Affiliation
School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK. carole.willard@manchester.ac.ukIssue Date
2006-09
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Show full item recordAbstract
BACKGROUND: Research exploring patients' care and treatment preferences at the end of life (EOL) suggests they prefer comfort more than life-extension, wish to participate in decision-making, and wish to die at home. Despite these preferences, the place of death for many patients is the acute hospital, where EOL interventions are reported to be inappropriately invasive and aggressive. AIM: This paper discusses the challenges to appropriate EOL care in acute hospitals in the UK, highlighting how this setting contributes to the patients' and families' care and treatment requirements being excluded from decision-making. METHODS: Twenty-nine cancer nurse specialists from five hospitals participated in a grounded theory study, using observation and semi-structured interviews. Data were collected and analysed concurrently using the constant comparative method. RESULTS: EOL interventions in the acute setting were driven by a preoccupation with treatment, routine practice and negative perceptions of palliative care. All these factors shaped clinical decision-making and prevented patients and their families from fully participating in clinical decision-making at the EOL.Citation
Challenges to end of life care in the acute hospital setting. 2006, 20 (6):611-5 Palliat MedJournal
Palliative MedicineDOI
10.1177/0269216306071064PubMed ID
17060254Type
ArticleLanguage
enISSN
0269-2163ae974a485f413a2113503eed53cd6c53
10.1177/0269216306071064
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