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    Challenges to end of life care in the acute hospital setting.

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    Authors
    Willard, Carole
    Luker, Karen
    Affiliation
    School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK. carole.willard@manchester.ac.uk
    Issue Date
    2006-09
    
    Metadata
    Show full item record
    Abstract
    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 Med
    Journal
    Palliative Medicine
    URI
    http://hdl.handle.net/10541/72413
    DOI
    10.1177/0269216306071064
    PubMed ID
    17060254
    Type
    Article
    Language
    en
    ISSN
    0269-2163
    ae974a485f413a2113503eed53cd6c53
    10.1177/0269216306071064
    Scopus Count
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    All Christie Publications

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