title: Loss of Dignity in End-of-Life Care in the Emergency Department: A Phenomenological Study with Health Professionals.
abstract: BACKGROUND
  The 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.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  Three 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."
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: Almería, Spain; Temuco, Chile; London, United Kingdom; Granada, Spain. Electronic address: jgranero@ual.es.
authors.forename: José
authors.initials: J
authors.lastname: Granero-Molina
authors.affiliation: Almería, Spain; Temuco, Chile; London, United Kingdom; Granada, Spain.
authors.forename: María Del Mar
authors.initials: Mdel M
authors.lastname: Díaz-Cortés
authors.affiliation: Almería, Spain; Temuco, Chile; London, United Kingdom; Granada, Spain.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Hernández-Padilla
authors.affiliation: Almería, Spain; Temuco, Chile; London, United Kingdom; Granada, Spain.
authors.forename: María Paz
authors.initials: MP
authors.lastname: García-Caro
authors.affiliation: Almería, Spain; Temuco, Chile; London, United Kingdom; Granada, Spain.
authors.forename: Cayetano
authors.initials: C
authors.lastname: Fernández-Sola
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D016529:Emergency Nursing; D004636:Emergency Service, Hospital; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology; D009741:Nursing Staff, Hospital / Q000523:psychology; D028723:Personhood; D010564:Personnel, Hospital / Q000523:psychology*; D012649:Self Concept; D013030:Spain; D013727:Terminal Care / Q000523:psychology*
keywords: Dignity; Emergency department; End-of-life care