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Awareness contexts revisited: indeterminacy in initiating discussions at the end-of-life.
- Source :
- Journal of Advanced Nursing (John Wiley & Sons, Inc.); Dec2013, Vol. 69 Issue 12, p2654-2664, 11p, 2 Charts
- Publication Year :
- 2013
-
Abstract
- Aims To explore if and how information about a transition to a palliative care approach was communicated to patients recently discharged from hospital and who fulfilled standardized criteria for palliative care need. Background Palliative care philosophy and, more recently, UK palliative care policy, endorse a context of 'open' awareness, where all parties openly acknowledge that the patient's death is approaching. The perceived benefits of making the patient aware of their prognosis encompass a variety of planning activities, which mean that death, when it occurs, is arguably more in keeping with the wishes of the patient. Design A qualitative inductive interview study conducted in 2010-2011. Methods Fifteen semi-structured interviews were conducted with 15 patients and 3 family carers. All patients were identified as having palliative care needs according to standardized criteria, 3-6 months after discharge from hospital. A thematic analysis was undertaken. Findings Contrary to the professed ideal of 'open' awareness, some participants were only partially aware and others wholly unaware that they were likely to be approaching the end-of-life. Those identified as unaware were over 85. Participants displayed a reluctance to acquire knowledge which would require them to face the imminence of death. Conclusion Philosophy and policy aside, people do not always conform to the autonomy paradigm of a self-directed life followed by a self-directed death. [ABSTRACT FROM AUTHOR]
- Subjects :
- COMMUNICATION
PATIENT aftercare
INTERVIEWING
RESEARCH methodology
PATIENT-professional relations
PALLIATIVE treatment
PATIENT satisfaction
PROGNOSIS
QUALITY of life
RESEARCH funding
SURVEYS
TERMINAL care
TERMINALLY ill
UNCERTAINTY
COMORBIDITY
QUALITATIVE research
DISCLOSURE
ATTITUDES toward death
FAMILY relations
THEMATIC analysis
HEALTH literacy
DATA analysis software
DESCRIPTIVE statistics
Subjects
Details
- Language :
- English
- ISSN :
- 03092402
- Volume :
- 69
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- Journal of Advanced Nursing (John Wiley & Sons, Inc.)
- Publication Type :
- Academic Journal
- Accession number :
- 91972462
- Full Text :
- https://doi.org/10.1111/jan.12151