Exploring preferences for place of death with terminally ill patients: qualitative study of experiences of general practitioners and community nurses in England

摘要: Objective To explore the experiences and perceptions of general practitioners community nurses in discussing preferences for place death with terminally ill patients. Design Qualitative study using semistructured interviews thematic analysis. Participants 17 19 (16 district nurses, three clinical nurse specialists). Setting 15 practices participating Gold Standards Framework palliative care from areas central England differing socio-geography. Practices were selected on basis size level adoption standards framework. Results All interviewees bar one had experience preferred They reported that frequently changed over time often defined or poorly formed patients’ minds. Preferences described as being co-created discussion patient or, conversely, inferred by health professional without direct questioning receiving a definitive answer patient. This inherent uncertainty challenged practicability, usefulness, value recording preference. The extent to which assessment enabling such can be used proxy effectiveness delivery is also limited this uncertainty. Generally, did not find an easy area practice, unless broached subject led discussions. Conclusions Further research needed enable development appropriate training support primary professionals. Better understanding importance patients their carers needed.