{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T16:52:43Z","timestamp":1782492763206,"version":"3.54.5"},"reference-count":27,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"unspecified","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Catalan Health Department -Death Observatory of Catalonia","award":["Good Death Study Code: 0002.LE01.20.037 (AQuAS)"],"award-info":[{"award-number":["Good Death Study Code: 0002.LE01.20.037 (AQuAS)"]}]},{"name":"Spanish CIBER of Epidemiology and Public Health","award":["ESPG152024 CIBER-ISCIII"],"award-info":[{"award-number":["ESPG152024 CIBER-ISCIII"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,2,17]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objective<\/jats:title>\n                    <jats:p>A qualitative study was conducted in Catalonia (Spain), incorporating the views and opinions of relatives, healthcare professionals and patients on what they considered a \u2018good death\u2019. This study aimed to describe barriers, facilitators and unmet needs related to the achievement of a good death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We recruited adult patients with advanced or chronic conditions, relatives and health and social care professionals involved in end-of-life processes of care, management or strategic planning. All participants took part in a qualitative study. The study was informed by phenomenological, hermeneutical and social constructivist perspectives and included 23 in-depth interviews and three focus group discussions with a total of 31 participants. Fieldwork was conducted between February and April 2022. Data were transcribed and analysed using qualitative thematic content and discourse analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six main themes were identified, comprising 17 subthemes. Facilitators and barriers related to achieving \u2018a good death\u2019 were categorised according to whether they occurred before death or during the dying process. Key facilitators include high-quality palliative care, open communication about death and the ability to choose the place of death. Key barriers included bureaucratic delays, inadequate resources, insufficient professional training and lack of respect for patients\u2019 preferences and wishes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study highlights the need to understand factors that facilitate or hinder the achievement of a good death and the quality of the dying process. Specifically, understanding individual preferences and unmet needs, enhancing communication, increasing awareness, reducing bureaucratic barriers and ensuring adequate resources are essential to support a more dignified end-of-life experience for patients, caregivers and healthcare professionals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-106622","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T14:25:11Z","timestamp":1773066311000},"page":"e106622","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Barriers, facilitators and unmet needs for achieving a good death and enhancing end-of-life care in the Catalan Health System: a qualitative study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7852-175X","authenticated-orcid":false,"given":"Vicky","family":"Serra-Sutton","sequence":"first","affiliation":[{"name":"Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain"},{"name":"CIBER Epidemiology and Public Health, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Fern\u00e1ndez-Giner","sequence":"additional","affiliation":[{"name":"Independent consultant, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2386-6703","authenticated-orcid":false,"given":"M\u00f3nica","family":"Caldeiro","sequence":"additional","affiliation":[{"name":"Vitruvian Medical Communications, Lugo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Garc\u00eda-Alt\u00e8s","sequence":"additional","affiliation":[{"name":"Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain"},{"name":"CIBER Epidemiology and Public Health, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mireia","family":"Espallargues","sequence":"additional","affiliation":[{"name":"Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain"},{"name":"Research Network on Chronicity, Primary Care, Health Prevention and Promotion (RICAPPS), Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"2026062609355691000_16.3.e106622.1","doi-asserted-by":"crossref","unstructured":"G\u00f3mez-Batiste X , Ambl\u00e0s J , Calsina-Berna A , et al . Development of palliative care: past, present, and future. en. In: MacLeod RD , Van den Block L , eds. Textbook of Palliative Care. 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