Palliative Medicine Department, Wellington Public Hospital, Private Bag 7902, Wellington 6242, New Zealand.
QJM. 2013 Aug;106(8):731-6. doi: 10.1093/qjmed/hct095. Epub 2013 Apr 22.
Although the majority of deaths occur in hospital it has been suggested that dying in hospital is largely a negative experience.
To explore the experience of relatives and staff of patients dying in hospital using qualitative grounded theory.
Patients receiving palliative care were identified who were likely to die in hospital. Family members were met by the researcher prior to the patient's death. The ward nurse and doctor (excluding palliative care team) most involved at that time were interviewed within 48 h of the death. The family were interviewed 2 weeks later. Interviewees described their experience of the patient's dying and death. Recruitment and thematic analysis of interviews occurred concurrently.
Twelve triads over 6 months (relative, nurse and doctor) were interviewed in relation to 12 patients. Dying patients and families need a guide to attend to their needs. Every detail is remembered by the family who take up residence in the hospital. Families value acts of kindness by staff. Hospital may offer benefits for the dying patient and family. However, there are gaps in care identified by families and staff. After death is critical time for the family. Junior doctors are often uncertain of their role, expressing grief and guilt. Young nurses inexperienced in care of dying patients value support and guidance by senior colleagues.
Leadership from nursing and medical staff is required for seamless provision of competent and compassionate care at this life changing time for grieving families.
尽管大多数死亡发生在医院，但有人认为在医院死亡在很大程度上是一种负面体验。
使用定性扎根理论探讨患者在医院死亡时家属和医护人员的体验。
确定了正在接受姑息治疗的患者，这些患者可能会在医院死亡。在患者死亡之前，研究人员会见了家属。在死亡后 48 小时内，采访了当时最相关的病房护士和医生（不包括姑息治疗团队）。两周后，对家属进行了采访。受访者描述了他们对患者临终和死亡的体验。采访的招募和主题分析是同时进行的。
在 6 个月内，共对 12 个患者的 12 个三人小组（家属、护士和医生）进行了采访。临终患者及其家属需要有人指导以满足他们的需求。家属会记住患者的每一个细节，他们在医院里安家。家属重视医护人员的善举。医院可能会为临终患者及其家属提供福利。然而，家属和医护人员都发现了护理方面的差距。死亡后对家属来说是一个关键时期。初级医生往往对自己的角色感到不确定，表达悲伤和内疚。缺乏照顾临终患者经验的年轻护士重视得到资深同事的支持和指导。
在这个改变生活的悲伤时期，护理和医疗团队需要领导，以提供有能力和富有同情心的无缝护理。
