Dying at home: why not? The views of community nurses on why cancer patients may not be able to achieve a home death
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Background: It is acknowledged that between 50-75% of those with cancer and more than 50% of adults (if diagnosed with a terminal illness) would prefer to die at home. Although the introduction of initiatives such as the UK Government’s End of Life Care Programme is intended to promote patient choice at this time, more than a quarter of those with a terminal illness do not die at home. A gap clearly exists between patients’ preferences and their actual place of death that is poorly understood. Various influencing factors have been suggested including local out of hours services, a cancer diagnosis and the ability of families to care. This study sought to explore the topic from the perspective of community nurses, in an attempt to identify factors locally, which might result in a change in decision away from a preferred home death for people with cancer. Methodology: As the study sought to explore personal perspectives on the topic, a qualitative methodology was adopted. Data collection was through focus groups, which enabled group discussion and interaction, and allowed participants to use their own frames of reference. A purposive sample of community Macmillan nurses and district nurses who could draw on examples from their practice in a discussion around place of death in cancer were invited to take part. Nineteen nurses from two primary care trusts in the north west of England participated in two audio taped focus groups. Data were analysed for emerging themes using thematic analysis. Results and Discussion: Two main themes emerged, carer breakdown and service provision. However contributory factors were identified including: delays in provision of services, unrealistic expectations of patients, carers and hospital staff, illness duration and patients’ perceptions of their carer’s abilities. This paper discusses the results and explores potential reasons for the findings.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it