{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T05:10:19Z","timestamp":1759727419774,"version":"build-2065373602"},"reference-count":34,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"unspecified","delay-in-days":278,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S1478951525100527_sec1a\">\n\t    <jats:title>Objectives<\/jats:title>\n\t    <jats:p>End-of-life care in the Emergency Department (ED) can be a challenge. Defining goals of care in dementia patients may be more complex. The quality of ED medical records is relevant for better care in the last hours or days of life. In this article, we explore the identification of last days of life recognition in ED records of dementia patients.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1478951525100527_sec2b\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>Retrospective qualitative review of ED medical records of patients with dementia in the last 7 days of life using reflexive thematic analysis. This study was conducted at a university tertiary hospital, with a 24 h\/7 days polyvalent ED. All 2021 ED medical records of dementia patients who presented to the ED within the last 7 days of their lives were included.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1478951525100527_sec3c\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>More than 1 in 4 patient\u2019s medical records (n = 55, 27,4%) made no explicit reference to the identification of last days of life and only 2 medical records contained this specific designation. Most relevant issues presented under three broader themes: (I) diagnosis and prognosis concerning the last days or hours of life; (II) goals of care, medical decisions and communication about care in the last days or hours of life; and (III) comfort and needs assessment in the last days of life of patients with dementia in the ED.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1478951525100527_sec4d\">\n\t    <jats:title>Significance of results<\/jats:title>\n\t    <jats:p>There is limited identification of the last days or hours of life in ED medical records and clinical notes are of poor-quality regarding communication and shared decision making.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s1478951525100527","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T04:48:24Z","timestamp":1759726104000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Reflexive thematic analysis of emergency department medical records of dementia patients regarding the identification of last days of life"],"prefix":"10.1017","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4463-6732","authenticated-orcid":false,"given":"Sara","family":"Vieira Silva","sequence":"first","affiliation":[{"name":"Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio"},{"name":"Universidade do Porto"}]},{"given":"Carla","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Universidade do Porto"},{"name":"Centro Hospitalar Universitario de Santo Antonio"},{"name":"University of Porto Institute of Biomedical Sciences Abel Salazar"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1655-7391","authenticated-orcid":false,"given":"B\u00e1rbara","family":"Antunes","sequence":"additional","affiliation":[{"name":"University of Cambridge"}]}],"member":"56","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"S1478951525100527_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejor.2022.01.023"},{"key":"S1478951525100527_ref32","doi-asserted-by":"publisher","DOI":"10.11622\/smedj.2016179"},{"key":"S1478951525100527_ref24","first-page":"453","article-title":"Perceived information needs and communication difficulties of inpatient physicians and nurses","author":"McKnight","year":"2001","journal-title":"Proceedings of the AMIA (American Medical Informatics Association) 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