title: Patients' perception of types of errors in palliative care - results from a qualitative interview study.
abstract: BACKGROUND
  Medical errors have been recognized as a relevant public health concern and research efforts to improve patient safety have increased. In palliative care, however, studies on errors are rare and mainly focus on quantitative measures. We aimed to explore how palliative care patients perceive and think about errors in palliative care and to generate an understanding of patients' perception of errors in that specialty.
  
  
  METHODS
  A semistructured qualitative interview study was conducted with patients who had received at least 1 week of palliative care in an inpatient or outpatient setting. All interviews were transcribed verbatim and analysed according to qualitative content analysis.
  
  
  RESULTS
  Twelve patients from two centers were interviewed (7 women, median age 63.5 years, range 22-90 years). Eleven patients suffered from a malignancy. Days in palliative care ranged from 10 to 180 days (median 28 days). 96 categories emerged which were summed up under 11 umbrella terms definition, difference, type, cause, consequence, meaning, recognition, handling, prevention, person causing and affected person. A deductive model was developed assigning umbrella terms to error-theory-based factor levels (definition, type and process-related factors). 23 categories for type of error were identified, including 12 categories that can be considered as palliative care specific. On the level of process-related factors 3 palliative care specific categories emerged (recognition, meaning and consequence of errors).
  
  
  CONCLUSIONS
  From the patients' perspective, there are some aspects of errors that could be considered as specific to palliative care. As the results of our study suggest, these palliative care-specific aspects seem to be very important from the patients' point of view and should receive further investigation. Moreover, the findings of this study can serve as a guide to further assess single aspects or categories of errors in palliative care in future research.
authors: Ludwig-Maximilians-University, Department of Anaesthesiology, Munich University Hospital, Munich, Germany. Isabel.Kiesewetter@med.uni-muenchen.de.|Ludwig-Maximilians-University, Department of Palliative Medicine, Munich University Hospital, Munich, Germany. Isabel.Kiesewetter@med.uni-muenchen.de.
authors: Isabel
authors: http://orcid.org/0000-0002-4729-6684
authors: I
authors: Kiesewetter
authors: Maudsley Training Programme, Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK.
authors: Christian
authors: C
authors: Schulz
authors: Ludwig-Maximilians-University, Department of Palliative Medicine, Munich University Hospital, Munich, Germany.
authors: Claudia
authors: C
authors: Bausewein
authors: Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, USA.
authors: Rita
authors: R
authors: Fountain
authors: Interdisciplinary Center for Palliative Medicine, Heinrich Heine University Hospital Düsseldorf, Düsseldorf, Germany.|LVR Clinic of Psychiatry, Psychosomatic and Psychotherapy for children and adolescence, Viersen, Germany.
authors: Andrea
authors: A
authors: Schmitz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D005260:Female; D005858:Germany; D006801:Humans; D007902:Length of Stay; D008297:Male; D019300:Medical Errors / Q000523:psychology*; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000628:therapy; D010166:Palliative Care / Q000523:psychology*; D010465:Perception; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology / Q000628:therapy; D036301:Qualitative Research; D055815:Young Adult
keywords: Error; Medical error; Palliative care; Patient’s perspective