Qualitative studies on the palliative care experience provided by emergency department staff:a Meta-synthesis

WANG Jing; WU Jiayun; ZOU Yaping

doi:10.12102/j.issn.2095-8668.2025.24.004

Abstract：Objective:To systematically integrate the experience of emergency department staff in providing palliative care,and to provide a reference for further promoting the development of emergency palliative care and improving the quality of service in China.Methods:Computerized searches were conducted for qualitative studies on emergency department staff's palliative care in Web of Science,PubMed,Cochrane Library,EMbase,CINAHL,CNKI,WanFang Data,CBM,and VIP,with a timeframe of the construction of the database to October 2024.The quality of the included literature was evaluated according to the 2016 edition from the Quality Assessment Criteria for Qualitative Research of the Centre for Evidence-Based Health Care at the Joanna Briggs Institute in Australia,and the results were integrated and summarized using Meta-synthesis methods.Results:A total of 16 articles were included,and 66 findings were extracted to form 11 categories,which were summarized into 3 integrated findings.Integration result 1 was emergency department staff recognized multiple challenges to providing palliative care,including environmental and resource constraints in the emergency department;insufficient theoretical knowledge and skills in palliative care among emergency department staff;lack of support for the patient's family among emergency department staff;ambiguity in the roles of emergency department staff;high emotional burden on emergency department staff;ethical and decision-making dilemmas among emergency department staff.Integration result 2 was emergency department staff actively deal with challenges and reap personal growth,including seeking peer support to release negative emotions;self-reflection to rekindle enthusiasm for work.Integration result 3 was emergency department staff believe that palliative services need to be improved,including strengthening emergency department staff's ability to provide palliative services;promoting effective communication and teamwork between doctors and nurses;and emphasizing family involvement.Conclusion:There are many challenges for emergency department staff providing palliative care,and hospital administrators should form a multidisciplinary team for emergency palliative care,build a support system for them,reduce negative emotions,and continuously improve the quality of emergency palliative care services.