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Original research
‘Food for Life and Palliation (FLiP)’: a qualitative study for understanding and empowering dignity and identity for terminally ill patients in Asia
  1. Paul Victor Patinadan1,
  2. Geraldine Tan-Ho1,
  3. Ping Ying Choo1,
  4. Casuarine Xinyi Low2,
  5. Andy Hau Yan Ho1,3,4
  1. 1Psychology, Nanyang Technological University, Singapore
  2. 2Health Services and Systems Research, Duke-NUS Medical School, Singapore
  3. 3Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
  4. 4The Palliative Care Centre for Excellence in Education and Research (PalC), Singapore
  1. Correspondence to Dr Andy Hau Yan Ho; andyhyho{at}ntu.edu.sg

Abstract

Objectives With ‘eating’ posited as Singapore’s domestic pastime, food experiences for Singaporeans constitute national, social, ethnic and personal identities. However, though they form significant parts of Singaporean existence across the lifespan, studies and observations about food experiences for individuals at the end of life remain noticeably absent. Extant literature continues to focus on nutritional practice during illness and the active dying process, forgoing the rich lived experiences of food in the lives of patients and their families. The current work sought to qualitatively extricate through a constructivist phenomenological approach, the ‘food voices’ of Singaporean palliative care patients and their families. It also simultaneously aimed to assess the role of food in bolstering their subjective feelings of dignity and identity, while also considering resultant clinical implications.

Setting Homes of patients within the Singaporean palliative care setting.

Participants A subset of qualitative data (n=25) in the form of dyadic interviews with terminally ill patients and a family caregiver was generated from a larger family dignity intervention study that explored the experience of living and dying among Asian palliative care patients and their families.

Results Framework analysis with both inductive and deductive approaches informed by the a priori domain of food resulted in the generation of four major themes, each with three subthemes. These were organised into the Food for Life and Palliation model. They include: (1) feeding identity and familial bonds, (2) liminal subsistence in illness transition, (3) food becoming lineage, and (4) compassionate nourishment.

Conclusions Clinical implications are considered; including food-focused interventions that enhance dignity, promote meaning-making and facilitate legacy construction. Developmental suggestions are also directed at industry partners producing end-of-life nutrition products.

  • adult palliative care
  • qualitative research
  • nutritional support

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. The data included in the study, namely qualitative quotes from participants, have all been deidentified.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. The data included in the study, namely qualitative quotes from participants, have all been deidentified.

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Footnotes

  • Contributors PVP, GTH, PYC, CXL and HAHY conceived the design of the study and were involved in data collection. PVP, GTH, PYC and CXL transcribed and analysed the data collected, with critical input from HAHY. All authors agreed upon the final theme generation. PVP drafted this version of the manuscript with critical review and input from the four other authors. All authors have read and given approval for this version.

  • Funding The study was funded by the Singapore Ministry of Education (MoE) Academic Research Fund (AcRF) Tier 2 Fund (Ref: MOE-T2-1-061) and the Lien Foundation Special Grant.

  • Disclaimer The funders played no role in study design, collection, analysis or interpretation of data, or preparation of manuscripts.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.