Family Caregivers’ Concerns about End-of-Life Symptoms in Palliative Home Care for Persons with Metastatic Spinal Cancer: Lessons Learned

Abstract

This lessons-learned academic article presents the researcher’s fieldwork experiences gained from working with Thai family caregivers of persons with metastatic spinal cancer receiving palliative home care. The purpose of this article is to reflect on the researcher’s learning process in qualitative research, particularly in relation to engaging with sensitive issues, building trust with participants, and positioning oneself appropriately as a researcher within a highly vulnerable context. This reflection employs a reflective approach grounded in the concepts of bracketing and ethical reflexivity to explore how the researcher learned through being present with, listening to, and accompanying participants during periods marked by loss and emotional distress. The reflect analysis highlights three key lessons: (1) confronting emotional distress arising from listening to family caregivers’ narratives about end-of-life symptoms, which underscored the importance of researcher self-care; (2) learning to maintain professional boundaries while practicing empathy through deep listening, thereby creating a safe space for participants to share their experiences; and (3) interpreting caregivers’ experiences through cultural and religious frameworks, which broadened the researcher’s understanding of spiritual dimensions in nursing care.

This article reflects the learning journey of a qualitative researcher working with vulnerable populations and demonstrates the value of reflective practice in strengthening ethical research competencies. The lessons derived contribute to the development of nursing practices that respect human dignity within end-of-life care and palliative care contexts.