Cornelia Ruland, RN, Ph.D. Nursing Theorist on Peaceful End of

Presented by:
Stacy Sutherland, RN
Cornelia M. Ruland, RN, P.D.
• Education
• Undergraduate
• University of Bergen, Bergen, Norway
• Haukeland School of Nursing, Bergen, Norway
• Certified Nurse Specialist
• National Hospital, Oslo, Norway
• University of Oslo, Oslo, Norway
• Ph.D.
• Case Western Reserve University, Cleveland, Ohio
(Ruland, 2014)
• Positions Held
• Nursing
• Other
(Ruland, 2014)
Middle Range Nursing Theory
Peaceful End of Life Theory
A theory from a standard od care that focused on the peaceful end of
life for terminally ill patients (Ruland & Moore, 1998).
Nurses are integral to the creation of peaceful end of life care, which
includes freedom from suffering, emotional support, closeness to
and participation by significant others, and treatment with empathy
and respect.1
Development of the Peaceful End of Life Theory
• Developed from a standard of care created by expert nurses to
manage the care of patients with terminal illnesses. 5
• Patient population-terminally ill pateints (half of whom had been
diagnosed with cancer). 5
• Focus includes pain relief, symptom management, and caring
• Main focus is to contribute peaceful and meaningful living in the
time that remains for the the patient and their significant others. 5
Reduction of outcome criteria from the standard
to outcome indicators of the proposed theory
• Outcome Criteria
• Not to have pain
• Not to experience nausea
• Outcome Indicator
• Not being in pain
• Experience of comfort
• Not to experience thirst
• Experience optimal comfort
• Experience a pleasant environment
(patient and significant other)
• Participate in decision making
regarding patient care (patient and
significant other).
• Experience of dignity/respect
• Experience being treated with dignity
and respect as human beings (patient
and significant other).
(Ruland & Moore, 1998)
Reduction of outcome criteria from the standard
to outcome indicators of the proposed theory
• Outcome Criteria
Maintain hope and meaningfulness
(patient and significant other)
Assist with clarifying practical and
economical issues related to the end
of life stage (patient and significant
Patient does not die alone
Patient is at peace
Significant Others
Takes part in caring for the patient as
they wish
Able to say farewell to the patient in
compliance with their beliefs, cultural
rites, and wishes
Informed about different funeral
procedures and possibilities.
• Outcome Indicator
• Being at Peace
• Closeness to significant
others/persons who care
(Ruland & Moore, 1998)
This theory was developed for terminally ill patients who are no
longer candidates for curative treatment. The patient and significant
others know that death is emanate and this theory provides
guidelines on how to physically and emotionally care for, not only the
patient but the significant other as well. 5
The guidelines of this theory not only provide standards for peaceful
end of life care but they can be applied to all apects of nursing and
patient centered care.5

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