NETSCC, Health Technology Assessment, Science Support Directorate, University of Southampton Science Park, UK.
J Adv Nurs. 2009 Oct;65(10):2161-74. doi: 10.1111/j.1365-2648.2009.05081.x.
This paper is a report of a study conducted to explore the determinants of satisfaction with health and social care services in the last 3 months and 3 days of life as reported by bereaved relatives of those who died from a stroke in an institutional setting.
There is limited research about how best to meet the needs of those who die from stroke. A thorough understanding of the determinants of satisfaction with end of life care is crucial for effective service provision to increase awareness of the needs of dying patients.
During a six-month period in 2003, a population-based survey of bereaved relatives of patients after stroke was conducted using a stroke-specific version of the Views of Informal Carers Evaluation of Services postal questionnaire (183 informants, response rate 37%). The sub-sample included those informants who reported that the deceased person had died in an institutional setting (91%, n = 165). The analysis was divided into two phases: univariate (Pearson chi-square test) and multivariate phase (logistic regression).
Logistic regressions showed that discussing any worries about the treatment of the deceased person and feeling that the doctors and nurses knew enough about their condition were predictors of satisfaction with doctors and nurses in the last 3 months of life. Meeting the personal care needs of the deceased person, being involved in decisions and feeling that the deceased person died in the right place were predictors of satisfaction with care in the last 3 days of life.
End of life care needs to address the individual needs of patients who die from stroke and those close to them. This study shows that individualised end of life care increases satisfaction and, although the data reported in this paper reflect care in 2003, there is no more recent evidence that contradicts this important overall finding.
本研究旨在探讨机构环境中因中风去世患者的亲属报告的临终前 3 个月和 3 天内对健康和社会保健服务满意度的决定因素。
关于如何满足中风患者的需求的研究有限。深入了解临终关怀满意度的决定因素对于有效提供服务至关重要，这可以提高对临终患者需求的认识。
在 2003 年的 6 个月期间，使用中风特定版本的《非正式护理人员对服务的意见评估》（VIOLES）邮寄问卷对中风患者的亲属进行了一项基于人群的调查（183 名受访者，应答率为 37%）。该子样本包括报告死者在机构环境中死亡的受访者（91%，n=165）。分析分为两个阶段：单变量（Pearson χ2 检验）和多变量阶段（逻辑回归）。
逻辑回归显示，讨论对死者治疗的任何担忧以及对医生和护士对其病情了解程度的看法是对医生和护士在临终前 3 个月满意度的预测因素。满足死者的个人护理需求、参与决策以及感到死者死在合适的地方是对临终前 3 天护理满意度的预测因素。
临终关怀需要满足中风死亡患者及其亲近者的个人需求。本研究表明，个性化的临终关怀可提高满意度，尽管本报告中报告的数据反映了 2003 年的护理情况，但没有最近的证据反驳这一重要的总体发现。
