TY - JOUR
T1 - “Hanging in a balance”
T2 - A qualitative study exploring clinicians’ experiences of providing care at the end of life in the burn unit
AU - Bayuo, Jonathan
AU - Bristowe, Katherine
AU - Harding, Richard
AU - Agbeko, Anita Eseenam
AU - Wong, Frances Kam Yuet
AU - Agyei, Frank Bediako
AU - Allotey, Gabriel
AU - Baffour, Prince Kyei
AU - Agbenorku, Pius
AU - Hoyte-Williams, Paa Ekow
AU - Agambire, Ramatu
N1 - Funding Information:
The authors wish to express their gratitude to the burn care team at KATH, Dr. Mary Abboah-Offei (Kings College, London) and Dr. Doris Leung (School of Nursing, The Hong Kong Polytechnic University). The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study is a part of an ongoing study supported by a BuildCare Africa grant from the Cicely Saunders Institute, Kings College, London.
Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study is a part of an ongoing study supported by a BuildCare Africa grant from the Cicely Saunders Institute, Kings College, London.
Publisher Copyright:
© The Author(s) 2020.
PY - 2021/2
Y1 - 2021/2
N2 - Background: Although the culture in burns/critical care units is gradually evolving to support the delivery of palliative/end of life care, how clinicians experience the end of life phase in the burn unit remains minimally explored with a general lack of guidelines to support them. Aim: To explore the end of life care experiences of burn care staff and ascertain how their experiences can facilitate the development of clinical guidelines. Design: Interpretive-descriptive qualitative approach with a sequential two phased multiple data collection strategies was employed (face to face semi-structured in-depth interviews and follow-up consultative meeting). Thematic analysis was used to analyze the data. Setting/participants: The study was undertaken in a large teaching hospital in Ghana. Twenty burn care staff who had a minimum of 6 months working experience completed the interviews and 22 practitioners participated in the consultative meeting. Results: Experiences of burn care staff are complex with four themes emerging: (1) evaluating injury severity and prognostication, (2) nature of existing system of care, (3) perceived patient needs, and (4) considerations for palliative care in burns. Guidelines in this regard should focus on facilitating communication between the patient and family and staff, holistic symptom management at the end of life, and post-bereavement support for family members and burn care practitioners. Conclusions: The end of life period in the burn unit is poorly defined coupled with prognostic uncertainty. Collaborative model of practice and further training are required to support the integration of palliative care in the burn unit.
AB - Background: Although the culture in burns/critical care units is gradually evolving to support the delivery of palliative/end of life care, how clinicians experience the end of life phase in the burn unit remains minimally explored with a general lack of guidelines to support them. Aim: To explore the end of life care experiences of burn care staff and ascertain how their experiences can facilitate the development of clinical guidelines. Design: Interpretive-descriptive qualitative approach with a sequential two phased multiple data collection strategies was employed (face to face semi-structured in-depth interviews and follow-up consultative meeting). Thematic analysis was used to analyze the data. Setting/participants: The study was undertaken in a large teaching hospital in Ghana. Twenty burn care staff who had a minimum of 6 months working experience completed the interviews and 22 practitioners participated in the consultative meeting. Results: Experiences of burn care staff are complex with four themes emerging: (1) evaluating injury severity and prognostication, (2) nature of existing system of care, (3) perceived patient needs, and (4) considerations for palliative care in burns. Guidelines in this regard should focus on facilitating communication between the patient and family and staff, holistic symptom management at the end of life, and post-bereavement support for family members and burn care practitioners. Conclusions: The end of life period in the burn unit is poorly defined coupled with prognostic uncertainty. Collaborative model of practice and further training are required to support the integration of palliative care in the burn unit.
KW - Burns
KW - end of life care
KW - palliative care
UR - http://www.scopus.com/inward/record.url?scp=85096182153&partnerID=8YFLogxK
U2 - 10.1177/0269216320972289
DO - 10.1177/0269216320972289
M3 - Journal article
C2 - 33198576
AN - SCOPUS:85096182153
SN - 0269-2163
VL - 35
SP - 417
EP - 425
JO - Palliative Medicine
JF - Palliative Medicine
IS - 2
ER -