Richards, N. , Ingleton, C., Gardiner, C. and Gott, M. (2013) Awareness contexts revisited: indeterminacy in initiating discussions at the end-of-life. Journal of Advanced Nursing, 69(12), pp. 2654-2664. (doi: 10.1111/jan.12151) (PMID:23600793)
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Abstract
Aims To explore if and how information about a transition to a palliative care approach was communicated to patients recently discharged from hospital and who fulfilled standardized criteria for palliative care need.<p></p> Background Palliative care philosophy and, more recently, UK palliative care policy, endorse a context of ‘open’ awareness, where all parties openly acknowledge that the patient's death is approaching. The perceived benefits of making the patient aware of their prognosis encompass a variety of planning activities, which mean that death, when it occurs, is arguably more in keeping with the wishes of the patient.<p></p> Design A qualitative inductive interview study conducted in 2010–2011.<p></p> Methods Fifteen semi-structured interviews were conducted with 15 patients and 3 family carers. All patients were identified as having palliative care needs according to standardized criteria, 3–6 months after discharge from hospital. A thematic analysis was undertaken.<p></p> Findings Contrary to the professed ideal of ‘open’ awareness, some participants were only partially aware and others wholly unaware that they were likely to be approaching the end-of-life. Those identified as unaware were over 85. Participants displayed a reluctance to acquire knowledge which would require them to face the imminence of death.<p></p> Conclusion Philosophy and policy aside, people do not always conform to the autonomy paradigm of a self-directed life followed by a self-directed death.<p></p>
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Richards, Dr Naomi |
| Authors: | Richards, N., Ingleton, C., Gardiner, C., and Gott, M. |
| College/School: | College of Social Sciences > School of Social & Environmental Sustainability |
| Journal Name: | Journal of Advanced Nursing |
| Publisher: | Blackwell |
| ISSN: | 1365-2648 |
| ISSN (Online): | 1365-2648 |
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