Family experiences of in-hospital end-of-life care for adults: A systematic review of qualitative evidence.
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Authors
Walker, Wendy
Jones, Jenny
Issue Date
2021-09-07
Journal
Type
Conference Abstract
Keywords
End of life care
Family
Acute hospitals
In-hospital
Adult
Quality improvement
Communication
Family
Acute hospitals
In-hospital
Adult
Quality improvement
Communication
Journal Title
Volume
Issue
Begin page
End page
DOI
Abstract
Background: In the UK healthcare system, end-of-life care (EoLC) has been identified as an area for quality improvement. Core to the National Health Service agreed single definition of quality is ‘care that provides a positive experience’ (NHS England 2016, p4). Whilst quality improvement applies to all care settings, particular attention has been paid to transforming EoLC in hospitals.
Aims: This presentation describes the process and outcomes of a systematic review of qualitative evidence based on the Joanna Briggs Institute methodology (Lockwood et al. 2020). Specifically, the review sought to generate propositions of what counts as a positive experience of EoLC, based upon family-reported descriptions in the extant literature.
Methods: A systematic process was enabled by the development of an a priori review protocol. Primary research, published 2014 onwards was identified using a sequential strategy of electronic and hand searches. Studies that met a pre-determined inclusion/exclusion criterion were uniformly appraised (CASP 2018) and synthesised using a meta-aggregative approach.
Results: Fifteen studies of European, Australasian and North American origin formed the review. The quality of each study was considered very good in view of a ‘yes’ response to most screening questions. Extracted findings were assembled into 12 categories, and subsequently developed into five synthesised findings: Understanding of approaching end of life; Essential care at the end of life; Interpersonal interactions; Environment of care; Patient and family care after death.
Discussion and conclusions: The review findings underline the importance of affective staff-patient-family care and communication. Consideration must be given to the fulfilment of family needs and apparent hallmarks of quality care that appear to influence experiential outcomes. Our developed understanding of family experiences serves as a guide for evidence-informed practice, quality improvement, audit and
research, including the future testing of an association between a positive experience of in-hospital EoLC care and family grief.
Citation
Walker, W. Efstathiou, N. Jones, J. Family experiences of in-hospital end-of-life care for adults: A systematic review of qualitative evidence. RCN International Nursing Research Conference: The value of nursing research in a time of global crisis Virtual Conference 07-09 September 2021. Abstract 0350.