'Less ticking the boxes, more providing support': A qualitative study on health professionals' concerns towards the Liverpool Care of the Dying Pathway

Palliative Medicine

Volumn 29, Issue 6, 2015, Pages 529-537

  Di Leo, Silvia ^a   Romoli, Vittoria ^b   Higginson, Irene J ^c   Bulli, Francesco ^d   Fantini, Susanna ^e   Sguazzotti, Erica ^f,g   Costantini, Massimo ^a  

^a S MARIA NUOVA HOSPITAL   (Italy)

^b UNIVERSITY OF GENOA   (Italy)

^c KING'S COLLEGE LONDON   (United Kingdom)

^d Istituto Scientifico Prevenzione Oncologica (ISPO)   (Italy)

^e Istituto di Tanatologia e Medicina Psicologica   (Italy)

^f UNIVERSITY OF TURIN   (Italy)

^g SAN LUIGI GONZAGA UNIVERSITY HOSPITAL   (Italy)

Author keywords

End of life care; interviews; LCP; qualitative research; thematic analysis; ward professionals

Indexed keywords

ARTICLE; CANCER PATIENT; CLINICAL PATHWAY; DOCUMENTATION; DYING; HEALTH CARE PERSONNEL; HEALTH CARE PLANNING; HOSPITAL; HUMAN; MEDICAL EDUCATION; NURSE ATTITUDE; PALLIATIVE THERAPY; PHYSICIAN ATTITUDE; PROFESSIONAL COMPETENCE; QUALITATIVE RESEARCH; SEMI STRUCTURED INTERVIEW; TERMINAL CARE; WORK EXPERIENCE; ADULT; CLUSTER ANALYSIS; FEMALE; HEALTH CARE QUALITY; HEALTH PERSONNEL ATTITUDE; MALE; MIDDLE AGED; PROGRAM EVALUATION; STANDARDS; VOCATIONAL EDUCATION;

ADULT; ATTITUDE OF HEALTH PERSONNEL; CLUSTER ANALYSIS; CRITICAL PATHWAYS; EDUCATION, PROFESSIONAL; FEMALE; HUMANS; MALE; MIDDLE AGED; PALLIATIVE CARE; PROGRAM EVALUATION; QUALITATIVE RESEARCH; QUALITY OF HEALTH CARE; TERMINAL CARE;

EID: 84930385791     PISSN: 02692163     EISSN: 1477030X     Source Type: Journal    
DOI: 10.1177/0269216315570408     Document Type: Article

References (35)

