{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:53:20Z","timestamp":1791179600340,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100015930","name":"Equity Trustees","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015930","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Older People Nursing"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Efforts to reduce hospital transfers from nursing homes at the end of life have received considerable attention. However, less is known about how hospitals are understood and experienced as places of death for nursing home residents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To synthesize qualitative evidence exploring stakeholder perceptions of hospital as a place of death for older adults living in nursing homes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A meta\u2010ethnography of qualitative evidence following the Meta\u2010ethnography Reporting Guidelines (eMERGe). Four bibliographic databases (MEDLINE, CINAHL, PsychINFO and Scopus) were systematically searched to identify all studies published from January 2012 to March 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>Studies were included if they reported qualitative findings on nursing home residents dying in hospital. Following quality appraisal, first\u2010 and second\u2010order constructs were extracted and translated across studies using reciprocal and refutational analysis to develop third\u2010order interpretations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Two overarching interpretive themes were generated: (1)\n                      <jats:italic>Controlling Symptoms of Dying: Comfort and Discomfort<\/jats:italic>\n                      ; and (2)\n                      <jats:italic>Acceptance of Death After All Efforts to Save Life Have Been Exhausted<\/jats:italic>\n                      . Hospitals were perceived as both impersonal environments and medically resource\u2010rich settings that legitimize death through medical authority.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hospitals occupy a paradoxical position in end\u2010of\u2010life care for nursing home residents. While often viewed as clinically oriented and less personal, they are also perceived to provide symptom control and reassurance that \u2018everything possible\u2019 has been done. Addressing these perceptions\u2014alongside strengthening palliative capacity within nursing homes\u2014is essential to supporting residents' preferences and enabling high\u2010quality end\u2010of\u2010life care across settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Practice<\/jats:title>\n                    <jats:p>Nurses can support more person\u2010centred end\u2010of\u2010life care by strengthening palliative symptom management in nursing homes, engaging residents and families in early advance care planning, and improving communication about dying and hospital treatment. These practices may help reduce avoidable hospital transfers and support residents to die in their preferred place.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/opn.70101","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T05:22:08Z","timestamp":1791177728000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hospitalization and Death Acceptance: A Meta\u2010Ethnography of Perceptions of Hospital as a Place of Death for Nursing Home Residents"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9998-6134","authenticated-orcid":false,"given":"Bridget","family":"Laging","sequence":"first","affiliation":[{"name":"Alfred Emergency Academic Centre Alfred Health  Melbourne Victoria Australia"},{"name":"School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7511-9967","authenticated-orcid":false,"given":"Rachel","family":"MacLean","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Studies, 3 Bailey Drive University of New Brunswick  Fredericton New\u00a0Brunswick Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2114-9974","authenticated-orcid":false,"given":"Jessica","family":"Dickson","sequence":"additional","affiliation":[{"name":"RMIT University Library  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1481-2881","authenticated-orcid":false,"given":"Janine","family":"Alan","sequence":"additional","affiliation":[{"name":"School of Population and Global Health The University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/NJH.0000000000000843"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afz174"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216319866648"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904\u2010024\u201001479\u20103"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.15043"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/opn.12125"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2017.04.014"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7342.905"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904\u2010016\u20100077\u20108"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951515001285"},{"key":"e_1_2_10_12_1","unstructured":"Critical Appraisal Skills Programme C.2023.\u201cCASP Qualitative Research Checklist.\u201dhttps:\/\/casp\u2010uk.net\/casp\u2010tools\u2010checklists\/."},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.13907"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/13607863.2019.1622074"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare\u20102019\u2010001832"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874\u2010018\u20100600\u20100"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102017\u2010021285"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2020.02.006"},{"key":"e_1_2_10_19_1","volume-title":"StatPearls","author":"Huffman J. 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