Barriers and facilitators influencing death at home: A meta-ethnography

Wahid, Abdul Samad; Sayma, Meelad; Jamshaid, Shiraz; Kerwat, Doa'a; Oyewole, Folashade; Saleh, Dina; Ahmed, Aaniya; Cox, Benita; Perry, Claire; Payne, Sheila

doi:10.1177/0269216317713427

Cited by 45 publications

(43 citation statements)

References 87 publications

(271 reference statements)

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“…Given the complexity of care at the end of life (EOL) and the need to plan for such care in advance, advance care planning (ACP) is increasingly regarded as the best way to improve and optimise EOL care (Braun et al, ; Epstein, Volandes, & O'Reilly, ; Ethier, Paramsothy, You, Fowler, & Gandhi, ; O'Sullivan & Higginson, ; Sinuff et al, ; Wahid et al, ). Advance care planning refers to a patient's decisions about prospective health care, in consultation with family members and healthcare providers.…”

Section: Introductionmentioning

confidence: 99%

“…ACP has been noted to improve quality of life and care satisfaction, can have a positive impact on the bereavement process of relatives and may significantly reduce healthcare costs (Detering et al, 2010;Zhang et al, 2009). Further, ACP has been found to impact on preferred place of death, in that it facilitates a death at home (Wahid et al, 2018), which is relevant given the large proportion of terminally ill patients who, against their wish, die in a hospital setting (Swerissen & Duckett, 2015). Finally, it may help patients and healthcare providers in making difficult and preference-based decisions around aggressive treatment or discontinuation of treatment (Ethier et al, 2018).…”

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confidence: 99%

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Factors influencing the engagement of cancer patients with advance care planning: A scoping review

et al. 2019

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Introduction Advance care planning (ACP) is increasingly regarded as the best way to optimise end‐of‐life (EOL) care. Studies have examined a multitude of factors impacting on the lagging uptake of ACP. In the current study, we specifically focused on patient factors related to the uptake of ACP in adult cancer patients. Methods A scoping review was conducted, for which we searched the CINAHL, Cochrane, MEDLINE and PsycINFO databases (January 2013–December 2018). Studies exploring patient‐related factors influencing the uptake of ACP in cancer patients were eligible for inclusion. Results Eleven papers and two overarching themes: person‐related (e.g. socio‐demographic) factors and “comprehension and awareness,” were identified. White, well‐educated patients with a support network were more likely to be involved in ACP. However, there is limited comprehension and awareness among cancer patients regarding ACP. Conclusions The identified themes warrant a tailored approach to ACP. With regard to person‐related factors, the existing body of knowledge on health literacy, disparities and shared decision‐making should be used when designing strategies to improve ACP uptake. Further, our findings regarding “comprehension and awareness” suggest that ACP should not be limited to a narrow process without acknowledging the complexity surrounding personalised cancer care near the EOL.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Factors influencing the engagement of cancer patients with advance care planning: A scoping review

et al. 2019

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“…There is increasing evidence that this planning can allow patients greater autonomy as they lose capacity and improve the grieving process for patients’ families after death 2. Despite their potential, many barriers exist to their completion, and it is widely acknowledged that they are completed suboptimally by clinicians worldwide 1–3…”

Section: Introductionmentioning

confidence: 99%

Improving the use of treatment escalation plans: a quality-improvement study

Sayma

Nowell

O’Connor

et al. 2018

Postgraduate Medical Journal

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“…The caregiver plays a pivotal role at the end-of-life as an essential part of the health care team, often at significant personal cost [21,52], while off-setting wider economic cost [53,54]. The patient's achieving death at home is strongly influenced by his having a caregiver's support [55,56]. The caregiver therefore directly impacts the patient's end-of-life experience.Teno [57] suggested that our response as health care professionals to the voices of patients and families is perhaps the best outcome measure of the quality of our care.…”

Section: Methodsmentioning

confidence: 99%

Unmet needs of patients with cancer in their last year of life as described by caregivers in a developing world setting: a qualitative study

Cox-Seignoret

Maharaj

2020

BMC Palliat Care

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Background: Palliative care is in its infancy in most of the developing world. We set out to explore the lived experiences of families and caregivers of recently deceased cancer patients in Trinidad and Tobago and to determine the unmet needs of the patients and what recommendations could be derived to improve the current services. Methods: A phenomenological approach with purposeful sampling was used. Participants were referred by key health professionals. Face-to-face interviews were conducted. Interviews were transcribed verbatim, with analysis and data collection occurring concurrently. Thematic content analysis was used to determine common domains, themes and sub-themes. Results: Interviews were completed with 15 caregivers. All were spouses or children of the deceased. Ages of the deceased ranged from 43 to 93, the average being 65.5 years. The deceased experienced a variety of cancers including lung, colorectal and oesophageal. Unmet needs were identified under 4 domains of institutions, community, the family unit and the wider society. Institutional unmet needs were delayed diagnosis and treatment and poor inter-institution coordination. Medical and nursing care failed in the areas of health care providers' attitudes, pain management and communication. The family unit lacked physical and psychosocial support for the caregiver and financial aid for the family unit. Societal needs were for public education to address myths and cultural beliefs around cancer. Conclusion: There is need for systemic interventions to improve the care of those dying from cancer in Trinidad and Tobago. Stakeholders need to commit to palliative care as a public health priority, implementing education, planning services and mobilizing community resources.

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Barriers and facilitators influencing death at home: A meta-ethnography

Cited by 45 publications

References 87 publications

Factors influencing the engagement of cancer patients with advance care planning: A scoping review

Factors influencing the engagement of cancer patients with advance care planning: A scoping review

Improving the use of treatment escalation plans: a quality-improvement study

Unmet needs of patients with cancer in their last year of life as described by caregivers in a developing world setting: a qualitative study

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