Promoting dignified end-of-life care in the emergency department: A qualitative study

Díaz-Cortés, María del Mar; Granero‐Molina, José; Hernández‐Padilla, José Manuel; Pérez‐Rodríguez, Rocío; Correa-Casado, Matías; Fernández‐Sola, Cayetano

doi:10.1016/j.ienj.2017.05.004

Cited by 23 publications

(17 citation statements)

References 40 publications

(54 reference statements)

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“…Humanising healthcare in ED is of more importance when recognising the less than ideal environment for end‐of‐life care 24 . One study described the ED in relation to dignified end‐of‐life care as ‘hostile’, signifying that steps are required to address the way in which care is provided in this setting 31 …”

Section: Discussionmentioning

confidence: 99%

What is a compassionate response in the emergency department? Learner evaluation of an End‐of‐Life Essentials online education module

Rawlings

Winsall

Yin

et al. 2021

Emerg Medicine Australasia

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Objective To evaluate the End‐of‐Life Essentials education module ‘Emergency Department End‐of‐Life Care’ and explore learners' views on what constitutes a compassionate response in the ED. Methods The present study used a multi‐methods approach. Learners comprised a mix of nurses, doctors and allied health professionals. A quantitative pre‐post evaluation analysis of learners' (n = 959) knowledge, skills, attitude and confidence was conducted, along with a qualitative thematic content analysis on learner responses (n = 538) to the post‐evaluation question, ‘What is a compassionate response for you in the emergency department?’ Data were extracted for a 12‐month period, 6 May 2019 to 6 May 2020. Results Learners' post‐evaluation ranks of knowledge, skill, attitude and confidence were significantly higher than the pre‐evaluation ranks (P < 0.001). Emerging themes from the qualitative data were organised into three overarching categories: communication skills (e.g. listening and use of names), care discussion and provision (e.g. provide information and discuss care plans) and humanising healthcare (e.g. emotional support and empathy, taking the time, and offering kindness and comfort). Conclusion The ‘Emergency Department End‐of‐Life Care’ module had a significant positive impact on learners in relation to perceived knowledge, skill, attitude and confidence. This evaluation suggests that the End‐of‐Life Essentials ED module could be a useful online learning resource for health professionals.

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Section: Discussionmentioning

confidence: 99%

What is a compassionate response in the emergency department? Learner evaluation of an End‐of‐Life Essentials online education module

Rawlings

Winsall

Yin

et al. 2021

Emerg Medicine Australasia

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“…The literature search identified 303 articles as potentially relevant, and of these, 120 articles were selected for full-text screening and 48 articles were included in the final analysis. 7,10 -56 The screening process is presented in Figure 1, and the overview of the 48 articles is presented in Table 2.…”

Section: Methodsmentioning

confidence: 99%

Reciprocal Dynamics of Dignity in End-of-Life Care: A Multiperspective Systematic Review of Qualitative and Mixed Methods Research

Choo

Tan-Ho

Dutta

et al. 2019

Am J Hosp Palliat Care

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Background: Preserving terminally ill patients’ dignity and well-being through dignified and holistic care has become the overarching goal in palliative care services. However, dignity is a multifaceted concept with a wide range of interpretations under different cultural contexts. Aim: The aim of this review is to understand the variations in subjective interpretations and constitutions of dignity in palliative or end-of-life care via an integrative worldview. Design: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline and used SPIDER tool to screen for appropriate and relevant articles for analysis. Data Sources: Four major databases were searched including CINAHL, ERIC, Medline, and PsycARTICLES between 2009 and 2018. Forty-eight qualitative studies that examined dignity from the perspectives of patients, family caregivers, and health-care professionals were selected for full text data analysis using thematic synthesis. Results: Analysis of the various concepts of dignity revealed 18 themes that were further categorized into 7 conceptual categories: (1) self-determination, (2) existential liberty, (3) relational connectedness, (4) caregiving revitalization, (5) mindful humanity, (6) patient–family care, and (7) sustainable culture. These 7 categories span across individual, familial, and institutional dimensions, forming a new Dynamic Reciprocity of Dignity model. Conclusions: The Dynamic Reciprocity of Dignity model highlights the importance of adopting a systemic lens to address dignity-related needs and concerns at the end of life, while providing insights on how compassionate care and self-compassion can serve as the foundation of dignified care, which in turn serve as a buffer against patients’ existential suffering as well as caregivers’ burnout and fatigue. Recommendations for clinical practice and future research directions are discussed.

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“…Care for relatives is described as an integrated part of palliative care but often in a context where patient, relatives and healthcare professionals have established a relationship prior to death (The World Health Organization 2015, Sundhedsstyrelsen [Danish Health Authority] 2017). Palliative care for relatives and the BID persons are likely to obtain limited focus and low priority in the ED as the overarching goal in the ED is to save lives and maintain a high patient flow, consequently nurses and physicians are trained and acknowledged for their instrumental life-saving skills (Beckstrand et al 2012, Decker et al 2015, Hogan et al 2016, European Society For Emergency Medicine (EUSEM) 2017, Sundhedsstyrelsen [Danish Health Authority] 2017, Diaz-Cortes et al 2018, Berbis-Morello et al 2018). However, caring for BID persons and their relatives require different skills and competencies and must be rendered.…”

Section: Accepted Articlementioning

confidence: 99%

How to care for the brought in dead and their relatives. A qualitative study protocol based on interpretive description

Bové

Rosted

Prip

et al. 2020

Journal of Advanced Nursing

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Aim: This project has two aims: 1) What do relatives to brought in dead describe as helpful and supportive care when they arrive at the emergency department to see and say goodbye to a deceased? 2) What do nurses describe as good nursing practice for brought in dead persons and their relatives and what may hinder or facilitate this practice in an emergency setting? Design: A qualitative study within the methodology Interpretive Description. Methods: Data will be collected through three data sources: Individual interviews with relatives to brought in dead persons, participant observations of relatives to brought in dead persons during their presence in the emergency department and focus group interviews with emergency nurses. Discussion: Brought in dead persons and their relatives are received and cared for in emergency departments by emergency nurses. Knowledge of how to render care for the relatives to brought in dead persons in an acute setting including what skills and competences this require of the nurses is warranted. We need to explore, describe and comprehend the experiences of both the relatives and the nurses in order to point out potential areas of improvement. Impact: This paper is a protocol of an Interpretive Description study offering insight into considerations and reflections in designing the study.

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Promoting dignified end-of-life care in the emergency department: A qualitative study

Cited by 23 publications

References 40 publications

What is a compassionate response in the emergency department? Learner evaluation of an End‐of‐Life Essentials online education module

What is a compassionate response in the emergency department? Learner evaluation of an End‐of‐Life Essentials online education module

Reciprocal Dynamics of Dignity in End-of-Life Care: A Multiperspective Systematic Review of Qualitative and Mixed Methods Research

How to care for the brought in dead and their relatives. A qualitative study protocol based on interpretive description

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