end-of-life care, hermeneutics, next of kin, shame



  1. Harstade, Carina Werkander PhD, RNT
  2. Roxberg, Asa PhD, RNT
  3. Brunt, David PhD, RNT
  4. Andershed, Birgitta PhD, RNT


The aim of this study was to gain a greater understanding of the experiences of shame of next of kin in end-of-life care. Seventeen next of kin who had lost a family member were interviewed. A method inspired by Gadamer's hermeneutic approach was used to interpret possible experiences of shame and to discuss these interpretations. The result showed that next of kin's experiences of shame are linked to their perception of the remaining time and are guided by views on morality and what is right and wrong. Shame can occur when the next of kin are involved and actually cause harm to the family member as well as in situations that are beyond their control. Shame can also involve actions that have nothing to do with what they have actually done but is instead a shame that is placed on them by others, for example, health professionals or relatives. Shame is interpreted as experiences of ignominy, humiliation, and disgrace. Second-order shame is also found. It is important that health professionals are aware of these experiences of unhealthy shame when they meet and support next of kin in end-of-life care.