Family caregivers' experiences of end-of-life care in the acute hospital setting : A qualitative study

• Published in: Scandinavian Journal of Caring Sciences
• Main Authors: Robertson, Svala Berglind, Hjörleifsdóttir, Elísabet, Sigurðardóttir, Þórhalla
• Other Authors: School of Health Sciences, Landspitali - The National University Hospital of Iceland
• Format: Article in Journal/Newspaper
• Language: English
• Published: 2021
• Subjects: Dauði; Sjúkrahús; Aðstandendur; acute hospital settings; bereavement; communication; end-of-life care; environment; family caregivers; grief; palliative care; Iceland
• Online Access: https://hdl.handle.net/20.500.11815/2876; https://doi.org/10.1111/scs.13025

Background: Acute hospital settings are generally not considered adequate places for end- of- life care, but terminally ill patients will continue to die in acute medical wards in the unforeseeable future. Aim: The aim of this study was to investigate family caregivers’ experiences of end- of- life care in an acute community hospital in Iceland. Methods: Fifteen in- depth qualitative semi- structured interviews were conducted with participants who had been primary caregivers. The transcribed interviews were analysed using thematic content analysis. Findings: Findings indicated that the acute hospital setting is not a suitable environ-ment for end- of- life care. Effective communication and management of symptoms characterised by warmth and security give a sense of resilience. Three main themes emerged: (1) Environmental influences on quality of care; (2) Communication in end- of- life care; (3) The dying process. Each of the themes encompassed a variety of subthemes. Conclusions: Findings suggest that effective communication is the cornerstone of quality of care in the acute hospital environment and essential for establishing a sense of security. The severity of symptoms can deeply affect family caregivers’ well- being. Acknowledging and appreciating the meaning of respect and dignity at the end- of- life from family caregivers’ perspective is vital. Peer reviewed