title: Communication of the death of a patient in hospices and nursing homes: a qualitative study.
abstract: OBJECTIVE
  Announcing the death of a patient to another in hospices and nursing homes (NH) requires special skills, especially when the recipient is another resident. The aim of this study is to describe how hospice and NH staff deal with the communication regarding a patient's death, if this communication is perceived as a problem, and strategies implemented.
  
  
  METHODS
  The 55 health care workers (HCWs, 26 nurses and 29 auxiliary nurses) of two NHs and two hospices in Turin (Italy) were interviewed with a semi-structured interview exploring the residents' perception of need to receiving information on another patient's death, the experiences of having given this information in the last 6 months, and the strategies implemented. The interviews were analyzed using Colaizzi's method and researchers looked for the main themes and related subthemes.
  
  
  RESULTS
  Six themes were identified and grouped into 2 main themes: a. the choice to tell the truth or not, which may be influenced by: the patients' request for confirmation of the fate of the other resident, by patients' fear of death ("I will be next"), the relationships among the guests, and personal and group experiences; b. the need to share own feelings and the burden of deciding whether or not to inform the other residents and how to go about this.
  
  
  CONCLUSIONS
  If a structured discussion of experiences and reflection on cases is not implemented, HCWs may limit communication to bare information, lies, and adopt behaviors of avoidance and concealment.
authors.affiliation: ASLTO1 Torino, Via Gradisca 10, 10100 Turin, Italy. Electronic address: maria.rivolta@unito.it.
authors.forename: Maria Marcella
authors.initials: MM
authors.lastname: Rivolta
authors.affiliation: S. Giovanni Hospital, Corso Bramante 88, 10100 Turin, Italy. Electronic address: licia.rivolta@libero.it.
authors.forename: Licia
authors.initials: L
authors.lastname: Rivolta
authors.affiliation: Department of Public Health and Paediatric Sciences, Turin University, Via Santena 5 bis, 10100 Turin, Italy. Electronic address: lorenza.garrino@unito.it.
authors.forename: Lorenza
authors.initials: L
authors.lastname: Garrino
authors.affiliation: Department of Public Health and Paediatric Sciences, Turin University, Via Santena 5 bis, 10100 Turin, Italy. Electronic address: paola.digiulio@unito.it.
authors.forename: Paola
authors.initials: P
authors.lastname: Di Giulio
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D003142:Communication; D005260:Female; D064946:Hospice and Palliative Care Nursing / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D007558:Italy; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D009735:Nursing Homes / Q000458:organization & administration*; D009859:Oncology Nursing / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D036301:Qualitative Research; D013727:Terminal Care / Q000458:organization & administration
keywords: Communication; Death; End of life care; Hospice; Nursing home; Palliative care; Qualitative research