Loss of Dignity in End-of-Life Care in the Emergency Department: A Phenomenological Study with Health Professionals

Abstract

IntroductionThe objective of this study was to explore and describe the experiences of physicians and nurses with regard to loss of dignity in relation to end-of-life care in the emergency department. MethodA phenomenological qualitative study was performed. Two focus groups and 12 individual interviews were conducted with a total of 26 participants, who had attended to patients in the emergency department an average of 14.3 years. An inductive analysis was carried out with the use of ATLAS.ti software to seek emerging themes. ResultsThree themes that helped us understand the phenomenon of the loss of dignity in end-of-life care in the emergency department emerged: (1) “Being exposed in a cold world,” with the subthemes “improvising dying person care” and “a lack of space to care for the dying person”; (2) “Being self-critical with professional attitudes,” with the subthemes “being aware of undignified actions” and “lack of a palliative culture”; and (3) “Family obstinacy and hospital rescue,” with the subthemes “making ill-advised choices” and “avoiding burden.” DiscussionThe dignity of people who are taken to the emergency department at the end of their life could be undermined by architectural and organizational characteristics, professionals’ attitudes, and decisions made by family members.