{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T19:02:27Z","timestamp":1773774147925,"version":"3.50.1"},"reference-count":51,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T00:00:00Z","timestamp":1753488000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T00:00:00Z","timestamp":1753488000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine how family caregivers of deceased nursing home residents scored and justified their ratings for each item on the Quality of Dying in Long\u2010Term Care scale and to identify the consistencies and discrepancies between their perceptions and the scores assigned when assessing the residents' end\u2010of\u2010life experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A convergent mixed\u2010methods design, comprising a cross\u2010sectional study and a thematic analysis for quantitative and qualitative phases, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Quantitative and qualitative data were collected simultaneously between May 2018 and February 2019. The two sets of data were analysed separately. For the quantitative component, family caregivers completed the quality of dying in long\u2010term care scale and a single\u2010item question assessing the final month of the residents' life. Descriptive statistics, Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      \u2010tests for comparative analyses and Spearman's correlations were applied to the quantitative data, while deductive thematic analysis was conducted for the qualitative data obtained through semi\u2010structured interviews.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty\u2010nine family caregivers completed the QoD\u2010LTC, and 11 participated in qualitative interviews. The mean overall QoD\u2010LTC score was 39.29 (SD\u2009=\u20097.58). The highest\u2010rated domain was \u2018Personhood\u2019 (M\u2009=\u20094.32; SD\u2009=\u20090.68), while the lowest was \u2018Preparatory Tasks\u2019 (M\u2009=\u20092.66; SD\u2009=\u20091.26). Interviewed family caregivers reported effective management of pain and other symptoms, satisfaction with the care provided and respectful and appropriate treatment. However, they identified significant shortcomings in communication concerning end\u2010of\u2010life issues, coping with death and advance care planning. Residents with cognitive impairment had significantly lower scores on the \u2018closure\u2019 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and \u2018preparatory tasks\u2019 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) domains as well as on the overall QoD\u2010LTC score (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Implications<\/jats:title>\n                    <jats:p>The findings demonstrate consistency between the quantitative and qualitative data, with high scores reported across most domains of the QoD\u2010LTC scale, with the exception of the \u2018Preparatory Tasks\u2019 domain. Cognitive impairment among residents was associated with lower perceived quality of the dying process from the perspective of family members.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Aspects related to closure and preparatory tasks were often overlooked. Strategies to enhance end\u2010of\u2010life communication and advance care planning are needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>\n                      The study adhered to the EQUATOR guidelines. The\n                      <jats:italic>Mixed Methods Reporting in Rehabilitation &amp; Health Sciences<\/jats:italic>\n                      (MMR\u2010RHS) checklist for mixed\u2010methods studies, the STROBE checklist for cross\u2010sectional studies, and the\n                      <jats:italic>Consolidated Criteria for Reporting Qualitative Research<\/jats:italic>\n                      (COREQ) guidelines for qualitative studies were used for reporting.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No funding was received for the completion of this study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.70095","type":"journal-article","created":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T07:38:31Z","timestamp":1753515511000},"page":"3726-3739","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quality of Dying Among Institutionalised Nursing Home Residents From the Caregivers' Perspective: A Mixed\u2010Methods Study"],"prefix":"10.1111","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4917-9078","authenticated-orcid":false,"given":"Daniel","family":"Puente\u2010Fernandez","sequence":"first","affiliation":[{"name":"Departamento de Enfermer\u00eda Universidad de Granada  Granada Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria ibs.GRANADA  Granada Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9980-9947","authenticated-orcid":false,"given":"Emilio","family":"Mota\u2010Romero","sequence":"additional","affiliation":[{"name":"Departamento de Enfermer\u00eda Universidad de Granada  Granada Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria ibs.GRANADA  Granada Spain"},{"name":"Unidad de Gesti\u00f3n Cl\u00ednica \u201cDr. Salvador Caballero\u201d Distrito Sanitario Granada Metropolitano  Granada Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3481-8156","authenticated-orcid":false,"given":"Manuel","family":"Fern\u00e1ndez\u2010Alc\u00e1ntara","sequence":"additional","affiliation":[{"name":"Departamento de Psicolog\u00eda de la Salud, Instituto de Investigaci\u00f3n Sanitaria y Biom\u00e9dica de Alicante (ISABIAL) Universidad de Alicante  Alicante Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2763-2572","authenticated-orcid":false,"given":"Mar\u00eda Paz","family":"Garcia\u2010Caro","sequence":"additional","affiliation":[{"name":"Departamento de Enfermer\u00eda Universidad de Granada  Granada Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria ibs.GRANADA  Granada Spain"},{"name":"Centro de Investigaci\u00f3n Mente, Cerebro y Comportamiento Universidad de Granada  Granada Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7732-3041","authenticated-orcid":false,"given":"Concepci\u00f3n","family":"Rold\u00e1n","sequence":"additional","affiliation":[{"name":"Departamento de Estad\u00edstica e Investigaci\u00f3n Operativa Universidad de Granada (Campus de Ceuta)  Ceuta Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2472-0590","authenticated-orcid":false,"given":"Rafael","family":"Montoya\u2010Juarez","sequence":"additional","affiliation":[{"name":"Departamento de Enfermer\u00eda Universidad de Granada  Granada Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria ibs.GRANADA  Granada Spain"},{"name":"Centro de Investigaci\u00f3n Mente, Cerebro y Comportamiento Universidad de Granada  Granada Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/02692163241287650"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/cky267"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.23938\/ASSN.0856"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532\u20105415.2007.01613.x"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnr.2021.151456"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.5296\/ije.v2i2.526"},{"key":"e_1_2_13_9_1","first-page":"1","volume-title":"Normativa Sobre Centros Residenciales de Personas Mayores","author":"Consejer\u00eda para la Igualda y Bienestar Social","year":"2007"},{"key":"e_1_2_13_10_1","volume-title":"A Concise Introduction to Mixed Methods Research","author":"Creswell J. 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