Loss of Dignity in End-of-Life Care in the Emergency Department: A Phenomenological Study with Health Professionals

Granero‐Molina, José; Díaz-Cortés, María del Mar; Hernández‐Padilla, José Manuel; García‐Caro, María Paz; Fernández‐Sola, Cayetano

doi:10.1016/j.jen.2015.10.020

Cited by 26 publications

(33 citation statements)

References 31 publications

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“…All studies were of relatively high quality with scores ranging between 8.5 to 10. Four studies14 20–22 were particularly high scoring, with consistent congruency between methodology and research objectives, methods and analysis of the results. All the studies sought ethical approval and had conducted the research in an ethical way.…”

Section: Resultsmentioning

confidence: 89%

“…This review included 11 studies, including 10 published papers and 1 PhD dissertation. All the papers were published in the last 5 years with several studies published in the year 2016 14–17. Although study participants included doctors, emergency nurses (charge nurse, clinical nurse educator, staff nurse, senior nurse) and palliative care nurses, the current analysis only included findings that were directly attributable to ED nurses.…”

Section: Resultsmentioning

confidence: 99%

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Views and experiences of nurses in providing end-of-life care to patients in an ED context: a qualitative systematic review

Mughal

Evans

2020

Emerg Med J

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IntroductionWith an increase in the population living with terminal illness, many patients are accessing EDs during the last days of their life. Yet EDs are often not well prepared to provide end-of-life (EOL) care. The aim of this review was to identify and synthesise studies that describe the views and experiences of emergency nurses in providing EOL care so as to understand the barriers and challenges that they face while caring for these patients and to identify factors that can support appropriate care delivery.MethodA qualitative meta-synthesis was undertaken using a thematic approach. Study quality was assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument tool. Five databases were searched in June 2016.ResultsEleven qualitative studies met the inclusion criteria and were assessed as having high quality. Sixty-nine findings were identified, combined into 11 descriptive themes and then synthesised into 3 analytical themes: (1) Incongruent ED environment and EOL care. (2) Lack of resources, systems and capacity. (3) EOL care as a rewarding act or an emotional burden.ConclusionThe review identified a need for: (1) Additional training for nurses. (2) The development of clear guidelines in the form of pathways and protocols. (3) Having a separate space for the dying. (4) Providing a supportive environment for staff dealing with high emotional burden and challenging workloads. In order to improve EOL care, organisations must work on the barriers that hinder care provision.

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Section: Resultsmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 99%

Views and experiences of nurses in providing end-of-life care to patients in an ED context: a qualitative systematic review

Mughal

Evans

2020

Emerg Med J

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“…Of particular interest are those authors who use the four steps of analysis in studies that are not hermeneutic. Several studies, whose authors have identified them as phenomenological, have used these four steps (Granero‐Molina, del Mar Díaz‐Cortés, Hernández‐Padilla, García‐Caro, & Fernández‐Sola, ; Hurst, Summers, Beaver, & Caress, ) and in each case that we examined they seem to have been used appropriately thereby rendering the transferability aspect of the method visible. A number of studies use a mix of hermeneutics and phenomenology (Kanji & Cameron, ; Kitzmüller, Asplund, & Häggström, ).…”

Section: Discussionmentioning

confidence: 99%

A critical analysis of articles using a Gadamerian based research method

Fleming

Robb

2019

Nursing Inquiry

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It is over 20 years since Michael Crotty's groundbreaking critique of phenomenological research in nursing. However, rather than entering into the acrimonious discussions that followed, we developed a research method that we believed translated Gadamer's philosophy into the world of empirical research. Fundamental to that work was our differentiation of hermeneutics from phenomenology. The aim of the present paper was to provide a critical analysis of the citations from publication in 2003 until the end of 2017. We identified 402 citations of which 362 were included. One hundred and sixty‐three articles mentioned the article in passing, usually in a list of authors who had discussed hermeneutics. Sixteen citations misrepresented the method mainly claiming that we discussed a method for hermeneutic phenomenology (or phenomenological hermeneutics). Of the 117 citations that partially used the method, the main focus was the four steps of data analysis. Sixty studies used our method in totality although they derive from varying philosophical standpoints. Disappointingly, there has been little critique of our Gadamerian research method. For health disciplines to truly make progress in the academic stage, it is vital that we engage in with critique, some of which will come through open and honest reflexive engagement with our topics.

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“…Other studies have identified the main problems that, according to professionals, affect dignity in the ED. Issues such as the exposure of bodies to “a cold world”, undignified actions from the professionals themselves and the care culture of “family obstinacy and hospital rescue” could lead to a loss of dignity for end‐of‐life patients in the ED (Beckstrand et al., ; Granero‐Molina et al., ). Promoting dignity in these environments involves redesigning the services focused on human dignity and providing care with a particular sensitivity and focus on emotional aspects (Díaz‐Cortés, et al., 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Various studies have already noted the need to define dignity, identify its loss and promote its preservation in places such as the ED (Beckstrand, Wood, Callister, Luthy, & Heaston, ; Sepúlveda et al., ). Some phenomenological studies have already incorporated the experiences of healthcare professionals, mostly ED physicians and nurses (Díaz‐Cortés et al., ; Fernández‐Sola et al., ; Granero‐Molina, Díaz‐Cortés, Hernández‐Padilla, García‐Caro, & Fernández‐Sola, ). However, it is necessary to research the phenomenon in other contexts and to incorporate the experiences of the patients and their relatives.…”

Section: Introductionmentioning

confidence: 99%

Characterization, conservation and loss of dignity at the end‐of‐ life in the emergency department. A qualitative protocol

Fernández‐Sola

Granero‐Molina

Díaz-Cortés

et al. 2018

Journal of Advanced Nursing

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Emerging themes that contribute to comprehending the phenomenon of dignity in end-of-life care in the emergency department are expected to be found. This study's results could have important implications in the implementation of new interventions in emergency departments. These interventions would be focused on improving: the social acceptance of death, environmental conditions, promotion of autonomy and accompaniment and assumption (takeover) of dignified actions and attitudes (respect for human rights).

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Loss of Dignity in End-of-Life Care in the Emergency Department: A Phenomenological Study with Health Professionals

Cited by 26 publications

References 31 publications

Views and experiences of nurses in providing end-of-life care to patients in an ED context: a qualitative systematic review

Views and experiences of nurses in providing end-of-life care to patients in an ED context: a qualitative systematic review

A critical analysis of articles using a Gadamerian based research method

Characterization, conservation and loss of dignity at the end‐of‐ life in the emergency department. A qualitative protocol

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