Discuss the Why–How–What of one of the qualitative studies listed below and respond to the questions below:

Why did the researchers think it was important to do this study?

What did their study do that those other studies did not do?

Choose one of the following articles:

• Franco, J. H. M., Evangelista, C. B., Rodrigues, M. de S. D., Cruz, R. A. de O., Franco, I. da S. M. F., & Freire, M. L. (2021). Music therapy in oncology: perceptions of children and adolescents in palliative care. Escola Anna Nery, 25(5).https://doi.org/10.1590/2177-9465-EAN-2021-0012
• Martí, G. C., Fernández, F. A., Fernández, S. C., Pérez, R. R., Esteban, B. A. A., Hernández, P. J. M., & Granero, M. J. (2023). Patients’ experiences and perceptions of dignity in end?of?life care in emergency departments: A qualitative study. Journal of Advanced Nursing (John Wiley & Sons, Inc.), 79(1), 269–280.https://doi.org/10.1111/jan.1543
• Article: Aims: To explore and understand the experiences of patients with advanced illness in relation to dignity during end?of?life care in emergency departments. Design: Qualitative study based on Gadamer’s hermeneutics. Methods: Between September 2019 and February 2020, 16 in?depth interviews were carried out with advanced illness patients who attended emergency departments. The participants were informed priorly and signed informed consent. The data were analysed using an inductive strategy for finding emerging themes. The Consolidated Criteria for Reporting Qualitative Research was used for writing the study’s report. Results: In the data analysis process, two main themes emerged that glean the experiences of patients in relation to dignity during end?of?life care in emergency departments. ‘Dignity as an individual’s attribute’ and ‘Acting with dignity: Dignity as a behavioural attribute’. Conclusion: Patient dignity in end?of?life care is centred around the principle of control (of oneself, one’s death and one’s emotions). The strategies required for patients to preserve their dignity can be somewhat incompatible with the dynamics and objectives of healthcare professionals who work in emergency departments. Impact statement The dignity of patients with advanced illness who attend emergency departments is a relevant issue that merits being addressed from the patients’ perspective. Participants have identified that dignity is a way of being and behaving in the face of illness. Emergency departments need to respect end?of?life patients’ desires by supporting and accompanying them, avoiding therapeutic obstinacy. We recommend care to be centred on patients’ well?being, to respect their autonomy and decision?making processes, and to allow prompt referrals to palliative care services. Patient or Public Contribution: Managers from the Emergency Departments participated in the study design and patients’ recruitment. Patients’ relatives were informed about the study’s aim, and they contributed to the development of the interview protocol.

Keywords: advanced illness; dignity; emergency departments; end?of?life care; nursing; qualitative research; hermeneutics

INTRODUCTION

Patients with advanced illness (AI) attend the emergency department (ED) relatively frequently. In fact, it is estimated that around 70% of patients with AI go at least once during the last months of their lives (Heymann et al., [23]). High incidences of mortality have been recorded amongst this group of patients in the week following their visit to the ED (Verhoef et al., [47]). The most frequent reasons for attending the ED are pain and dyspnoea, with more than 75% of patients admitted as a consequence (Verhoef et al., [47]). In developed countries, the number of end?of?life patients attending the ED has increased due to the rise in the elderly population (Mierendorf & Gidvani, [31]). The high frequency of attending ED among patients with AI puts them in contact with patients from technological environments that are highly dynamic (Schneider et al., [42]) and depersonalized (O’Shay, [33]). This particular type of contact could make patients with AI who attend ED more aware of their vulnerability (Muñoz?Terrón, [32]). Emergency situations at the end of life are an intense experience (Collier & Broom, [ 8]), that exacerbate the problems related to these patients’ dignity (Rogmark & Lynøe, [39]; Ruíz?Fernández et al., [40]). It is, therefore, vital to address the issue of end?of?life care in ED (Fernández?Sola et al., [12]).