Positive emotion communication: Fostering well-being at end of life.

OBJECTIVE: Little is known about positive emotion communication (PEC) in end-of-life care. This study aims to identify types and patterns of PEC among hospice nurses, caregivers, and patients.

METHODS: A coding system based on positive psychology theory was applied as a secondary analysis to audio recordings of hospice nurse home visits with cancer patients and family caregivers, collected as part of a prospective longitudinal study. Eighty recordings (4 visits from 20 triads) were coded for humor, connection, praise, positive focus, gratitude, taking joy/savoring, and perfunctory statements.

RESULTS: Descriptive statistics revealed the greatest proportion of PEC was made by nurses. Humor was most frequently used across all speakers. Cluster analysis revealed four PEC visit types: Savor/Take Joy; Humor; Perfunctory; and Other-focused Expressions of Positive Emotions. Linear mixed effect regression was used to estimate the trajectory of PEC over time, but no significant change was found.

CONCLUSION: We found that positive emotions are common in nurse, caregiver and patient communication at end-of-life and do not decline closer to death.

PRACTICE IMPLICATION: This study is among the first to explore PEC at end-of-life, and offers a way to bring strengths-based approaches into end of life communication research.