A qualitative study exploring the benefits of hospital admissions from the perspectives of patients with palliative care needs

Abstract

Background: The acute hospital plays a significant role in caring for people with a life-limiting illness. Most research to date has focused exclusively upon the negative aspects of hospitalisation. Currently, there is little known about the benefits of hospital admissions for patients with palliative care needs. Aim: The aim of this study was to explore the benefits of hospital admissions, from the perspectives of patients with palliative care needs. Design: A qualitative study design was adopted. Longitudinal, semi-structured, face-to-face interviews were used to elicit the views of patients admitted to hospital in one large urban acute hospital in New Zealand. Setting/participants: The study sample comprised 14 patients admitted to Auckland City Hospital between July 2013 and March 2014 who met one of the Gold Standard Framework Prognostic Indicators for palliative care need. Results: Through a process of thematic analysis, four themes were identified from the data: being cared for and feeling safe, receiving care to manage at home, relief for family and ‘feeling better and/or getting better’. The benefits of being in hospital were reported to extend beyond treatments received. Most participants reported their preference was to come to hospital even if they had been able to access the care they received in hospital at home. Conclusion: This research contributes to a greater understanding of the benefits associated with hospitalisation for patients with palliative care needs. The findings suggest that such benefits extend beyond the treatment patients receive and challenge current assumptions regarding the role of the acute hospital in palliative care.

The ‘problematisation’ of palliative care in hospital: an exploratory review of international palliative care policy in five countries

“…However, there is clear evidence indicating that preferences may change as a person’s circumstances evolve. Indeed, the closer to death people come, the less likely they will be to choose death at home and in fact many will choose a hospital setting [ 35 , 36 ]. Moreover, while ‘home’ is commonly understood to be a fixed geographical location, research has shown that home is in fact a malleable concept [ 37 , 38 ].…”

“…Moreover, whilst people rarely choose the hospital as their preferred place of care at the end of life [ 40 ], the hospital may become an attractive refuge during periods of acute illness. For example, patients with palliative care needs admitted to hospital during a period of acute illness have described feeling safe and cared for while being monitored and observed by health professionals with knowledge and expertise about their illness [ 36 ]. This suggests that when care needs are changing home may feel less safe than inpatient settings.…”

What Makes a Good Palliative Care Physician? A Qualitative Study about the Patient’s Expectations and Needs when Being Admitted to a Palliative Care Unit

“…However, we know far too little about the patient’s view of palliative care. Just a handful of studies have been published in this field, and these were focused on the preferred place of death, communication, and the influence of cultural backgrounds [ 3 , 11 – 17 ]. Patients’ preferences in palliative care revealed four key aspects: living a meaningful life, responsive health care personnel and care environment, and responsiveness in the organization of palliative care [ 18 ].…”

While I breathe, I hope. Principles of palliative care in chronic breathlessness and advanced lung diseases

“…Patients with incurable lung diseases lack understanding of their condition and knowledge about the dynamics of COPD or similar fatal diseases and the possibility of dying from this disease, as well as patient education and reassurance of appropriate symptom management (e.g. to prevent sensation of suffocation) are well-accepted measures to help these patients [13]. Eligibility criteria for palliative care units and hospices can be found in Table 1.…”