AffiliationSchool of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK. email@example.com
MetadataShow full item record
AbstractBACKGROUND: 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.
CitationChallenges to end of life care in the acute hospital setting. 2006, 20 (6):611-5 Palliat Med
- Families' acceptance of near death: a qualitative study of the process for introducing end-of-life care.
- Authors: Wakunami M, Kawabata H, Murakami M, Maezawa M
- Issue date: 2009 Jun
- 'A bed in the middle of nowhere': parents' meanings of place of death for adults with cystic fibrosis.
- Authors: Lowton K
- Issue date: 2009 Oct
- Patient approaches to clinical conversations in the palliative care setting.
- Authors: Clover A, Browne J, McErlain P, Vandenberg B
- Issue date: 2004 Nov
- End of life decision-making for cancer patients.
- Authors: Parks SM, Winter L
- Issue date: 2009 Dec
- Hospitalisations at the end of life: using a sentinel surveillance network to study hospital use and associated patient, disease and healthcare factors.
- Authors: Van den Block L, Deschepper R, Drieskens K, Bauwens S, Bilsen J, Bossuyt N, Deliens L
- Issue date: 2007 May 8