Perceptions of a good death: A qualitative study in intensive care units in England and Israel.
OBJECTIVE
To explore factors perceived to contribute to 'a good death' and the quality of end of life care in two countries with differing legal and cultural contexts.


METHODS
Multi-centre study consisting of focus group and individual interviews with intensive care nurses. Data were analysed using qualitative thematic analysis; emotional content was analysed using specialist linguistic software.


METHODS
Fifty five Registered Nurses in intensive care units in Israel (n=4) and England (n=3), purposively sampled across age, ICU experience and seniority.


RESULTS
Four themes and eleven sub-themes were identified that were similar in both countries. Participants identified themes of: (i) timing of communication, (ii) accommodating individual behaviours, (iii) appropriate care environment and (iv) achieving closure, which they perceive prevent, and contribute to, a good death and good quality of end of life care. Emotional content showed significant amount of 'sadness talk' and 'discrepancy talk', using words such as 'could and 'should' when participants were talking about the actions of clinicians.


CONCLUSIONS
The qualities of a good death were more similar than different across cultures and legal systems. Themes identified by participants may provide a framework for guiding end of life discussions in the intensive care unit.
Plymouth University, Faculty of Health and Human Sciences, Plymouth, United Kingdom; Monash University, Nursing & Midwifery, Melbourne, Australia. Electronic address: ruth.endacott@plymouth.ac.uk.
R
R
Endacott
Plymouth University, Faculty of Health and Human Sciences, Plymouth, United Kingdom.
C
C
Boyer
Hadassah Medical Centre, Jerusalem, Israel.
J
J
Benbenishty
Kaplan Medical Centre, Rehovot, Israel.
M
M
Ben Nunn
Yeovil District Hospital NHS Foundation Trust, Yeovil, United Kingdom.
H
H
Ryan
Taunton & Somerset NHS Foundation Trust, Taunton, United Kingdom.
W
W
Chamberlain
Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom.
C
C
Boulanger
Hadassah Hebrew University, School of Nursing & Midwifery, Jerusalem, Israel.
F D
FD
Ganz
D000328:Adult; D001293:Attitude to Death; D003142:Communication; D004739:England; D005260:Female; D017144:Focus Groups; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D007557:Israel; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D010465:Perception; D011368:Professional-Family Relations; D036301:Qualitative Research; D013727:Terminal Care / Q000592:standards*
Communication; End of life; Focus groups; Intensive care unit; Linguistic inquiry; Nurse; Qualitative research