Death news communication process: A qualitative study on physician and family member experiences in the emergency department

Emergency departments are units where healthcare delivery is intense, uncertainty is high, and time pressure is pronounced. Deaths occurring in this setting bring forth a communication process that is difficult to manage and highly sensitive for both healthcare professionals and family members. Therefore, understanding how death notification communication unfolds in emergency departments, the factors influencing this process, and how the parties experience it is essential. This study aims to explore the death notification communication process between physicians and family members in emergency department deaths, adopting a holistic approach that considers the experiences of both sides. Within this scope, the study seeks to reveal the challenges encountered, how communication strategies and contextual conditions shape the process, to understand the implications of the notification for both parties, and to develop concrete recommendations for improvement. A phenomenological approach, one of the qualitative research designs, was used. The participants consisted of 34 individuals: 18 physicians experienced in delivering death notifications in the emergency department and 16 family members who lost a relative in the emergency department. Face-to-face interviews were conducted using semi-structured interview forms, audio-recorded, transcribed, and analyzed through thematic analysis in line with interpretative phenomenological analysis principles. Interviews with physicians revealed five main themes: practices and strategies in the communication process, communication styles, factors affecting the process, the impact on physicians, and recommendations for improvement. Interviews with family members yielded five themes: experiences related to communication, experiences with healthcare services, experiences regarding the physical environment, the impact of communication on family members, and expectations about the process. Additionally, to develop improvement-oriented recommendations, visits were made to the emergency and intensive care units of Padua University Hospital in Italy, and the findings from physician interviews conducted there were reflected in the recommendations section. In conclusion, the study found that death notification communication in emergency departments creates distinct psychological and emotional effects on physicians and family members, that physicians employ various communication styles, strategies, and practices, and that the process is multidimensional and complex, shaped by individual, institutional and cultural factors.