ArticleBMJ open2020
Challenges and facilitators of hospice decision-making: a retrospective review of family caregivers of home hospice patients in a rural US-Mexico border region-a qualitative study.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Improving communication of prognostic uncertainty in advanced illness: a realist review.BMJ open · 2026Pooled it
- Decision-making factors related to palliative care and hospice use in the community: a systematic review based on Andersen's behavioural model of health services use.BMC palliative care · 2025Pooled it
- Palliative care in rural, remote, and northern communities: a scoping review.BMC palliative care · 2026Article
- Article
- Identifying the pathways to increased death literacy: Building a conceptual causal model through a mixed-methods pragmatic ESC-DAGs approach.Palliative care and social practice · 2026Article
- Factors of caregiver support under integrated care for older adults in rural areas: a scoping review.Frontiers in public health · 2026Article
- Chinese physicians' experiences with end-of-life communication and hospice care transition: a qualitative study with content analysis.BMC palliative care · 2025Article
- Nurses' self-regulation after engaging in end-of-life conversations with advanced cancer patients: a qualitative study.BMC nursing · 2024Article
- Hospice preference of the family decision-makers for cancer patients in China: an exploratory study.BMC palliative care · 2022Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesHospice care (HC) is seen as a comprehensive approach, that enhances quality of end-of-life (EOL) care, for terminally ill patients. Despite its positive aspects, HC enrolment is disproportionate for rural patients, who are less likely to use HC in comparison to their urban counterparts. The purpose of this study was to explore decision-making experiences, related to utilisation of HC programmes from a retrospective perspective, with family caregivers (FCGs) in a rural US-Mexico border region.
designThis qualitative study was conducted from May 2017 to January 2018 using semistructured face to face interviews with FCGs. Data were analysed using thematic analysis.
settingThe HC programme was situated at a local home health agency, located in rural Southern California, USA.
participantsTwenty-eight informal FCGs of patients who were actively enrolled in the HC programme agreed to participate in the study.
resultsConversation about HC as an option was initiated by home healthcare staff (39.3%), followed by physicians (32.1%). Emerging themes related to challenges in utilisation of HC and decision-making included: (1) communication barriers; (2) lack of knowledge/misperception about HC; (3) emotional difficulties, including fear of losing their patient, doubt and uncertainty about the decision, denial and (4) patients are not ready for HC. Facilitators included: (1) patient's known EOL wishes; (2) FCG-physician EOL communication; (3) the patient's deteriorating health and (4) home as the place for death.
conclusionsHC patients' FCGs in this rural region reported a lack of knowledge or misunderstanding of HC. It is recommended that healthcare providers need to actively engage family members in patient's EOL care planning. Optimal transition to an HC programme can be facilitated when FCGs are informed and have a clear understanding about patients' medical status along with information about HC.
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