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May 10, 2019

ESOC-2019

‘IT WAS AS IF THE DOTS HADN'T BEEN JOINED UP': BEREAVED FAMILIES' EXPERIENCES OF END OF LIFE CARE IN ACUTE STROKE WARDS: A QUALITATIVE INVESTIGATION

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severe stroke

end of life care

acute hospital setting

bereaved families

qualitative research

Abstract

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Keywords

severe stroke

end of life care

acute hospital setting

bereaved families

qualitative research

Abstract

Background and Aims: Despite significant improvements in survival, severe stroke remains a major cause of mortality. Acute stroke settings have a key role at the end of people’s lives following a severe stroke. Ensuring appropriate, timely, high quality, person-centred, safe and effective end-of-life care in these settings is a professional priority. A competent and motivated workforce with appropriate training is essential to achieve this. This study aimed to illuminate bereaved family members’ experiences of end-of-life care in an acute stroke setting following implementation of an end-of-life care training intervention for all its healthcare staff. Methods: A qualitative exploratory study using in-depth, semi-structured, face to face, digitally recorded interviews was conducted by an independent research nurse and experienced qualitative researcher with no prior contact with the patient or family. Nine bereaved (> three months) family members, all women, participated. Interviews were fully transcribed and analysed by two independent researchers using thematic analysis. Results: The analysis identified three major themes: the variable nature and quality of interaction with healthcare staff, with glimpses of good practice in terms of doctor’s timeliness, respect, sensitivity, compassion and clarity when conversing about the gravity of patients' condition. Findings illuminated positive end-of-life care practices following a severe stroke in terms of recognising dying and family members’ support, care and engagement in decision-making. However, a pressing need for improved, timely, proactive and regular interaction with family members of people dying imminently in the acute stroke care setting was identified. Conclusions: End-of-life stroke care in the busy, noisy, fast paced acute hospital environments is not without challenge for many reasons. Furthermore, interacting with the family members of imminently dying people is a delicate, difficult territory. Yet these are the places where people die and the manner of a person’s dying casts an indelible mark on those who live on.

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© Copyright 2019 Morressier GmbH.
All rights reserved.