ArticleBMJ open2016
Qualitative critical incident study of patients' experiences leading to emergency hospital admission with advanced respiratory illness.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Self-care towards the end of life: A systematic review and narrative synthesis on access, quality and cost.Palliative medicine · 2025Pooled it
- The impact of a personalised action plan delivered at discharge to patients with COPD on readmissions: a pilot study.Scandinavian journal of caring sciences · 2020Trial
- Considerations in referring older patients to hospital in acute situations: a qualitative study based on the experiences of healthcare providers.BMC primary care · 2026Article
- A Qualitative Study Identifying the Potential Risk Mechanisms Leading to Hospitalization for Patients With Chronic Lung Disease.CHEST pulmonary · 2024Article
- Improving patients', carers' and primary care healthcare professionals' experiences of discharge communication from specialist palliative care to community settings: a protocol for a qualitative interview study.BMC palliative care · 2024Article
- Patients' lived experiences of breathlessness prior to prehospital care - A phenomenological study.Nursing open · 2022Article
- Article
- Integrating Palliative Care into the Chronic Illness Continuum: a Conceptual Model for Minority Populations.Journal of racial and ethnic health disparities · 2019Review
- Pre-hospital and emergency department pathways of care for exacerbations of chronic obstructive pulmonary disease (COPD).Journal of thoracic disease · 2019Review
- Emergency admissions and subsequent inpatient care through an emergency oncology service at a tertiary cancer centre: service users' experiences and views.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2019Article
- 'I'll be in a safe place': a qualitative study of the decisions taken by people with advanced cancer to seek emergency department care.BMJ open · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe high volume of emergency admissions to hospital is a challenge for health systems internationally. Patients with lung cancer and chronic obstructive pulmonary disease (COPD) are frequently admitted to hospital as emergency cases. While the frequency of emergency admission has been investigated, few studies report patient experiences, particularly in relation to the decision-making process prior to emergency admission. We sought to explore patient and carer experiences and those of their healthcare professionals in the period leading up to emergency admission to hospital.
setting3 UK hospitals located in different urban and rural settings.
designQualitative critical incident study.
participants24 patients with advanced lung cancer and 15 with advanced COPD admitted to hospital as emergencies, 20 of their carers and 50 of the health professionals involved in the patients' care.
resultsThe analysis of patient, carer and professionals' interviews revealed a detailed picture of the complex processes involved leading to emergency admission to hospital. 3 phases were apparent in this period: self-management of deteriorating symptoms, negotiated decision-making and letting go. These were dynamic processes, characterised by an often rapidly changing clinical condition, uncertainty and anxiety. Patients considered their options drawing on experience, current and earlier advice. Patients tried to avoid admission, reluctantly accepting it, albeit often with a sense of relief, as anxiety increased with worsening symptoms.
conclusionsPatients with advanced respiratory illness, and their carers, try to avoid emergency admission, and use logical and complex decision-making before reluctantly accepting it. Clinicians and policy-makers need to understand this complex process when considering how to reduce emergency hospital admissions rather than focusing on identifying and labelling admissions as 'inappropriate'.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.