Discussion
terminally ill
To the best of our knowledge, there is no university inpatient hospice in Germany yet, so this is the first prospective qualitative study of such a unit. This study deliberately focused on the perspective of clinical staff and volunteers who currently work at the Department of Palliative Medicine of the University Hospital in Cologne, Germany, and will most likely play a major role in the proposed university inpatient hospice.Our findings revealed that most clinical staff and volunteers anticipated improvements with the intended university inpatient hospice, although their expectations were divided between both hope and concern while adhering to legal and general requirements, which they feared might oppose such a project. Participants expressed concern about leadership and staffing plans, albeit most pronounced among clinical staff. It was noticeable how especially nursing staff repeatedly articulated concerns about being interchanged between the palliative care ward and the intended inpatient hospice while they had explicitly chosen to work in palliative medicine. Caring for complex and terminally ill patients and their principal caregivers has been associated with work- and client-related stress [Clinical staff expressed a clear need for teaching and research, which is not surprising given its attachment with the university hospital. Research in the intended university hospice is of particular importance as there is rarely any hospice research in Germany. It should also be a high priority for patients and hospice residents giving them time with and attention from researchers [In Germany, 95% of costs for an inpatient hospice stay are borne by the statutory health insurance and long-term care insurance while the remaining 5% are borne by donations [Another important finding was that although the general consensus is that hospice residents often experience loss of hunger as the dying process unfolds [