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[Reasons for deciding to die in hospital or at home. The vision of professionals].

Authors :
Lima-Rodríguez JS
Asensio-Pérez MLR
Palomo-Lara JC
Ramírez-López EB
Lima-Serrano M
Source :
Gaceta sanitaria [Gac Sanit] 2018 Jul - Aug; Vol. 32 (4), pp. 362-368. Date of Electronic Publication: 2018 May 21.
Publication Year :
2018

Abstract

Objective: To discover the reasons for deciding to die in hospital or at home, from the perspective of professionals involved.<br />Method: Qualitative phenomenological study. Intentional sample. Four multidisciplinary focus groups were held, two in hospitals and two in primary care centres in Seville (Spain). Twenty-nine professionals with at least two years experience in the care of people with a terminal disease participated, following the theoretical saturation of information criterion.<br />Results: Responses from the first script were gathered in three core categories: patient and the family, professionals and care process. Patients are generally not asked about their preferences as to where they wish to die, and if their family is not aware of their preference, it is not possible to carry out advanced planning of care. Families tend to choose the hospital because of the possibility of monitoring and resources in primary care. Professionals are trained in how to approach death, but they do not feel sufficiently prepared and focus on the clinical and administrative issues. The care process favours oncology patients because it is easier to identify their illness as terminal. Resources are not equal and interlevel communication needs to be improved. The family's involvement in the process is not facilitated, which impedes their decision-making.<br />Conclusions: Advance care planning and use of the advance directive should be promoted, as well as, interlevel communication and coordination, supply resources, especially in primary care, and professionals should receive training on how to approach death.. The patient's family should be involved in the care process and provided the necessary support.<br /> (Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)

Details

Language :
Spanish; Castilian
ISSN :
1578-1283
Volume :
32
Issue :
4
Database :
MEDLINE
Journal :
Gaceta sanitaria
Publication Type :
Academic Journal
Accession number :
29793673
Full Text :
https://doi.org/10.1016/j.gaceta.2018.04.005