Skip to main content Accessibility help

The integration of a person-centered approach in palliative care

  • Mireille Lavoie (a1), Danielle Blondeau (a1) and Isabelle Martineau (a2)



The philosophy underlying palliative care places the respect of patients and their autonomy at the heart of clinical practice. A study was conducted at a palliative care facility to document changes that occurred after the integration of a person-centered approach focusing on human freedom (which is linked to autonomy): the humanbecoming school of thought. It aimed to describe changes observed in the beliefs and practices of healthcare providers, the concept and respect of autonomy by healthcare providers, care and respect of autonomy experienced by patients' relatives, and consideration of patients' wishes through their documentation.


The method adopted consisted of a pre-project – process – post-project descriptive qualitative design and was inspired by teaching-learning and mentoring models. Data were collected from 51 healthcare providers and 10 relatives through semistructured interviews and from the medical records of 30 patients during the pre- and post-project phases. They were analyzed and compared at the end of the study. The process phase consisted of offering training sessions and mentoring, encouraging the involvement of healthcare providers, and cocreating integration and care tools.


While the analysis exposed some discrepancies with the language of the approach and differences between nurses and other healthcare providers, it revealed, above all, similarities in the changes observed between the different sources of data. The focus moved from being task-centered to being person-centered; the affirmation of the priority of respecting patients' choices, desires, and needs; a presence shifting from being available to true listening; the affirmation of following the ever-changing rhythm of the patient; and a notion of respect of autonomy now including the other.

Significance of results:

In line with the philosophy of palliative care, the project demonstrated that the integration of the humanbecoming approach can result in changes that contribute to the development of a more person-centered practice.


Corresponding author

Address correspondence and reprint requests to: Mireille Lavoie, Faculté des Sciences Infirmières, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Université Laval, Québec (Québec), G1V 0A6Canada. E-mail:


