Lived Experiences and Meanings of End-of-Life Dreams and Visions Among Patients with Advanced Cancer: An Interpretative Phenomenological Analysis of Meaning, Connection, and Self-Continuity

Abstract

End-of-life dreams and visions (ELDVs) are meaningful subjective experiences commonly reported by dying patients. While prior research has shown their emotional and existential value, evidence from non-Western settings remains scarce. This study explored the lived experiences and meanings of ELDVs among Iranian patients with advanced cancer. Using Interpretative Phenomenological Analysis (IPA), eleven patients who had experienced at least one ELDV were recruited via purposive sampling. Semi-structured interviews were analyzed through within-case and cross-case procedures to identify emergent themes. Three superordinate themes emerged. First, Reconstructing the Meaning of Death: From Threat to Peace and Tolerability showed how participants reframed death from fear and uncertainty into acceptance, transition, rest, and relief. Second, Family Support and Emotional Bonds in Relieving Suffering and Maintaining Connection underscored the role of family presence, memories, and attachment in easing distress and preserving identity. Third, Dream-Like Experiences, Perceptual Phenomena, and Altered States of Consciousness captured sensory-rich encounters with deceased loved ones, symbolic imagery, altered consciousness, and meaningful bodily sensations. ELDVs were woven into personal narratives, cultural meanings, spiritual frameworks, and coping processes. These findings indicate that ELDVs among Iranian patients with advanced cancer are complex experiences at the intersection of body, relationships, identity, and meaning. Rather than mere unusual perceptions, they may support emotional regulation, meaning-making, and self-continuity in end-of-life care.