Preliminary study of the end-of-life process through data triangulation in a regional Hospital

Authors

DOI: https://doi.org/10.6018/eglobal.428511
Keywords: Palliative Care; Research techniques; Patient care; Family; Healthcare Staff.

Abstract

Objective: To know the characteristics of the end-of-life process in a Regional Hospital, according to the actors involved, establishing convergence/divergence elements in care process, decision-making, information and knowledge.
Method: Observational, cross-sectional, descriptive, convergent of mixed methods and data triangulation study. Carried out on a sample of 63 subjects, of which 25 were health professionals, 19 family caregivers and 19 medical records of patients who died in the course of a year.
Results: Data triangulation shows discrepancies between family members and health professionals regarding care quality and the information provided. The lack of documentation in medical records of care aspects related to decision-making or terminal sedation stands out.
Conclusion: This study provides an integrated view of end-of-life care provided in a Regional Hospital, identifying priority areas of intervention in order to improve quality of life in this process, such as patient involvement in decision-making, appropriate completion of medical records and health professional training.

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Author Biographies

María del Mar Alfaya-Góngora, Departamento de Enfermería, Universidad de Granada

Graduated in Nursing in 1982. Graduated in Anthropology, Social and Cultural in 2006. Professor of the Nursing Department since 1980 at the University of Granada. Official career of the Ministry of Health. Experience in health and university management from 1980 to the present.

Miguel Ángel Gallardo-Vigil, Departamento Métodos de Investigación y Diagnóstico en Educación, Universidad de Granada

Miguel Ángel Gallardo Vigil has a degree and a doctorate in Educational Psychology from the
University of Granada in 1998 and 2003 respectively. Professor of the Department of Research
Methods and Diagnosis in Education since 1999 at the Faculty of Education and Humanities of
Melilla. His research focuses on various topics related to the educational field: university
education, use of ICT, cultural diversity ... He is a member of the Research Group "Curricular
innovation in multicultural contexts" (HUM.358). He is the author of several studies for the Ministry
of Education on early school leaving in the cities of Ceuta and Melilla as well as on school
coexistence.

Silvia Navarro-Prado, Departamento de Enfermería, Universidad de Granada

Professor of the Faculty of Health Sciences of Melilla at the University of Granada. Nurse Specialist in Obstetrics and Gynecology (Midwife) Master's Degree in Health Care for the Promotion of the Autonomy of the people and Assistance in the End Processes Life Doctor in Nursing

References

Esteban M, Grau, IC, Castells G, Bullicg I, Busquet X, Aranzana A; et al. Complejidad asistencial en la atención al final de la vida: criterios y niveles de intervención en atención comunitaria de salud. Med. paliat. 2015; 22(2): 69-80.

Florêncio MM, Lopes de Almeida M C. The illness experience: Palliative care given the impossibility of healing. Rev. Esc. Enferm. USP. 2016; 50:7-53.

Donato CT, Matuoka Y, Yamashita C, Salvetti MG. Effects of dignity therapy on terminally ill patients: a systematic review. Rev. Esc. Enferm. USP. 2016;50(6):1011-1021.

Fascioli A. Los cuidados paliativos al final de la vida: Expresión del reconocimiento del otro. Enfermería (Montev.) . 2016; 5(2):46-53.

Sepúlveda JM, Morales JM, Morales IM, Canca JC, Crespillo E, Timonet E. El derecho a morir con dignidad en un hospital de agudos: un estudio cualitativo. Enferm. clín. (Ed. Impr.). 2014; 24(4): 211-218.

Lima JS, Asensio MR, Palomo JC Ramírez EB, Lima M. Razones para decidir morir en el hospital o en el domicilio. Visión de los/las profesionales. Gac. Sanit. (Barc., Ed. Impr.). 2018; 32(4): 362-368.

Lozano B, Huertas MM. Cuidados paliativos, cuidados compartidos. Cult. cuid. 2018; 49: 100-107.

Esteban M, Fernández J, Boira RM, Martínez T, Nadal S, Castell G. Concordancia entre la complejidad observada desde diferentes niveles asistenciales en pacientes crónicos complejos, con enfermedad avanzada o al final de la vida mediante un modelo de abordaje de la complejidad. Med. paliat. 2018; 4: 236-244.

García MT, Gil E, Fernández MC, Sanz EM, Dones M, Domínguez A, et al. Programa centralizado de formación en Cuidados Paliativos. Coordinación Regional de la Comunidad de Madrid 2010-2015. Educ. med. (Ed. Impr.). 2017; 18(2): 103-113.

