Unit for Research on Aging Society, Department of Sociology, Chair of Epidemiology and Preventive Medicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland; Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland.
Unit for Research on Aging Society, Department of Sociology, Chair of Epidemiology and Preventive Medicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.
J Am Med Dir Assoc. 2020 Mar;21(3):439.e1-439.e8. doi: 10.1016/j.jamda.2019.07.018. Epub 2019 Sep 11.
To examine factors associated with perceived quality of communication with physicians by relatives of dying residents of long-term care facilities (LTCFs).
A cross-sectional retrospective study in a representative sample of LTCFs conducted in 2015. In each LTCF, deaths of residents during the 3 months before the researcher's visit were reported. Structured questionnaires were sent to the identified relatives of deceased residents.
A total of 736 relatives of deceased residents in 210 LTCFs (in Belgium, Finland, Italy, the Netherlands, and Poland).
The Family Perception of Physician-Family Communication scale (FPPFC) was used to assess the quality of end-of-life (EOL) communication with physicians as perceived by relatives. We applied multilevel linear regression models to find factors associated with the FPPFC score.
The quality of EOL communication with physicians was perceived by relatives as higher when the relative spent more than 14 hours with the resident in the last week of the resident's life (b = 0.205; P = .044), and when the treating physician visited the resident at least 3 times in the last week of the resident's life (b = 0.286; P = .002) or provided the resident with palliative care (b = 0.223; P = .003). Relatives with higher emotional burden perceived the quality of EOL communication with physicians as lower (b = -0.060; P < .001). These results had been adjusted to countries and LTCF types with physicians employed on-site or off-site of the facility.
The quality of EOL communication with physicians, as perceived by relatives of dying LTCF residents, is associated with the number of physician visits and amount of time spent by the relative with the resident in the last week of the resident's life, and relatives' emotional burden.
LTCF managers should organize care for dying residents in a way that enables frequent interactions between physicians and relatives, and emotional support to relatives to improve their satisfaction with EOL communication.
调查长期护理机构（LTCF）临终居民的亲属感知与医生沟通质量的相关因素。
2015 年在 LTCF 中进行的代表性样本的横断面回顾性研究。在每个 LTCF 中，报告了研究人员访问前 3 个月内居民的死亡情况。向已识别的已故居民的亲属发送了结构化问卷。
比利时、芬兰、意大利、荷兰和波兰 210 家 LTCF 中，736 名已故居民的亲属。
使用家庭感知医师家庭沟通量表（FPPFC）评估亲属对医生临终（EOL）沟通质量的感知。我们应用多水平线性回归模型来寻找与 FPPFC 评分相关的因素。
当亲属在居民生命的最后一周与居民共度超过 14 小时（b=0.205；P=0.044），以及当主治医生在居民生命的最后一周至少访问居民 3 次（b=0.286；P=0.002）或为居民提供姑息治疗（b=0.223；P=0.003）时，亲属认为与医生的 EOL 沟通质量更高。情感负担较高的亲属认为与医生的 EOL 沟通质量较低（b=-0.060；P<0.001）。这些结果已经调整到有现场或场外医生的国家和 LTCF 类型。
临终 LTCF 居民亲属感知的与医生的 EOL 沟通质量与医生访视次数和亲属在居民生命的最后一周与居民共度的时间以及亲属的情感负担有关。
LTCF 管理者应组织临终关怀服务，使医生与亲属之间能够频繁互动，并为亲属提供情感支持，以提高他们对 EOL 沟通的满意度。
