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Updated: Feb 16, 2026

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Published on: February 16, 2011
Positive emotion communication: Fostering well-being at end of life
Alexandra L Terrill1, Lee Ellington2, Kevin K John3
1University of Utah, Department of Occupational & Recreational Therapies, Salt Lake City, USA.
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.
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