Onwuteaka-Philipsen Bregje D, Pasman H Roeline W, Korfage Ida J, Witkamp Erica, Zee Masha, van Lent Liza Gg, Goossensen Anne, van der Heide Agnes
Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Expertise Center for Palliative Care, Amsterdam UMC, VU University, Amsterdam, The Netherlands.
Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Palliat Med. 2021 May;35(5):830-842. doi: 10.1177/02692163211003778. Epub 2021 Apr 7.
During the COVID-19 outbreak restricting measures may have affected the provision of good end-of-life care for patients with and without COVID-19.
To describe characteristics of patients who died and the care they received, and to examine how patient characteristics, setting and visiting restrictions are related to provided care and evaluation of the dying process.
An open observational online survey among healthcare professionals about their experience of end-of-life care that was provided to a patient with or without COVID-19 who died between March and July 2020.
SETTING/PARTICIPANTS: Healthcare professionals (nurses, physicians and others) in the Netherlands from all settings: home ( = 163), hospital ( = 249), nursing home ( = 192), hospice ( = 89) or elsewhere ( = 68).
Of patients reported on, 56% had COVID-19. Among these patients, 358 (84.4%) also had a serious chronic illness. Having COVID-19 was negatively, and having a serious chronic illness was positively associated with healthcare staff's favourable appreciation of end-of-life care. Often there had been visiting restrictions in the last 2 days of life (75.8%). This was negatively associated with appreciation of care at the end of life and the dying process. Finally, care at the end of life was less favourably appreciated in hospitals and especially nursing homes, and more favourably in home settings and especially hospices.
Our study suggests that end-of-life care during the COVID-19 pandemic may be further optimised, especially in nursing homes and hospitals. Allowing at least some level of visits of relatives seems a key component.
在新冠疫情期间，限制措施可能影响了为感染和未感染新冠病毒的患者提供优质的临终关怀。
描述死亡患者的特征及其接受的护理，并研究患者特征、环境和探访限制如何与所提供的护理以及对临终过程的评估相关。
针对医护人员开展一项开放性观察性在线调查，了解他们在2020年3月至7月期间为感染或未感染新冠病毒且已死亡的患者提供临终关怀的经历。
地点/参与者：荷兰所有环境中的医护人员（护士、医生及其他人员）：家中（=163人）、医院（=249人）、养老院（=192人）、临终关怀机构（=89人）或其他地方（=68人）。
在报告的患者中，56%感染了新冠病毒。在这些患者中，358人（84.4%）还患有严重慢性病。感染新冠病毒与医护人员对临终关怀的积极评价呈负相关，而患有严重慢性病则与之呈正相关。在生命的最后两天通常存在探访限制（75.8%）。这与对临终护理和临终过程的评价呈负相关。最后，临终护理在医院尤其是养老院中得到的评价较低，而在家庭环境尤其是临终关怀机构中得到的评价较高。
我们的研究表明，新冠疫情期间的临终关怀可能需要进一步优化，尤其是在养老院和医院。允许亲属至少进行一定程度的探访似乎是一个关键因素。
