1University of Adelaide, South Australia
Since 2018, DonateLife South Australia and the Royal Adelaide Hospital (RAH) have collaborated to deliver routine family follow up after bereavement in the intensive care unit (ICU) (see https://doi.org/10.1071/AH20005). This follow up includes a telephone interview that invites bereaved family to comment on the quality of care and communication experienced in the ICU. We analysed all qualitative data collected during the 100+ interviews that were completed in relation to deaths that occurred in the RAH ICU between 1 February 2018 and 30 May 2019.
Using Nvivo 12, we conducted a reflexive thematic analysis, as conceptualised by Virginia Braun and Victoria Clarke. We used as a sensitising concept the notion of a person’s spirit of engagement developed by moral philosopher Christopher Cordner. Finally, we developed a concept map of the relationships we observed between patterns of meaning in the data (between codes).
Participants deeply appreciated staff providing them and their loved one with practical expressions of care and hospitality. These, along with staff sometimes crossing professional boundaries, expressed staff’s spirit of engagement, which in turn helped to maintain the patient’s dignity. Private space also helped to maintain the patient’s dignity, and it helped family to have enough time to say goodbye. Family not feeling rushed and being informed about their loved one dying also helped family to have enough time to say goodbye. Being informed or not turned on the quality of doctors’ communication. When family were not clearly informed, or had to wait long periods, they felt rushed and that they did not have enough time to say goodbye.
Dr Drew Carter is a health ethics researcher who draws on a Wittgensteinian tradition of moral philosophy to advance thinking on the allocation of health care resources and to conduct ethics reviews and analyses as part of Health Technology Assessments.