The decision for hospice care in patients with terminal illness in Shanghai: A mixed-method study.
Chunyan Chen, Xiaobin Lai, Aiping Xu and 3 others
PMID 35079607WHAT IT FOUND
Families of hospice patients chose it mainly when no other place was available (82.19%) or it was near home (64.38%).
Most decisions were family discussions; patients were involved in 43.15% and nurses in 2.05%.
Key findings
01The most common reason for choosing hospice was that families could not find any other place for the patient (82.19%), followed by the ward being near home (64.38%).
02Most families (84.93%) collectively discussed choosing the hospice ward, while the patient was involved in 43.15%, doctors in 17.81%, nurses in 2.05%, and 32.19% realized the patient was at the terminal stage.
03Interviews described families choosing hospice after home care became impossible or after struggling to find a hospital bed.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only families of patients already in hospice wards were studied, so the paper cannot explain why other families did not choose hospice. The survey used a self-designed 10-item questionnaire, and only 10 family members tested it in a pilot. Pandemic restrictions interrupted data collection, reduced admissions and family visits, and limited interviews to one center with 9 participants. The paper reports reasons and decision processes, not patient outcomes or effects of any intervention. The authors report 146 survey participants but also state the sample was smaller than estimated.
Declared interests
Funded by a Fudan University original research project; authors declared no conflict of interest.
The easy way to misread this
Do not conclude that nurses usually guide families into hospice care. Only 2.05% of family decision-makers reported nurses joined the decision-making process, and the study included only families who had already chosen hospice.