title: Patient and family experiences of palliative care in hospital: what do we know? An integrative review.
abstract: BACKGROUND
  In most developed countries, acute hospitals play a significant role in palliative care provision and are the setting in which most people die. They are often the setting where a life-limiting diagnosis is made and where patients present when symptoms develop or when they are not well managed. Understanding the experiences of hospital admissions for people with a life-limiting illness and their families is essential in understanding the role acute hospitals play in providing palliative care.
  
  
  OBJECTIVE
  The aim of this review is to synthesise current evidence regarding the experience of palliative care in an acute hospital setting from the perspectives of patient and family.
  
  
  METHODS
  An integrative review was completed using standard processes followed by a process of data extraction and synthesis.
  
  
  METHODS
  Using predefined search terms, literature was sourced from five electronic databases including MEDLINE (EBSCO), CINAHL, EMBASE, Cochrane and PsycINFO between January 1990 and November 2011. Reference lists from relevant articles were cross-checked and pertinent journals hand searched for articles.
  
  
  RESULTS
  In total, 32 articles were included in the review. Five recurring themes were identified from the synthesised data: symptom control and burden, communication with health professionals, decision-making related to patient care and management, inadequate hospital environment and interpersonal relationships with health professionals.
  
  
  CONCLUSIONS
  This review has identified that, largely as a result of study design, our knowledge of patient and family experiences of palliative care in an acute hospital remains limited to discrete aspects of care. Further research is required to explore the total patient and family experience taking into account all aspects of care including the potential benefits of hospital admissions in the last year of life.
authors.affiliation: 1School of Nursing, University of Auckland, New Zealand.
authors.forename: Jackie
authors.initials: J
authors.lastname: Robinson
authors.forename: Merryn
authors.initials: M
authors.lastname: Gott
authors.forename: Christine
authors.initials: C
authors.lastname: Ingleton
mesh_terms: D001291:Attitude of Health Personnel; D017281:Cost of Illness; D003657:Decision Making; D019049:Developed Countries; D005190:Family / Q000523:psychology*; D015285:Hospital-Patient Relations; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D010166:Palliative Care / Q000523:psychology*; D017064:Process Assessment, Health Care; D011369:Professional-Patient Relations
keywords: Palliative care; hospitalisation; patient admission; patient satisfaction; professional–family relations