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Concepts and Definitions for “Actively Dying,” “End of Life,” “Terminally Ill,” “Terminal Care,” and “Transition of Care”: A Systematic Review
Open accessAbstract
Context The terms "actively dying," "end of life," "terminally ill," "terminal care," and "transition of care" are commonly used but rarely and inconsistently defined.Objectives We conducted a systematic review to examine the concepts and definitions for these terms.Methods We searched MEDLINE, PsycINFO, Embase, and CINAHL for published peer-reviewed articles from 1948 to 2012 that conceptualized, defined, or examined these terms. Two researchers independently reviewed each citation for inclusion and then extracted the concepts/definitions when available. We also searched 10 dictionaries, four palliative care textbooks, and 13 organization Web sites, including the U.S. Federal Code.Results One of 16, three of 134, three of 44, two of 93, and four of 17 articles defined or conceptualized actively dying, end of life, terminally ill, terminal care, and transition of care, respectively. Actively dying was defined as "hours or days of survival." We identified two key defining features for end of life, terminally ill, and terminal care: life-limiting disease with irreversible decline and expected survival in terms of months or less. Transition of care was discussed in relation to changes in 1) place of care (e.g., hospital to home), 2) level of professions providing the care (e.g., acute care to hospice), and 3) goals of care (e.g., curative to palliative). Definitions for these five terms were rarely found in dictionaries, textbooks, and organizational Web sites. However, when available, the definitions were generally consistent with the concepts discussed previously.Conclusion We identified unifying concepts for five commonly used terms in palliative care and developed a preliminary conceptual framework toward building standardized definitions.
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Metadata
- Authors
- Hui, D., Nooruddin, Z., Didwaniya, N., Dev, R., De La Cruz, M., Kim, S. H., Kwon, J. H., Hutchins, R., Liem, C., & Bruera, E.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- Myongji Hospital (KR)
- Hallym University (KR)
- Corresponding author
- Hui, David
- Venue
- Journal of Pain and Symptom Management
- Publisher
- Elsevier BV
- Published
- 2014-01
- Volume
- 47
- Issue
- 1
- Pages
- 77-89
- ISSN
- 0885-3924 (ISSN-L)
- PMC
- PMC3870193
- OpenAlex
- W2088378149
- Cited by
- 411
- References
- 33
- Citations by year
- 2026: 42 · 2025: 42 · 2024: 49 · 2023: 55 · 2022: 53 · 2021: 52 · 2020: 47 · 2019: 20 · 2018: 17 · 2017: 11 · 2016: 9 · 2015: 8 · 2014: 4
- FWCI
- 1.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain and Symptom Management (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (RO1NR010162-01A1, RO1CA122292-01, RO1CA124481-01)
- institutional startup grant (#18075582)
- M. D. Anderson Cancer Center Support Grant (CA 016672)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- end of life, dying patients, end-of-life care, care transitions, definitions, conceptual framework, palliative care, life-limiting illness, goals of care, standardized terminology
- MeSH terms
- Humans, Models, Theoretical, Terminology as Topic, Palliative Care, Terminal Care, Terminally Ill
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