Hide All
Addington-Hall, J. (2002). Research sensitivities to palliative care patients. European Journal of Cancer, 11, 220224.
Bolmsjö, I. (2000). Existential issues in palliative care – Interviews with cancer patients. Journal of Palliative Care, 16, 2024.
Bottorff, J.L., Steele, R., Davies, B., et al. (1998). Striving for balance: Palliative care patients' experiences of making everyday choices. Journal of Palliative Care, 14, 717.
Bournes, D.A. (2002). Research evaluating human becoming in practice. Nursing Science Quarterly, 15, 190195.
Bournes, D.A. & Ferguson–Paré, M. (2007). Human Becoming and 80/20: An Innovative Professional Development Model for Nurses. Nursing Science Quarterly, 20, 237253.
Buckley, J., & Herth, K. (2004). Fostering hope in terminally ill patients. Nursing Standard, 19, 3341.
Canadian Hospice Palliative Care Association (2002). A Model to Guide Hospice Palliative Care: Based on National Principales of Norms of Practice.
Canadian Nurses Association (2012). Hospice Palliative Care Nursing Certification. Exam blueprint and speciality competencies.
Carter, H., MacLeod, R., Brander, P., et al. (2004). Living with a terminal illness: Patients' priorities. Journal of Advanced Nursing, 45, 611620.
Chochinov, H. (2009). The culture of research in palliative care: You probably think this song is about you. Journal of Palliative Medicine, 12, 215217.
Chochinov, H.M., Hack, T., McClement, S., et al. (2002). Dignity in the terminally ill: A developing empirical model. Social Science & Medicine, 54, 433443.
Cohen, S.R. & Mount, B.M. (2000). Living with cancer: “Good” days and “bad” days – What produces them? Cancer, 89, 18541865.
Committe on Quality of Health Care in America (2001). Crossing the Quality Chasm: A new Health System for the 21st Century. Washington, DC: National Academies Press.
Direction de la lutte contre le cancer (2008). Plan directeur de développement des compétences des intervenants en soins palliatifs. Québec: Direction des communications du ministère de la Santé et des Services sociaux du Québec.
Goodridge, D. & Duggleby, W. (2010). Using a quality framework to assess rural palliative care. Journal of Palliative Care, 26, 141150.
Hewitt-Taylor, J. (2003). Issues involved in promoting patient autonomy in health care. British Journal of Nursing, 12, 13231330.
Hutchings, D. (2002). Parrallels in practice: Palliative nursing practice and Parse's theory of human becoming. American Journal of Hospice and Palliative Care, 19, 408414.
Janssens, R. & Gordijn, B. (2000). Clinical trial in palliative care : An ethical evaluation. Patient Education and Counseling, 41, 5562.
Jollien, A. (2010). Le métier d'homme ou l'art du devenir. Paper presented at the Conférence Michel–Sarrazin, Université Laval.
Jonas, C.M. (1999). Evaluation of the human becoming theory in family practice. In Illuminations. The Human Becoming Theory in Practice and Research. Parse, R.R. (ed.), pp. 347366. London: Jones and Bartlett Publishers.
Kinghorn, S. & Gaines, S. (2007). Palliative Nursing: Improving end-of-life care. Edinburgh: Elsevier.
Lalande, A. (2002). Vocabulaire technique et critique de la philosophie. Paris: PUF.
Lavoie, M., Blondeau, D. & Picard-Morin, J. (2011). The autonomy experience of patients in palliative care. Journal of Hospice and Palliative Nursing, 13, 4753.
Lee, O.J. & Pilkington, F.B. (1999). Practice with persons living their dying: A human becoming perspective. Nursing Science Quarterly, 12, 324328.
Legault, F. & Ferguson–Paré, M. (1999). Advancing nursing practice: An evaluation study of Parse's theory of human becoming. Canadian Journal of Nursing Leadership, 12, 3035.
Major, F. & Pepin, J. (2001). L'expérience d'autonomie de la personne âgée qui vit avec un membre de sa famille. Recherche en soins infirmiers, 64, 3646.
McLoughlin, K. (2010). Dying to talk: Unsettling assumptions toward research with patients at the end of life. Palliative and Supportive Care, 8, 371375.
Mitchell, G.J. (1999a). Evaluation of the human becoming theory in practice in an acute care setting. In Illuminations. The Human Becoming Theory in Practice and Research. Parse, R.R. (ed.), pp. 367399. London: Jones and Bartlett Publishers.
Mitchell, G.J. (1999b). The lived experience of restriction–freedom in later life. In Illuminations. The Human Becoming Theory in Practice and Research. Parse, R.R. (ed.), pp. 159195. London: Jones and Bartlett Publishers.
Mitchell, G.J. (2006). Parse's theory of human becoming in nursing practice. In Nursing Theory. Utilization & Application, 3rd ed., Alligood, M.R. & Tomey, A.M. (eds.), pp. 431445. Maryland Heights, MO: Mosby Elsevier.
Mitchell, G.J. & Bournes, D.A. (2000). Nurse as patient advocate? In search of straight thinking. Nursing Science Quarterly, 13, 204209.
Mitchell, G.J., Bournes, D.A. & Hollett, J. (2006). Human becoming-guided patient-centered care. A new model transforms nursing practice. Nursing Science Quarterly, 10, 218224.
Nambisan, V. (2010). Research in palliative care – A four-principle justification. European Journal of Palliative Care, 17, 7679.
Northrup, D.T. & Cody, W.K. (1998). Evaluation of the human becoming theory in practice in an acute care psychiatric setting. Nursing Science Quarterly, 11, 2330.
Parse, R.R. (2008). A humanbecoming mentoring model. Nursing Science Quarterly, 21, 195198.
Parse, R.R. (2011). The humanbecoming modes of inquiry: Refinements. Nursing Science Quarterly, 24, 1115.
Parse, R.R. (1998). The Human Becoming School of Thought. A Perspective for Nurses and Other Health Professionals. Thousand Oaks, CA: Sage Publications.
Parse, R.R. (2007). The humanbecoming school of thought in 2050. Nursing Science Quarterly, 20, 308311.
Parse, R.R. (2004). A humanbecoming teaching-learning model. Nursing Science Quarterly, 17, 3335.
Parse, R.R. (2010). Human dignity: A humanbecoming ethical phenomenon. Nursing Science Quarterly, 23, 257262.
Parse, R.R. (2001). Qualitative Inquiry: The Path of Sciencing. Boston: Jones and Bartlett Publishers.
Pellegrino, E.D. (1990). The relationship of autonomy and integrity in medical ethics. In Ethics in Medicine. Allebeck, P. & Jansson, B. (eds.), pp. 321. New York: Raven Press.
Pilkington, F.B., & Jonas-Simpson, C. (1996). The Humanbecoming Theory: A Manual for the Teaching-Learning Process. Toronto, Canada: International Consortium of Parse Scholars.
Randall, F. & Downie, R.S. (2006). The Philosophy of Palliative Care. Critique and Reconstructuion. Oxford: Oxford University Press.
Saltmarche, A., Kolodny, V. & Mitchell, G. (1998). An educational approach for patient-focused care. Shifting attitudes and practice. Journal of Nursing Staff Development, 14, 8186.
Sartre, J.-P. (1956). Being and Nothingness. An Essay on Phenomenological Ontology. New York: Philosophical Library.
Shirley, J.L. (2007). Limits of autonomy in nursing's moral discourse. Advances in Nursing Science, 30, 1425.
Stanley, G.D. & Meghani, S.H. (2001). Reflections on using Parse's theory of human becoming in a palliative care setting in Pakistan. Canadian Nurse, 97, 2325.
Vig, E.K. & Pearlman, R.A. (2003). Quality of life while dying: A qualitative study of terminally ill older men. Journal of American Geriatrics Society, 51, 15951601.
Volker, D.L., Kahn, D. & Penticuff, J.H. (2004). Patient control and end-of-live care Part II: The patient perspective. Oncology Nursing Forum, 31, 954960.


The integration of a person-centered approach in palliative care

  • Mireille Lavoie (a1), Danielle Blondeau (a1) and Isabelle Martineau (a2)


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed