Division of Palliative Care, Department of Family and Community Medicine, Providence Health Care, University of British Columbia.
BMC Palliat Care. 2013 Jul 20;12(1):25. doi: 10.1186/1472-684X-12-25.
The goal of the study was to assess perceived level of satisfaction with end-of-life care, focusing on the last 48 hours of life.
A previously validated instrument was used in a telephone survey with bereaved family members (n=90) of patients who died within an organization in British Columbia.
Bereaved family members had many unmet needs for information about the patient's changing condition, the process of dying, how symptoms would be managed and what to do at the time of death. In addition, many bereaved relatives felt that the patient or resident had an unmet need for emotional support and that their own emotional needs were not addressed adequately. The last place of care had the most significant effect on all of these variables, with acute care and residential care having the most unmet needs. Hospice had the fewest unmet needs, followed by the palliative and the intensive care units.
We discuss these findings in relation to overall satisfaction with care, focus on individual, ethno-cultural and diversity issues, information and decision-making, symptom management and attending to the family. We conclude by offering possible practices address the end-of-life needs of patients and family members.
本研究旨在评估临终关怀的满意度,重点关注生命的最后 48 小时。
采用经先前验证的工具,对不列颠哥伦比亚省一家机构内死亡患者的家属(n=90)进行电话调查。
在患者病情变化、死亡过程、如何处理症状以及死亡时该做什么等方面,患者家属有许多未满足的信息需求。此外,许多失去亲人的亲属感到患者或居民在情感支持方面存在未满足的需求,而他们自己的情感需求也没有得到充分满足。临终关怀的地点对所有这些变量都有最显著的影响,急性护理和住院护理的未满足需求最多。临终关怀中心的未满足需求最少,其次是姑息治疗和重症监护病房。
我们根据总体护理满意度讨论了这些发现,重点关注个人、种族文化和多样性问题、信息和决策、症状管理以及家属的照顾。最后,我们提出了一些可能的做法,以满足患者和家属的临终需求。