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Choice of where we die: a classification reform to discern diversity in individual end of life pathways

Description du projet

Une meilleure classification des lieux de décès

Il est important de respecter les préférences en matière de lieu de décès. La première étape consiste à classifier les lieux de décès (domicile, hôpital, entre autres) d’une manière qui soit significative pour les personnes. Dans ce contexte, le projet EOLinPLACE, financé par l’UE, créera une base solide pour le premier outil de classification international permettant de cartographier les lieux préférés et réels où les personnes décèdent. Le projet mènera une étude à méthode mixte dans quatre pays couvrant la variation des cibles existantes afin d’explorer les nuances et les points communs dans les parcours de fin de vie des personnes. Les résultats fourniront de nouvelles idées sur la manière de prendre soin des personnes en fin de vie.

Objectif

All humans die, >60% from a chronic disease. Whenever possible, this should happen where that individual feels it is the right place to be, so they feel empowered and safe. We know that most would prefer dying at home but many die in hospital. To help achieve preferences we must dig deeper. Until now, science has failed to capture the dynamics and diversity of preferences and places where people are cared for at the end of life. Current classifications of dying places are incomplete and inconsistent. I am driven by the vision of reforming the way dying places are classified and understood, refining and shifting the focus from the end-point (place of death) to the pathway that precedes it.
I want to develop a strong foundation for a pioneering international classification tool that maps preferred and actual places towards death grounded on what they mean for individuals (beyond a purely physical or medical view). To achieve this I combine classic methods of developing health classifications with a bottom-up participatory research approach, working with patient and family representatives. First, I conduct a novel mixed-methods study (ethnography followed by longitudinal study) in 4 countries covering existing target variation, to explore nuances and commonalities in the experiences of patients with life-threatening conditions and their families. Based on this, I build a contemporary classification and assess its content validity in focus groups with patients, carers and other stakeholders. I then test it in varied settings to examine construct validity, reliability, responsiveness, data quality and interpretability. All data are integrated to deepen understanding of different end of life pathways in caring environments and what influences them.
Prompted by my discoveries on preferences and concern with unfit classifications for a fast-growing need in a changed social world with limited care resources, my research will open new directions in how to care for the dying.

Régime de financement

ERC-STG - Starting Grant

Institution d’accueil

UNIVERSIDADE DE COIMBRA
Contribution nette de l'UE
€ 1 874 391,00
Adresse
PACO DAS ESCOLAS
3004-531 Coimbra
Portugal

Voir sur la carte

Région
Continente Centro (PT) Região de Coimbra
Type d’activité
Higher or Secondary Education Establishments
Liens
Coût total
€ 1 874 391,00

Bénéficiaires (1)