Bereaved family members’ perceptions of the quality of end-of-life care across four types of inpatient care settings

BMC Palliative Care

Research Article

Diane Allan¹  Daren K. Heyland²  Darcee Bidgood³  S. Robin Cohen⁴  Leah Norgrove⁵  Kelli Stajduhar⁶  Richard Sawatzky⁷  Anne M. Gadermann⁸ 

[1] College of Nursing, University of Saskatchewan, 104 Clinic Place, S7N 2Z4, Saskatoon, SASK, Canada;Critical Care Medicine, Queen’s University, 76 Stuart Street, K7L 2V7, Kingston, ON, Canada;Institute on Aging and Lifelong Health, University of Victoria, PO Box 1700 STN CSC, V8W 2Y2, Victoria, BC, Canada;Oncology and Medicine, McGill University, Lady Davis Research Institute, Jewish General Hospital, 845 Sherbrooke Street West, H3A 0G4, Montreal, QC, Canada;Palliative Care, Saanich Peninsula Hospital, Island Health, 2166 Mt. Newton X Road, V8M 2B2, Saanichton, BC, Canada;School of Nursing and Institute on Aging and Lifelong Health, University of Victoria, PO Box 1700 STN CSC, V8W 2Y2, Victoria, BC, Canada;School of Nursing, Trinity Western University, 7600 Glover Road, V2Y 1Y1, Langley, BC, Canada;School of Population and Public Health, University of British Columbia, 2206 East Mall, V6T 1Z3, Vancouver, BC, Canada;

关键词: Bereaved family members’;    Quality of care;    Inpatient healthcare settings;    End-of-life care;    Palliative care;   

DOI  :  10.1186/s12904-017-0237-5

 received in 2017-06-02, accepted in 2017-11-13,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe aims of this study were to gain a better understanding of how bereaved family members perceive the quality of EOL care by comparing their satisfaction with quality of end-of-life care across four different settings and by additionally examining the extent to which demographic characteristics and psychological variables (resilience, optimism, grief) explain variation in satisfaction.MethodsA cross-sectional mail-out survey was conducted of bereaved family members of patients who had died in extended care units (n = 63), intensive care units (n = 30), medical care units (n = 140) and palliative care units (n = 155). 1254 death records were screened and 712 bereaved family caregivers were identified as eligible, of which 558 (who were initially contacted by mail and then followed up by phone) agreed to receive a questionnaire and 388 returned a completed questionnaire (response rate of 70%). Measures included satisfaction with end-of-life care (CANHELP- Canadian Health Care Evaluation Project - family caregiver bereavement version; scores range from 0 = not at all satisfied to 5 = completely satisfied), grief (Texas Revised Inventory of Grief (TRIG)), optimism (Life Orientation Test – Revised) and resilience (The Resilience Scale). ANCOVA and multivariate linear regression were used to analyze the data.ResultsFamily members experienced significantly lower satisfaction in MCU (mean = 3.69) relative to other settings (means of 3.90 [MCU], 4.14 [ICU], and 4.00 [PCU]; F (3371) = 8.30, p = .000). Statistically significant differences were also observed for CANHELP subscales of “doctor and nurse care”, “illness management”, “health services” and “communication”. The regression model explained 18.9% of the variance in the CANHELP total scale, and between 11.8% and 27.8% of the variance in the subscales. Explained variance in the CANHELP total score was attributable to the setting of care and psychological characteristics of family members (44%), in particular resilience.ConclusionFindings suggest room for improvement across all settings of care, but improving quality in acute care and palliative care should be a priority. Resiliency appears to be an important psychological characteristic in influencing how family members appraise care quality and point to possible sites for targeted intervention.

【 授权许可】

CC BY   
© The Author(s). 2017