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Looking for Control at the End of Life Through the Bond: A Grounded Theory on the Hospital Discharge Process in Palliative Care

Carrillo, Gloria, Mabel, RN, MSc, PhD; Arias-Rojas, Mauricio, RN, MSc, PhD(c); Carreño, Sonia, Patricia, RN, MSc, PhD; Gómez, Olga, Janeth, RN, MSc, PhD; López, Rocío, RN, CNS; Cárdenas, Diana, Carolina, RN, MSc

Journal of Hospice & Palliative Nursing: June 2018 - Volume 20 - Issue 3 - p 296–303
doi: 10.1097/NJH.0000000000000447
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The hospital-to-home transition in palliative care is a vital process that requires continuity of care through the discharge process. However, little is known about the perceptions of patients with cancer and their family caregivers during this important palliative care transition in the Colombian health care context. The purpose of this study was to explore the experiences of the patient-family caregiver dyad in palliative care during the transition process between hospital and home in a health care institution in Bogota, Colombia. Using a grounded constructivist theory design, 30 patients with cancer receiving palliative care and 30 family caregivers participated in this study. The data were collected through 36 dyad interviews conducted in either the hospital or home of the participants. For the analysis, the constructivist analytical method was used. Findings revealed that “Looking for control at the end of life through the bond” was the main category of the study. This category could be further elaborated into 4 categories: (1) yearning for home; (2) recognizing burden; (3) experiencing uncertainty, a lack of control; and (4) achieving control. By understanding the patient and family caregiver perspective of care during the hospital-to-home transition, health care systems have the possibility to implement care programs in palliative care with an innovative educational component for health care professionals.

Gloria Mabel Carrillo, RN, MSc, PhD, is associate professor, Nursing School, Universidad Nacional de Colombia, Bogotá, Colombia.

Mauricio Arias-Rojas, RN, MSc, PhD(c), is adjunct professor, Nursing School, Universidad de Antioquia, Medellín, Colombia.

Sonia Patricia Carreño, RN, MSc, PhD, is assistant professor, Nursing School, Universidad Nacional de Colombia, Bogotá, Colombia.

Olga Janeth Gómez, RN, MSc, PhD, is associate professor, Nursing School, Universidad Nacional de Colombia, Bogotá, Colombia.

Rocío López, RN, CNS, is nurse practitioner, Instituto Nacional de Cancerología E.S.E., Bogotá, Colombia.

Diana Carolina Cárdenas, RN, MSc, is occasional professor, Nursing School, Universidad Nacional de Colombia, Bogotá, Colombia.

Address correspondence to Mauricio Arias-Rojas, RN, MSc, PhD(c), Universidad de Antioquia, Nursing School, Becario Colciencias 727, Calle 64 No. 53-09 office 323, Medellín, Colombia (edier.arias@udea.edu.co).

The authors have no conflicts of interest to disclose.

The study was funded by the Instituto Nacional de Cancerología E.S.E. Bogota-Colombia, Call for research 2015–2016 (research project number C41030610-938).

© 2018 by The Hospice and Palliative Nurses Association.