Rights statement: The final, definitive version of this article has been published in the Journal, Qualitative Health Research, 28 (5), 2018, © SAGE Publications Ltd, 2018 by SAGE Publications Ltd at the Qualitative Health Research page : http://journals.sagepub.com/home/qhr on SAGE Journals Online: http://journals.sagepub.com/
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Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
}
TY - JOUR
T1 - An alternative view of self-discharge against medical advice
T2 - an opportunity to demonstrate empathy, empowerment, and care
AU - Machin, Laura Louise
AU - Goodwin, Dawn Samantha
AU - Warriner, David
N1 - The final, definitive version of this article has been published in the Journal, Qualitative Health Research, 28 (5), 2018, © SAGE Publications Ltd, 2018 by SAGE Publications Ltd at the Qualitative Health Research page : http://journals.sagepub.com/home/qhr on SAGE Journals Online: http://journals.sagepub.com/
PY - 2018/4/1
Y1 - 2018/4/1
N2 - In this article, we present the experiences of discharging against medical advice from the perspectives of 17 hospital and community-based health care practitioners, and 16 patients, and relatives from a range of medical and surgical wards. Semistructured, in-depth interviews were conducted and thematically analyzed. We identified that practitioners, patients, and relatives frequently expressed empathy for each other during the interviews, and discharge against medical advice was presented as a way for patients to have control over their health. Contrary to predominantlynegative framings that highlight increased mortality and morbidity, and portray people who discharge against medical advice as poor decision makers, we conclude discharge against medical advice can be framed positively. It can be an opportunity to empathize, empower, and care. We recommend that the vocabulary used in hospital discharge against medical advice policies and documents should be updated to reflect a culture of medicine that values patient autonomy, patient centeredness, and shared decision making.
AB - In this article, we present the experiences of discharging against medical advice from the perspectives of 17 hospital and community-based health care practitioners, and 16 patients, and relatives from a range of medical and surgical wards. Semistructured, in-depth interviews were conducted and thematically analyzed. We identified that practitioners, patients, and relatives frequently expressed empathy for each other during the interviews, and discharge against medical advice was presented as a way for patients to have control over their health. Contrary to predominantlynegative framings that highlight increased mortality and morbidity, and portray people who discharge against medical advice as poor decision makers, we conclude discharge against medical advice can be framed positively. It can be an opportunity to empathize, empower, and care. We recommend that the vocabulary used in hospital discharge against medical advice policies and documents should be updated to reflect a culture of medicine that values patient autonomy, patient centeredness, and shared decision making.
KW - care
KW - compassion
KW - empathy
KW - empower
KW - self-discharge
KW - qualitative
U2 - 10.1177/1049732318754514
DO - 10.1177/1049732318754514
M3 - Journal article
VL - 28
SP - 702
EP - 710
JO - Qualitative Health Research
JF - Qualitative Health Research
SN - 1049-7323
IS - 5
ER -