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. 2024 Jan;38(1):110-120.
doi: 10.1177/02692163231207495. Epub 2023 Nov 9.

'Thank you for loving me': A qualitative study on perceptions of gratitude and their effects in palliative care patients and relatives

Emmanuelle Poncin  1   2 , Emilie Bovet  3 , Emmanuel Tamches  1 , Boris Cantin  4 , Josiane Pralong  5 , Betty Althaus  1 , Gian Domenico Borasio  1 , Mathieu Bernard  1
Affiliations

'Thank you for loving me': A qualitative study on perceptions of gratitude and their effects in palliative care patients and relatives

Emmanuelle Poncin et al. Palliat Med. 2024 Jan.

Abstract

Background: Empirical studies suggest that gratitude positively influence the quality of life of palliative patients and relatives. However, the literature is marked by a lack of conceptual clarity about what gratitude is and whether it can bring about individual and social benefits.

Aim: This paper explores how palliative care patients and relatives understand gratitude, how discursive representations of gratitude may affect their positions, perceptions and relations, and how to conceptualise gratitude in the palliative context.

Design: We examine 33 gratitude letters written by patients and relatives and 25 semi-structured interviews conducted as part of a pilot gratitude intervention study. We use a qualitative approach, thematic analysis, within a conceptual framework of discourse analysis.

Settings/participants: Data were collected from 23 patients and 13 relatives recruited through three hospital palliative care services in French-speaking Switzerland.

Results: Participants articulate gratitude in five ways: (1) appreciating others; (2) love; (3) need to reciprocate; (4) appreciating the little things; (5) solace amid serious illness. While some of these representations are sources of positive emotions and outlook, wellbeing and hope, others may confirm self-perceptions of powerlessness and burden. These results support a tridimensional conceptualisation of gratitude in palliative care as source of individual benefits, valuing closest relationships and moral obligation.

Conclusion: Our study suggests that gratitude is a key to a good (end of) life, whilst highlighting potential negative effects. It could help healthcare professionals to better understand what gratitude means to patients and relatives, which may facilitate awareness and fostering of gratitude in palliative care.

Keywords: Gratitude; discourse analysis; palliative care; positive; psychology; qualitative research.

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Conflict of interest statement

Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Participants’ representations of gratitude and their performative effects.
Figure 2.
Figure 2.
Conceptualising gratitude in the palliative care context.
See this image and copyright information in PMC

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