End-of-Life Care in Nursing Homes: A Qualitative Interpretive Meta-Synthesis.

BACKGROUND

Due to large number of deaths occurring in nursing home (NH) settings, along with reports of pain and suffering, there is great need for improvements in the provision of end-of-life (EOL) care in NHs.

OBJECTIVE

The aim of this study was to develop a comprehensive understanding of the experience of dying in NHs through the perspective of residents, family, and facility staff.

DESIGN

This study uses a qualitative interpretive meta-synthesis to provide a holistic view of EOL care in NHs across multiple qualitative studies.

SETTING/SUBJECTS: Researchers synthesized the findings of 13 qualitative articles, including the diverse perspective of 91 dying residents, 419 NH staff, and 156 family members/caregivers across at least 44 NHs.

METHODS

A qualitative meta-synthesis employs the following steps: identification of studies, theme extraction, translation, and synthesis of findings.

RESULTS

Thematic analysis is organized using a conceptual model demonstrating the links between environmental and personal factors impacting EOL care in NHs.

CONCLUSIONS

Findings provide support for the importance of a relational community and culture change within NHs for positive EOL experiences, in addition to providing a model to guide future research priorities.