title: Tidying rooms and tending hearts: An explorative, mixed-methods study of hospital cleaning staff's experiences with seriously ill and dying patients.
abstract: Palliative care is based on multi-professional team work. In this study, we investigated how cleaning staff communicate and interact with seriously ill and dying patients as well as how cleaning staff cope with the situation of death and dying.
  
  
  
  Sequential mixed methods, consisting of semi-structured interviews, focus groups, and a questionnaire. Interviews and focus group discussions were content analyzed and results were used to create a questionnaire. Quantitative data were submitted to descriptive analysis.
  
  
  
  Large university clinic in southern Germany.
  
  
  
  A total of 10 cleaning staff participated in the interviews and 6 cleaning staff took part in the focus group discussion. In addition, three managerial cleaning staff participated in a separate focus group. Questionnaires were given to all cleaning staff ( n = 240) working at the clinic in September 2008, and response rate was 52% (125/240).
  
  
  
  Cleaning staff described interactions with patients as an important and fulfilling aspect of their work. About half of participants indicated that patients talk with them every day, on average for 1-3 min. Conversations often revolved around casual topics such as weather and family, but patients also discussed their illness and, occasionally, thoughts regarding death with cleaning staff. When patients addressed illness and death, cleaning staff often felt uncomfortable and helpless.
  
  
  
  Cleaning staff perceive that they have an important role in the clinic-not only cleaning but also supporting patients. Likewise, patients appreciate being able to speak openly with cleaning staff. Still, it appears that cleaning staff may benefit from additional training in communication about sensitive issues such as illness and death.
authors.affiliation: 1 Clinic for Palliative Care, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Jors
authors.affiliation: 1 Clinic for Palliative Care, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
authors.forename: Svenja
authors.initials: S
authors.lastname: Tietgen
authors.affiliation: 1 Clinic for Palliative Care, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
authors.forename: Carola
authors.initials: C
authors.lastname: Xander
authors.affiliation: 2 Department of Radio-oncology, St. Josefsklinik Offenburg, Offenburg, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Momm
authors.affiliation: 1 Clinic for Palliative Care, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
authors.forename: Gerhild
authors.initials: G
authors.lastname: Becker
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003142:Communication; D005260:Female; D017144:Focus Groups; D005858:Germany; D006797:Housekeeping, Hospital; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology*; D010564:Personnel, Hospital / Q000523:psychology*; D011369:Professional-Patient Relations; D013727:Terminal Care / Q000523:psychology*; D055815:Young Adult
keywords: Palliative care; interprofessional relations; job satisfaction; palliative medicine; patient care team