Qualitative Research in Psychology, 9:151–172, 2012 Copyright © Taylor & Francis Group, LLC ISSN: 1478-0887 print/1478-0895 online DOI: 10.1080/14780881003663424 Death Confrontation, Spiritual-Existential Experience and Caring Attitudes in Palliative Care Nurses: An Interpretative Phenomenological Analysis MÉLANIE VACHON, 1 LISE FILLION, 2 AND MARIE ACHILLE 3 1 University of Quebec at Montreal, Psychology, Montreal, Quebec, Canada and McGill University Health Center, Palliative Care Service, Montreal, Quebec, Canada 2 Laval University, Nursing, Quebec City, Quebec, Canada 3 University of Montreal, Psychology, Montreal, Quebec, Canada The present qualitative study aims to (a) better understand how palliative care nurses handle death proximity; (b) describe their subjective spiritual-existential experience; and (c) explore the potential links between death confrontation and spiritual-existential experience in nurses. Eleven palliative care nurses participated in a semi-structured interview. Data were analysed using interpretative phenomenological analysis. The first level analysis allowed for a description of the emerging themes of nurses’ experi- ence of death confrontation, spiritual-existential experience, and caring attitudes. The second level analysis allowed for the emergence of a typology, identifying a higher meaning for the nurses’ mechanisms of subjective regulation of death proximity, inte- grating death, fighting death, and suffering death. Results were interpreted within a humanist-existential perspective. Keywords: death confrontation; Heidegger’s ontology; interpretative phenomenolog- ical analysis; intersubjective regulation; nurses; palliative care; spiritual-existential experience Introduction Western society is often portrayed as being in a state of death denial (Aries 1981; Becker 1973; Byock 2002; Callahan 2000; Zimmermann 2004). This is partly explained by the fact that death confrontation is likely to engender distress, anxiety, and fear that may be regu- lated by different psychological mechanisms (Moriaglia 2004). According to Yalom, fear of death plays a major role in our internal experience and, to cope with this fear, we erect defences against death awareness that shape character structure (Yalom 1980). Although most people protect themselves from death awareness through denial, the acknowledge- ment of one’s finiteness has also been suggested as a condition for mature zestful leaving (Fromm 1964). Heidegger (1962) has indeed suggested that awareness of one’s own death allows us to live in a state of mindfulness that shifts us from one mode of existence (inauthentic) to a higher one (authentic). Correspondence: Mélanie Vachon, PhD, University of Quebec at Montreal, C. P. 8888 Succursale Centre-ville, Montreal, Quebec H3C 3P8, Canada. E-mail: vachon.melanie@uqam.ca 151