Rodríguez I, Villamor A, Lahosa MT, Dorca M, Mas M, Salvador MI. Conocimientos y actitudes de enfermeras de onco-hematología ante el documento de voluntades anticipadas. Rev. cuba. enferm. 2018; 34(2): 1-15

Pascual MC. Información a familiares de pacientes en proceso final de vida en unidades de cuidados intensivos. Evaluación por parte de las enfermeras. Enferm. clín. (Ed. Impr.). 2014; 24(3):168-174.

Sánchez MR, Moreno M, Hueso C, Campos C, Varella A, Montoya R. Dificultades y factores favorables para la atención al final de la vida en residencias de ancianos: un estudio con grupos focales. Aten. prim. (Barc., Ed. Impr.). 2017; 49(5): 278-285.

Velarde JF, Luengo R, González R, González S, Álvarez B, Palacios D. Dificultades para ofrecer cuidados al final de la vida en las unidades de cuidados intensivos. La perspectiva de enfermería. Gac. Sanit. (Barc., Ed. Impr.). 2017; 31(4):299-304

Puerto HM. Calidad de vida en cuidadores familiares de personas en tratamiento contra el cáncer. Rev. cuid. (Bucaramenga. 2010). 2015; 6(2): 1029-1040.

Instituto Nacional de Estadística. Cifras oficiales de población resultantes de la revisión del Padrón municipal a 1 de enero [Internet]. INE; 2017 [citado 2018 mar. 1]. Disponible en: https://www.ine.es/jaxiT3/Datos.htm?t=2915

Guerrero RF, Prado M, Ojeda MG. Reflexión crítica epistemológica sobre métodos mixtos en investigación de enfermería. Enferm. univ. 2016; 13(4): 246-252.

Alzás T, García LM. La evolución del concepto de triangulación en la investigación social. Rev Pesqui Qualit. 2017; 5(8): 395-418.

Sepúlveda JM, Morales JM, Morales IM, Sánchez JC, Timonet EM, Rivas F. Análisis de la toma de decisiones compartidas al final de la vida en las historias clínicas. Med. paliat. 2017; 24(1):14-20.

Kreetapirom P, Jaruratanasirikul S, Pruphetkaew N. Audit of paediatric residents' medical records. Clin Teach. 2017; 14(3): 189-194.

López JJ, Moreno MG, Saavedra CH, Espinosa AL, Camacho JU. La importancia del registro clínico de enfermería: un acercamiento cualitativo. Nure Investigación. 2018; 15(93): 1-9.

Dy SM. Patient safety and end-of-life care: common issues, perspectives, and strategies for improving care. Am Hosp Care. 2016;33(8): 791-796.

Burge F, Lawson B, Asada Y, Mclntyre PF, Grufeld E, Flowerdew G. Bereaved family member perceptions of patient-focused family-centred care during the last 30 days of life using a mortality follow-back survey: does location matter?. BMC Palliat Care. 2014; 13:25

Manalo MF. End-of-Life Decisions about Withholding or Withdrawing Therapy: Medical, ethical, and Religio-cultural considerations. Palliat Care. 2013; 7: 1-5

Van Der Eerden M, Csikos A, Busa A, Hughes S, Radbruch L, Menten J, et al. Experiences of patients, family and professional caregivers with Integrated Palliative Care in Europe: protocol for an international, multicenter, prospective, mixed method study. BMC Palliat Care. 2014; 13:52. DOI: https://doi.org/10.1186/1472-684X-13-52

Singer AE, Goebel JR, Kim YS, Dy SM, Ahluwalia SC, Clifford M, et al. Populations and interventions for palliative and end-of-life care: a systematic review. J Palliat Med. 2016; 9(9): 995-1008.

Otte IC, Jung C. Bally K, Elger BS, Schildmann J. Interprofessional Silence at the End of Life: Do Swiss General Practitioners and Hospital Physicians Sufficiently Share Information About Their Patients?. J Palliat Med. 2016; 19(9): 983-986.

Published
01-04-2021
How to Cite
[1]
Alfaya-Góngora, M. del M. et al. 2021. Preliminary study of the end-of-life process through data triangulation in a regional Hospital. Global Nursing. 20, 2 (Apr. 2021), 426–452. DOI:https://doi.org/10.6018/eglobal.428511.
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Section
ORIGINAL RESEARCH