Reasons of Transfer in Emergency Units of Patients in End of Life Situation.

Reasons of Transfer in Emergency Units of Patients in End of Life Situation.

This qualitative study aimed to describe and understand the factors leading to the admission in emergency unit of patients coming from their home, in an end of life situation.

This study was conducted in the university hospital of Besançon, France. Semi-structured interviews were conducted with general practitioners and family members in order to understand the factors leading, from their points of view, to the admission in emergency unit whereas this hospitalization wasn't necessary.

Inclusion Criteria:

• FOR PATIENTS :
• aged of 18 yo or more
• Admitted in the emergency unit of the university hospital of Besançon
• who died within the 3 days following their admission in the emergency unit
• who died of a chronic disease in terminal phase
• for whom therapeutic goals were only focused on comfort
• living at their home or at their family's home before their transfer in emergency unit
• accompanied by at least one main carer (family member or friend) and one general practitioner during the last weeks before death
• FOR MAIN CARERS :
• Family members or friends of the patient
• who were the main carers of the patient during his/her last weeks
• speaking easily in french
• who agreed for being interviewed and whom psychic and emotional state is compatible with a interview
• living within 80km from Besançon
• FOR GENERAL PRACTITIONERS :
• who were the main medical actor for the patient during his/her last weeks
• who agreed for being interviewed
• working within 80km from Besançon

Exclusion Criteria:

• FOR PATIENTS :
• Patients who expressed a wish to not die at home
• Patients who died because of any other medical event than predictable death following the terminal phase of a chronic disease
• minors
• FOR MAIN CARERS AND GENERAL PRACTITIONERS :
• refusal to participate to the interviews