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dc.contributor.advisorOyebode, Jan R.
dc.contributor.advisorCapstick, Andrea
dc.contributor.authorGreen, Laura I.
dc.date.accessioned2019-08-28T11:14:20Z
dc.date.available2019-08-28T11:14:20Z
dc.date.issued2017
dc.identifier.urihttp://hdl.handle.net/10454/17231
dc.description.abstractThe alleviation of suffering lies at the core of compassionate end-of-life care, yet little is known about the lived experience of suffering. Motivated by a series of reports on poor care of older people in hospital, this study addresses suffering in older people at the end of life in an acute hospital ward in the United Kingdom. Methods were developed from a synthesis of ethnographic fieldwork and phenomenological interpretation. Data were collected using participant observation on an acute care ward for older people in a hospital in Northern England, over 186 hours between June and August 2015. Data included field notes, documents, photographs and informal interviewing. Staff and patient participants were identified using theoretical sampling. Data were analysed using a hermeneutic approach involving a continuous process of analysis, further data collection, posing of problems and questions, and interpretation. This cyclical approach to the data enabled the development of interpretive perspectives which could then be further explored in the field. Findings suggested that care for older people was shaped by competing ideologies of care and organisational regulatory processes. Particularly when there was ambiguity regarding prognosis, there was a tendency for care to default to a ‘rescuing’ acute care model. Through exploring the experiences of individual patients and placing these in the context of cultures of care, I suggest that iatrogenic suffering was a significant concern that often went unrecognised. Patient-centred goals must be more focused upon avoidance of iatrogenic suffering. Recommendations include innovations in clinical education and multiprofessional working.en_US
dc.language.isoenen_US
dc.rights<a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/"><img alt="Creative Commons License" style="border-width:0" src="http://i.creativecommons.org/l/by-nc-nd/3.0/88x31.png" /></a><br />The University of Bradford theses are licenced under a <a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/">Creative Commons Licence</a>.eng
dc.subjectEthnographyen_US
dc.subjectSufferingen_US
dc.subjectCompassionen_US
dc.subjectEmbodimenten_US
dc.subjectEnd-of-life careen_US
dc.subjectPalliative careen_US
dc.subjectAcute hospitalen_US
dc.subjectOlder peopleen_US
dc.subjectDementiaen_US
dc.subjectEthical decision makingen_US
dc.titleHere, there is nobody. An ethnography of older people's end-of-life care in hospitalen_US
dc.type.qualificationleveldoctoralen_US
dc.publisher.institutionUniversity of Bradfordeng
dc.publisher.departmentFaculty of Health Studiesen_US
dc.typeThesiseng
dc.type.qualificationnamePhDen_US
dc.date.awarded2017
refterms.dateFOA2019-08-28T11:14:20Z


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