A qualitative inquiry into the barriers and facilitators to achieving home death
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Accepted version
Author(s)
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.
Date Issued
2020-05-27
Date Acceptance
2017-06-26
Citation
BMJ Supportive and Palliative Care, 2020, 10
ISSN
2045-4368
Publisher
BMJ
Journal / Book Title
BMJ Supportive and Palliative Care
Volume
10
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
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
Engineering & Physical Science Research Council (EPSRC)
Identifier
http://www.ncbi.nlm.nih.gov/pubmed/28760819
PII: bmjspcare-2016-001260
Grant Number
EP/H019804/1
Subjects
EolC
barriers
facilitators
home death
Publication Status
Published
Coverage Spatial
England
Article Number
ARTN e18
Date Publish Online
2017-07-31