Family Carers' Experiences of Goals of Care Conversations in Acute Hospital Settings.

decision-making end of life family goals of care qualitative methods

Journal

Journal of applied gerontology : the official journal of the Southern Gerontological Society
ISSN: 1552-4523
Titre abrégé: J Appl Gerontol
Pays: United States
ID NLM: 8606502

Informations de publication

Date de publication:
20 Sep 2023
Historique:
medline: 20 9 2023
pubmed: 20 9 2023
entrez: 20 9 2023
Statut: aheadofprint

Résumé

End-of-life Goals of Care (GoC) discussions aim to support care that is consistent with patients' preferences and values. This study uses an exploratory qualitative design drawing upon a social constructivist epistemology to examine family carers' perspectives on GoC within acute Australian hospital settings. Twenty-five family carers of aging inpatients were recruited from six Australian hospitals to participate in recorded, semi-structured interviews. Data were transcribed and analyzed using reflexive thematic analysis. Three main themes were developed. Theme 1 explored carers' experiences of GoC discussions-identifying varying levels of preparedness and carers' hopes for open, two-way discussions initiated by empathic Health Care Professionals (HCPs). Theme 2 examined carers' unmet needs for time, space, consistency, and support to make careful decisions. Theme 3 identified carers advocating for patients' needs when they could not do it themselves. Preparing carers and normalizing GoC discussions relating to end-of-life care maximizes benefits for patients, carers, and HCPs involved.

Identifiants

pubmed: 37728282
doi: 10.1177/07334648231198973
pmc: PMC10666475
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

7334648231198973

Références

JAMA Intern Med. 2015 Apr;175(4):549-56
pubmed: 25642797
Psychooncology. 2018 Mar;27(3):1035-1041
pubmed: 29315989
BMC Health Serv Res. 2016 Oct 6;16(1):555
pubmed: 27716183
J Adv Nurs. 2007 Aug;59(3):290-8
pubmed: 17590210
Gerontologist. 2018 Jul 13;58(4):739-748
pubmed: 28329800
Dementia (London). 2020 Jul;19(5):1532-1559
pubmed: 30253658
J Appl Gerontol. 2021 Oct;40(10):1180-1188
pubmed: 32233717
Med J Aust. 2014 Oct 20;201(8):452-5
pubmed: 25332031
J Adv Pract Oncol. 2016 Mar;7(2):146-154
pubmed: 28090365
BMC Geriatr. 2017 Jul 31;17(1):167
pubmed: 28760149
J Gen Intern Med. 2020 Dec;35(12):3572-3580
pubmed: 33037591
BMC Health Serv Res. 2016 Nov 15;16(1):655
pubmed: 27846832
Qual Health Res. 2016 Nov;26(13):1753-1760
pubmed: 26613970
Z Psychosom Med Psychother. 2017 Jun;63(2):131-150
pubmed: 28585507
J Alzheimers Dis. 2021;83(4):1767-1773
pubmed: 34459407
Palliat Med. 2019 Jun;33(6):589-606
pubmed: 30969160
J Appl Gerontol. 2022 Feb;41(2):380-390
pubmed: 33660545
Palliat Med. 2021 Jan;35(1):109-119
pubmed: 32928056
ESC Heart Fail. 2016 Dec;3(4):245-252
pubmed: 27867525
J Gen Intern Med. 2020 May;35(5):1559-1566
pubmed: 31637653
Emerg Med Australas. 2019 Aug;31(4):525-532
pubmed: 31044525
Int J Qual Health Care. 2007 Dec;19(6):349-57
pubmed: 17872937
Intern Med J. 2014 Oct;44(10):961-6
pubmed: 24942613
Palliat Med. 2019 Sep;33(8):926-941
pubmed: 31184529
Singapore Med J. 2016 Jan;57(1):22-8
pubmed: 26831313
Int J Qual Health Care. 2016 Sep;28(4):456-69
pubmed: 27353273
Palliat Med. 2018 Feb;32(2):329-336
pubmed: 29017018
BMC Palliat Care. 2019 Feb 8;18(1):18
pubmed: 30736788
J Appl Gerontol. 2022 Jun;41(6):1595-1603
pubmed: 35437036
BMC Med Educ. 2021 Jun 14;21(1):343
pubmed: 34126985

Auteurs

Kitty Vivekananda (K)

School of Educational Psychology and Counselling, Faculty of Education, Monash University, Melbourne, VIC, Australia.

Jayamini S Jayawardene (JS)

School of Educational Psychology and Counselling, Faculty of Education, Monash University, Melbourne, VIC, Australia.

Moira O'Connor (M)

WA Cancer Prevention Research Unit, School of Population Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.

Kaaren J Watts (KJ)

WA Cancer Prevention Research Unit, School of Population Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.

Anton D Leonard (AD)

Critical Care and Intensive Care, Royal Perth Bentley Group, East Metropolitan Health Service, Perth, WA, Australia.

Sharon Keesing (S)

School of Occupational Therapy, Speech Pathology and Social Work, Curtin University, Perth, WA, Australia.

Georgia Halkett (G)

Curtin School of Nursing, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.

Josephine Shaw (J)

Cancer Prevention Research Unit, School of Psychology, Curtin University, Perth, WA, Australia.

Valerie Colgan (V)

WA Cancer and Palliative Care Network, WA Department of Health, Perth, WA, Australia.

Kevin Yuen (K)

Palliative Care Department, Royal Perth Bentley Group, East Metropolitan Health Service, Perth, WA, Australia.

Renate Jolly (R)

Respiratory Medicine, Royal Perth Bentley Group, East Metropolitan Health Service, Perth, WA, Australia.

Simon C Towler (SC)

Staff Specialist, Intensive Care Unit, Fiona Stanley Hospital, South Metropolitan Health Service, Perth, WA, Australia.
Acting State Medical Director, DonateLife, WA, MHPHDS Division, North Metropolitan Health Service, Perth, WA, Australia.
Clinical Lead, End-of-Life Care, WA Department of Health, Perth, WA, Australia.

Anupam Chauhan (A)

Department of Intensive Care Medicine, Rockingham Hospital, South Metropolitan Health Service, Perth, WA, Australia.

Margherita Nicoletti (M)

Palliative Care, Rockingham Hospital, South Metropolitan Health Service, Perth, WA, Australia.

Claire E Johnson (CE)

Monash Nursing and Midwifery, Monash University, Melbourne, Australia.
Eastern Health, Melbourne, VIC, Australia.
Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia.

Classifications MeSH