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- Title
'It was peaceful, it was beautiful': A qualitative study of family understandings of good end-of-life care in hospital for people dying in advanced age.
- Authors
Gott, Merryn; Robinson, Jackie; Moeke-Maxwell, Tess; Black, Stella; Williams, Lisa; Wharemate, Rawiri; Wiles, Janine
- Abstract
Background: Hospitals are important sites of end-of-life care, particularly for older people. A need has been identified to understand best practice in hospital end-of-life care from the service-user perspective. Aim: The aim of this study was to identify examples of good care received in the hospital setting during the last 3 months of life for people dying in advanced age from the perspective of bereaved family members. Design: A social constructionist framework underpinned a qualitative research design. Data were analysed thematically drawing on an appreciative enquiry framework. Setting/participants: Interviews were conducted with 58 bereaved family carers nominated by 52 people aged >80 years participating in a longitudinal study of ageing. Data were analysed for the 21 of 34 cases where family members were 'extremely' or 'very' satisfied with a public hospital admission their older relative experienced in their last 3 months of life. Results: Participants' accounts of good care aligned with Dewar and Nolan's relation-centred compassionate care model: (1) a relationship based on empathy; (2) effective interactions between patients/families and staff; (3) contextualised knowledge of the patient/family; and (4) patients/families being active participants in care. We extended the model to the bicultural context of Aotearoa, New Zealand. Conclusion: We identify concrete actions that clinicians working in acute hospitals can integrate into their practice to deliver end-of-life care with which families are highly satisfied. Further research is required to support the implementation of the relation-centred compassionate care model within hospitals, with suitable adaptations for local context, and explore the subsequent impact on patients, families and staff.
- Subjects
NEW Zealand; PALLIATIVE treatment; ELDER care; AGING; BEREAVEMENT; CONCEPTUAL structures; CUSTOMER satisfaction; CRITICAL care medicine; EMPATHY; HOSPITAL admission &; discharge; INTERVIEWING; LONGITUDINAL method; PATIENT-family relations; MEDICAL personnel; PATIENT-professional relations; PATIENTS; PUBLIC hospitals; PSYCHOLOGY of the terminally ill; QUALITATIVE research; THEMATIC analysis; HEALTH literacy; PATIENTS' families; FAMILY attitudes; PSYCHOLOGY
- Publication
Palliative Medicine, 2019, Vol 33, Issue 7, p793
- ISSN
0269-2163
- Publication type
Article
- DOI
10.1177/0269216319843026