Patients' experiences and perceptions of dignity in end‐of‐life care in emergency departments: A qualitative study.

Abstract

Aims: To explore and understand the experiences of patients with advanced illness inrelation to dignity during end-of-life care in emergency departments.Design: Qualitative study based on Gadamer's hermeneutics.Methods: Between September 2019 and February 2020, 16 in-depth interviews werecarried out with advanced illness patients who attended emergency departments.The participants were informed priorly and signed informed consent. The data wereanalysed using an inductive strategy for finding emerging themes. The ConsolidatedCriteria for Reporting Qualitative Research was used for writing the study's report.Results: In the data analysis process, two main themes emerged that glean the ex-periences of patients in relation to dignity during end-of-life care in emergency de-partments. ‘Dignity as an individual's attribute’ and ‘Acting with dignity: Dignity as abehavioural attribute’.Conclusion: Patient dignity in end-of-life care is centred around the principle of con-trol (of oneself, one's death and one's emotions). The strategies required for patientsto preserve their dignity can be somewhat incompatible with the dynamics and objec-tives of healthcare professionals who work in emergency departments.Impact statement: The dignity of patients with advanced illness who attend emer-gency departments is a relevant issue that merits being addressed from the patients'perspective. Participants have identified that dignity is a way of being and behavingin the face of illness. Emergency departments need to respect end-of-life patients'desires by supporting and accompanying them, avoiding therapeutic obstinacy. Werecommend care to be centred on patients' well-being, to respect their autonomy anddecision-making processes, and to allow prompt referrals to palliative care services.