Inpatient transfer to a care home for end-of-life care: What are the views and experiences of patients and their relatives? A systematic review and narrative synthesis of the UK literature

Thomas, Tabitha; Kuhn, Isla; Barclay, Stephen

doi:10.1177/0269216316648068

Cited by 11 publications

(7 citation statements)

References 27 publications

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“…There is evidence of SOs experiences within end-of-life care. Thomas et al [5] published a systematic review based on three primary studies within UK. The SOs was reported as often strongly against the transfer from hospital for their loved one's end-of-life care.…”

Section: Introductionmentioning

confidence: 99%

Significant others’ experience of hospitalized patients’ transfer to home: A systematic review and meta-synthesis

Uhrenfeldt

Fegran

Aagaard

et al. 2018

Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheit

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Background: Significant others are individuals representing family members or neighbors, friends, colleagues or members of the same household, who act as relatives or surrogates. Significant others play an important role when patients are transferred or discharged after hospitalization. Objective: The objective of this review is to identify, appraise and synthesize the best available evidence exploring significant others' experiences of the discharge or transfer of adult patients after hospitalization. Methods: A qualitative comprehensive systematic review and meta aggregation.Types of participants: Participants of this review are the 'significant other(s)'; persons who are important or influential to the patient's life. Phenomena of interest: How the significant others' experience hospitalized patients' transitions and the psychosocial and existential issues during transfer from hospital to home. Context: Studies that investigate the organizational culture during hospitalization. Types of studies: Studies that focus on qualitative data including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research. Search Strategy: The search aimed at finding published and unpublished studies in English, German, Danish, Swedish and Norwegian, and was unrestricted by time. Eleven electronic databases and eleven websites were searched. Critical appraisal: Methodological validity of the qualitative papers was assessed independently by two reviewers using the standardized critical appraisal instruments from the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Data Extraction: Data were extracted from papers included in the review using the standardized data extraction tool from the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Data Synthesis: Qualitative research findings were synthesized. Results: A total of 189 findings from twelve studies were aggregated into three categories. An aggregated finding was generated based on the primary studies: SOs existential strength is linked to preparations for the discharge including care planning meeting(s) and learning-by-doing care activities led by health care providers during hospitalizations. Conclusions:The studies in this review provided useful and credible statements from caregivers' voices that are not previously aggregated nor presented. The findings enlighten both positive and burdensome experiences in the everyday life of caring for a significant other after discharge.

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Section: Introductionmentioning

confidence: 99%

Significant others’ experience of hospitalized patients’ transfer to home: A systematic review and meta-synthesis

Uhrenfeldt

Fegran

Aagaard

et al. 2018

Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheit

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“…25 The variable availability of palliative care in nursing homes is a structural challenge that has been examined in Australia and elsewhere. 26 A recent literature review of the experience of patients and family members in the United Kingdom suggests that a nursing home transfer was overwhelmingly a negative experience 27 – although the review also noted that there is very little high-quality research in this area. Better integration of palliative care and institutionalised care could mitigate many of the concerns of the physicians interviewed for this study – and perhaps ease some of the clinical and moral tension.…”

Section: Discussionmentioning

confidence: 99%

Palliative care physicians’ perspectives on transferring patients to nursing homes and communication strategies to facilitate this transition: A qualitative study

Stiel¹,

Nagarajan

Forster

et al. 2019

Palliat Med

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Background: As modern medicine extends the life expectancy of patients with life-limiting illnesses and health system resource pressures intensify, palliative care physicians increasingly need to transfer stable patients from specialist palliative care units to nursing homes. The experience of palliative care physicians in decision-making and communicating with patients and families about the need for this transition is underexplored in the literature. Aim: This study aimed to explore the experiences of and communication techniques used by palliative care physicians as they consider and discuss nursing home placements for their patients. Design: A qualitative approach using semi-structured interviews was used. Interviews were transcribed verbatim and analysed using thematic analysis. Setting/participants: Purposive sampling was used to recruit 18 Australian palliative care physicians known for their interest or strength in communication skills across a range of palliative care settings. Results: Themes emerged from domains of physician experience (abandonment, systemic pressures, prognostic uncertainty, exacerbation of loss, and restoring resilience) and communication strategies (forecasting, checking in, provide context, and acknowledging grief). Conclusion: This study highlights the tension Australian palliative care physicians experience when transferring palliative care patients to nursing home and the complexity involved in decision-making. Physicians identified several communication strategies to engage patients and families to ease the transition.

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“…This qualitative focus group study was informed by the researchers' recent systematic literature review 3 and clinical knowledge of transitions between settings at the end of life that in turn informed the development of a conceptual framework and semi-structured focus group guide (Appendix 1). Five focus groups were conducted with hospice staff involved in discharge planning at five different hospices (indicated as A to E).…”

Section: Designmentioning

confidence: 99%

“…In the United Kingdom and Australia, those who cannot be discharged home are transferred to longterm care settings such as care homes. The limited published literature, 3 which largely comprised retrospective audits of patient discharge from UK PCUs, has found such transfers to care homes to be problematic, potentially increasing patient and family distress, while a significant proportion deteriorate before they are ever transferred. [4][5][6][7] In many Western healthcare systems, transitions between care settings occur with increasing frequency towards the end of life.…”

Section: Introductionmentioning

confidence: 99%

The difficulties of discharging hospice patients to care homes at the end of life: A focus group study

2018

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Inpatient transfer to a care home for end-of-life care: What are the views and experiences of patients and their relatives? A systematic review and narrative synthesis of the UK literature

Cited by 11 publications

References 27 publications

Significant others’ experience of hospitalized patients’ transfer to home: A systematic review and meta-synthesis

Significant others’ experience of hospitalized patients’ transfer to home: A systematic review and meta-synthesis

Palliative care physicians’ perspectives on transferring patients to nursing homes and communication strategies to facilitate this transition: A qualitative study

The difficulties of discharging hospice patients to care homes at the end of life: A focus group study

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