1. Singer PA, Bowman KW. Quality end-of-life care: a global perspective. BMC Palliat Care. 2002 ; 1: 4
2. Lancet. 2012 ; 379 (9822). 1171
3. End of life care strategy: promoting high quality care for all adults at the end of life. London: Department of Health ; 2008: 1-167.
4. A controlled trial to improve care for seriously ill hospitalized patients: the study to understand prognosis and preferences for outcomes and risks of treatments (SUPPORT). JAMA. 1995 ; 274: 1591-1598
5. Bailey FA, Burgio KL, Woodby LL, et al. Improving processes of hospital care during the last hours of life. Arch Intern Med. 2005 ; 165: 1722-1727
6. Luhrs CA, Meghani S, Homel P, et al. Pilot of a pathway to improve the care of imminently dying oncology inpatients in a Veterans Affairs Medical Center. J Pain Symptom Manage. 2005 ; 29 (6). 544-551
7. Ellershaw J, Ward C. Care of the dying patient: the last hours or days of life. BMJ. 2003 ; 326: 30-34
8. Chan R, Webster J. End-of-life care pathways for improving outcomes in caring for the dying. Cochrane Database Syst Rev. 2010 ; 1: CD008006
9. UK Department of Health. Review of Liverpool Care Pathway for dying patients, https://www.gov.uk/government/publications/review-of-liverpool-care-pathway-for-dying-patients (2013, accessed 4 June 2014).
10. Costantini M, Romoli V, Di Leo S, et al. Liverpool Care Pathway for patients with cancer in hospital: a cluster randomised trial. Lancet. 2014 ; 383: 226-237
11. Costantini M, Ottonelli S, Canavacci L, et al. The effectiveness of the Liverpool Care Pathway in improving end of life care for dying cancer patients in hospital. A cluster randomised trial. BMC Health Serv Res. 2011 ; 11: 13
12. Klabunde CN, Willis GB, Casalino LP. Facilitators and barriers to survey participation by physicians: a call to action for researchers. Eval Health Prof. 2013 ; 36 (3). 279-295
13. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007 ; 19 (6). 349-357
14. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006 ; 3 (2). 77-101
15. Gambles M, Sirzaker S, Jack BA, et al. The Liverpool Care Pathway in hospices: an exploratory study of doctor and nurse perceptions. Int J Palliat Nurs. 2006 ; 12: 414-421
16. Walker R, Read S. The Liverpool Care Pathway in intensive care: an exploratory study of doctor and nurse perceptions. Int J Palliat Nurs. 2010 ; 16 (6). 267-273
17. Glare P, Virik K, Jones M, et al. A systematic review of physicians' survival predictions in terminally ill cancer patients. BMJ. 2003 ; 327 (7408). 195-198
18. Gibbins J, McCoubrie R, Alexander N, et al. Diagnosing dying in the acute hospital setting - are we too late?. Clin Med. 2009 ; 9 (2). 116-119
19. Parry R, Seymour J, Whittaker B, et al Rapid evidence review: pathways focused on the dying phase in end of life care and their key components. Nottingham: Sue Rider Care Centre for the Study of Supportive, Palliative and End of Life Care, NHS National End of Life Care Programme ; 2013: 1-35.
20. Hancock K, Clayton JM, Parker SM, et al. Truth-telling in discussing prognosis in advanced life-limiting illnesses: a systematic review. Palliat Med. 2007 ; 21 (6). 507-517
21. Parker SM, Clayton JM, Hancock K, et al. A systematic review of prognostic/end-of-life communication with adults in the advanced stages of a life-limiting illness: patient/caregiver preferences for the content, style, and timing of information. J Pain Symptom Manage. 2007 ; 34 (1). 81-93
22. Rodin G, Mackay JA, Zimmermann C, et al. Clinician-patient communication: a systematic review. Support Care Cancer. 2009 ; 17 (6). 627-644
23. Rodin G, Zimmermann C, Mayer C, et al. Clinician-patient communication: evidence-based recommendations to guide practice in cancer. Curr Oncol. 2009 ; 16 (6). 42-49
24. Fine E, Reid MC, Shengelia R, et al. Directly observed patient-physician discussions in palliative and end-of-life care: a systematic review of the literature. J Palliat Med. 2010 ; 13 (5). 595-603
25. Lokker ME, van Zuylen L, Veerbeek L, et al. Awareness of dying: it needs words. Support Care Cancer. 2012 ; 20 (6). 1227-1233
26. Di Leo S, Beccaro M, Finelli S, et al. Expectations about and impact of the Liverpool Care Pathway for the dying patient in an Italian hospital. Palliat Med. 2011 ; 25: 293-303
27. Clark JB, Sheward K, Marshall B, et al. Staff perceptions of end-of-life care following implementation of the Liverpool Care Pathway for the Dying Patient in the acute care setting: a New Zealand perspective. J Palliat Med. 2012 ; 15 (4). 468-473
28. Sykes N. The end of the Liverpool Care Pathway?. Lancet Oncol. 2013 ; 14 (10). 926-927
29. Aldridge H. LCP: an effective tool in well-trained hands. Int J Palliat Nurs. 2009 ; 15 (9). 421
30. Chapman S. The Liverpool Care Pathway: 'tick box' approach not encouraged. Int J Palliat Nurs. 2009 ; 15 (9). 420-421
31. George R, Martin J, Robinson V. The Liverpool Care Pathway for the dying (LCP): lost in translation and a tale of elephants, men, myopia - and a horse. Palliat Med. 2014 ; 28 (1). 3-7
32. Zimmermann C, Rodin G. The denial of death thesis: sociological critique and implications for palliative care. Palliat Med. 2004 ; 18: 121-128
33. McConnell T, O'Halloran P, Porter S, et al. Systematic realist review of key factors affecting the successful implementation and sustainability of the Liverpool Care Pathway for the dying patient. Worldviews Evid Based Nurs. 2013 ; 10 (4). 218-237
34. Parker M. We need an alternative to the Liverpool care pathway for patients who might recover. BMJ. 2013 ; 346: f3702
35. Higginson IJ, Koffman J, Hopkins P, et al. Development and evaluation of the feasibility and effects on staff, patients, and families of a new tool, the Psychosocial Assessment and Communication Evaluation (PACE), to improve communication and palliative care in intensive care and during clinical uncertainty. BMC Med. 2013 ; 11: 213