A qualitative inquiry into the barriers and facilitators to achieving home death

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Title: A qualitative inquiry into the barriers and facilitators to achieving home death
Author(s): Sayma, M
Saleh, D
Kerwat, D
Jamshaid, S
Ahmed, A
Oyewole, F
Wahid, AS
Perry, C
Cox, B
Item Type: Journal Article
Abstract: OBJECTIVES: To explore the barriers and facilitators to patients achieving death at home. METHODS: In-depth, semistructured interviews with end-of-life care experts were conducted to develop an insight into the barriers and facilitators to achieving death at home. Thirty-three interviews were conducted compromising of a mixture of face-to-face and tele interviews. Experts included healthcare professionals working in the community, hospital and policy/academic settings. Thematic analysis was undertaken on interview transcripts. RESULTS: Three overarching themes, further divided into a total of 12 subthemes were identified. The three themes were 'managing people', 'education' and 'planning'. The 'managing people' theme included subthemes of patient preferences and family influences; the 'education' theme encompassed knowledge and training, perceptions of death and communication and the 'planning' theme contained seven subthemes including 'coordination', 'resources' and 'cost'. CONCLUSIONS: Multiple barriers and facilitators to achieving death at home were identified in this study. Of particular significance was the identification of the fear and stigma associated with death among doctors, patients and their families serving as a barrier to home death, not previously identified in the literature. Additionally, the importance of social networks and resource provision were highlighted as key in influencing patient death at home.
Publication Date: 31-Jul-2017
Date of Acceptance: 26-Jun-2017
URI: http://hdl.handle.net/10044/1/50050
DOI: https://dx.doi.org/10.1136/bmjspcare-2016-001260
ISSN: 2045-4368
Publisher: BMJ
Journal / Book Title: BMJ Supportive and Palliative Care
Copyright Statement: © 2017 The Author(s). This article has been accepted for publication in BMJ Supportive and Palliative Care following peer review. The definitive copyedited, typeset version can be found at Sayma M, Saleh D, Kerwat D, et al A qualitative inquiry into the barriers and facilitators to achieving home death BMJ Supportive & Palliative Care Published Online First: 31 July 2017. doi: 10.1136/bmjspcare-2016-001260
Sponsor/Funder: Engineering & Physical Science Research Council (EPSRC)
Funder's Grant Number: EP/H019804/1
Keywords: EolC
barriers
facilitators
home death
EolC
barriers
facilitators
home death
Publication Status: Published
Conference Place: England
Appears in Collections:Imperial College Business School



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