Discussing preferred place of death with patients: Staff experiences in a UK specialist palliative care setting

摘要

Background: National end-of-life care policies propose that health professionals regularly discuss matters such as preferred place of death (PPD) with patients. Aim: To explore clinician experiences of discussing PPD with palliative care patients. Method: Six clinicians from a Scottish hospice each participated in a semi-structured interview. Interview data was analysed using interpretative phenomenological analysis. Results: Four themes were integral to the participants' accounts: the importance of discussing preferences at the end of life (staff recognise the value of discussing patients' final wishes), identifying how and when to discuss PPD (discussions are tailored to the individual), reflecting on the emotional aspects of discussing PPD (discussing PPD is challenging but rewarding), and a journey from expectations to experience (discussing PPD becomes easier with time). Conclusion: Although potentially difficult, the participants believed that advance care planning is important and beneficial. With time, they had developed communication strategies enabling them to discuss PPD in an effective, patient-centred way.