing education and literature need to concentrate on raising awareness of nurses' role in providing emotional support.