Tranberg Mattias, Jacobsen Juliet, Fürst Carl Johan, Engellau Jacob, Schelin Maria E C
Division of Palliative Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
The Institute for Palliative Care at Lund University and Region Skåne, Lund, Sweden.
Palliat Med Rep. 2022 Aug 4;3(1):116-122. doi: 10.1089/pmr.2022.0024. eCollection 2022.
Communication with patients and families about serious illness impacts quality of life and helps facilitate decision-making.
To elucidate the pattern of communication about serious illness for patients who have died in an inpatient setting.
Three hundred patients from the Swedish Registry of Palliative Care 2015-2017 were randomly selected for manual chart review.
Patients who died in a palliative care, oncology, or internal medicine unit in Sweden were selected.
We report on the frequency of conversations at three time points, 6 months or longer before death ("Years"), 15 days-6 months before death ("Months"), and 0-14 days before death ("Days"). We also report the timing of the conversation about dying.
A total of 249 patients were included after exclusions; they had an average of 2.1 conversations (range 1-6). The first conversation took place a median of 53 days before death and the last conversation took place a median of 9 days before death. Separate conversations with the next of kin took place a median of two days before death. We could verify a conversation about dying in only 156/249 (63%) medical records.
Communication about serious illness between clinicians, patients, and families occurs iteratively over a period before death. Measuring the quality of communication about serious illness using a years, months, and days framework may help ensure that patients and families have sufficient information for medical and personal decision making.
与患者及其家属就严重疾病进行沟通会影响生活质量，并有助于促进决策制定。
阐明在住院环境中死亡的患者关于严重疾病的沟通模式。
从瑞典姑息治疗登记处2015 - 2017年的患者中随机选取300例进行人工病历审查。
选取在瑞典姑息治疗、肿瘤或内科病房死亡的患者。
我们报告在三个时间点的谈话频率，死亡前6个月或更长时间（“年”）、死亡前15天至6个月（“月”）以及死亡前0至14天（“天”）。我们还报告关于死亡的谈话时机。
排除后共纳入249例患者；他们平均有2.1次谈话（范围1 - 6次）。第一次谈话发生在死亡前中位数53天，最后一次谈话发生在死亡前中位数9天。与近亲的单独谈话发生在死亡前中位数2天。我们仅在156/249（63%）的病历中核实到关于死亡的谈话。
临床医生、患者和家属之间关于严重疾病的沟通在死亡前的一段时间内反复进行。使用年、月和天的框架来衡量关于严重疾病的沟通质量可能有助于确保患者和家属拥有足够信息用于医疗和个人决策。
