• María Remedios Sánchez-García, Marina Moreno-Rodríguez, César Hueso-Montoro, Concepción Campos-Calderón, Ana Varella-Safont, and Rafael Montoya-Juárez.
• Centro de Salud Cúllar Vega, Distrito de Atención Primaria Granada-Metropolitano, Servicio Andaluz de Salud, Junta de Andalucía, Cúllar Vega, Granada, Andalucía, España. Electronic address: mremedios.sanchez.sspa@juntadeandalucia.es.
• Aten Primaria. 2017 May 1; 49 (5): 278285278-285.

AimTo identify the facilitators and barriers experienced by professional related to end of life care in nursing homes.DesignDescriptive qualitative research with phenomenological orientation, through content analysis.PlacementNursing Homes at Primary Care District in Granada (Spain).ParticipantsFifteen clinical professionals with, at least 6 months of experience in nursing homes, without specific background in palliative care.MethodsThree focus groups were undertaken with professionals of different disciplines and nursing homes. Interviews were recorded and transcribed literally. An open and axial coding was performed to identify relevant categories.ResultsProfessionals identified difficulties in the communication with families related to relatives' feelings of guilt, difficulty in understanding the deterioration of their relative, and addressing too late the issue of death. Regarding decision making, professionals recognized that they do not encourage participation of patients. Advance directives are valued as a necessary tool, but they do not contemplate implementing them systematically. Other difficulties that professionals highlighted are lack of coordination with other professionals, related to misunderstanding of patients' needs, as well as lack of training, and lack of material and human resources. Facilitators include relationships with primary care teams.ConclusionIt is necessary to improve communication among nursing homes professionals, families, patients and other health workers.Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

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