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Revista Española de Salud Pública

On-line version ISSN 2173-9110Print version ISSN 1135-5727


VAZQUEZ-GARCIA, Daniel; RICA-ESCUIN, Marisa De la; GERMAN-BES, Concepción  and  CABALLERO-NAVARRO, Ana Luisa. Healthcare professionals' perceptions and confrontation at patients' end-of-life in emergency departments: A qualitative systematic review. Rev. Esp. Salud Publica [online]. 2019, vol.93, e201908051.  Epub Sep 07, 2020. ISSN 2173-9110.


Emergency services are specialized in population's severe illness care. However, the increasing trend of chronic patients which in some cases require of palliative care, has lead to a higher influx of this type of patients in emergency services, thus growing the rate of deaths consequently. How is this fact perceived by the health professionals and which strategies they count on to face patients' death? The aim of this work was to deeply review the perception and the strategies to face patients' death in the end-of-life (EOL) at emergency services.


Systematic review of qualitative studies was made according to PRISMA statements. Research was performed in the following bibliographic databases: Pubmed, Web of Science, Scopus, EMBASE, CINAHL, VHL Regional portal, Cuiden, COCHRANE LIBRARY and JBI. Inclusion criteria were as follows: Physicians and Nurses with at least one year of working experience as health professionals, Pediatric care excluded. Methodological quality, data extraction and its inclusion process was made in agreement with the tools described in JBI.


The extracted findings were structured and added in 4 thematic categories: 1) Priority of professional attention according to the causes and origin of patient's death; 2) Environmental barriers in the department hindering attention at the EOL; 3) professionals' emotions dealing with patients' death; 4) Professional strategies dealing with patient' death.


Health care professionals (Physicians and nurses) face more efficiently patients' death when is caused by a critic disease than when is caused by chronic/palliative diseases. Environment and the lack of training have been identified as factors that difficult end-of-life attention in emergency services.

Keywords : Attitude to death; Attitude of health personnel; Emergency medical services; Emergency service hospital; Hospice care; Hospice and palliative care nursing; Palliative medicine; Terminally ill; Qualitative research.

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