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Finding a voice at the end of life: exploring preferred place of death in a hospice context.

Walker, Susan

Finding a voice at the end of life: exploring preferred place of death in a hospice context. Thumbnail


Susan Walker


This study explored the views of patients, carers and staff within one UK hospice on talking about preferred place of death (PPD). The UK Government's End of Life Care Strategy (EOLC, 2008) states that patients' PPD should be identified, documented and reviewed; yet the hospice in this study did not systematically record such information. It was, therefore, important to ask questions about patient, carer and staff views on PPD as this had not yet been explored. Hence the aims of this exploratory study were to:
• Explore key considerations about PPD from the perspectives of hospice patients, carers and staff
• Generate theory about the participants’ experience of PPD

The methodology of constructivist grounded theory enabled a substantive theory to be generated which offered an interpretative explanation of the participants’ concerns regarding PPD. Data collection methods of focus groups amongst hospice staff, and semi-structured interviews with hospice patients and carers, captured the views of a cross-section of people within the hospice context.

The grounded theory demonstrated that recording the patient’s PPD is a means of ‘Enabling the Patient Voice to be Heard’. The ways in which the grounded theory impacts the end of life care landscape were explored including questions around contemporary societal discourses on death; current end of life planning; communication issues at the end of life; health service provision and the roles of healthcare professionals, patients and carers.
A reflexive account of the research process and the limitations of the study are also presented. The unique contribution of the study is stated and recommendations for further work are suggested.

Publication Date Oct 1, 2016
Keywords palliative care; end of life care; preferred place of death; hospice;
qualitative; user and carer perspectives; reflexivity; ethics; constructivist grounded theory.


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