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Centre for Policy on Ageing | |
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Exploring preferences for place of death with terminally ill patients
— qualitative study of experiences of general practitioners and community nurses in England | | Author(s) | Daniel Munday, Mila Petrova, Jeremy Dale |
| Journal title | British Medical Journal, vol 339, no 7714, 25 July 2009 |
| Pages | pp 214-218 |
| Source | www.bmj.com |
| Keywords | Death ; Terminal illness ; Terminal care ; Consumer choice ; Attitude ; General practitioners ; District nurses ; Qualitative Studies ; Midlands [England]. |
| Annotation | Participants were 17 general practitioners (GPs) and 19 nurses (16 district nurses and 3 clinical nurse specialists) from 15 general practices in three areas of central England with differing socio-geography and participating in the the Gold Standards Framework for palliative care. Practices were selected on the basis of size and level of adoption of the framework. All interviewees bar one had experience of discussing preferred place of death with terminally ill patients. They reported that preferences for place of death frequently changed over time and were often ill defined or poorly formed in patients' minds. Preferences were often described as being co-created in discussion with the patient or, conversely, inferred to the health professional without direct questioning or receiving a definitive answer from the patient. The inherent uncertainty challenged the practicability, usefulness, and value of recording a definitive preference. The extent to which the assessment of enabling such preferences can be used as a proxy for the effectiveness of palliative care delivery is also limited by this uncertainty. Generally, interviewees did not find discussing preferred place of death an easy area of practice, unless the patient broached the subject or fed the discussions. Further research is needed to enable development of appropriate training and support for primary care professionals. Better understanding of the importance of place of death to patients and their carers is also needed. (RH). |
| Accession Number | CPA-090810212 A |
| Classmark | CW: CV: LV: WYC: DP: QT6: QTG: 3DP: 82X * |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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