IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology (E.L.), Sydney, New South Wales, Australia; Department of Palliative Care, Calvary Health Care (E.L.), Kogarah, New South Wales, Australia.
School of Psychology (F.M.), University of Queensland, Queensland, Australia.
J Pain Symptom Manage. 2024 Feb;67(2):147-156. doi: 10.1016/j.jpainsymman.2023.10.025. Epub 2023 Nov 15.
Australian COVID-19 public health measures reduced opportunities for people to communicate with healthcare professionals and be present at the death of family members/friends.
To understand if pandemic-specific challenges and public health measures during the COVID-19 pandemic impacted end-of-life and bereavement experiences differently if the death, supported by palliative care, occurred in a hospital or at home.
A cross-sectional online survey was completed by bereaved adults during 2020-2022. Analyses compared home and in-patient palliative care deaths and bereavement outcomes. Additional analyses compared health communication outcomes for those identified as persons responsible or next of kin.
SETTING/PARTICIPANTS: Of 744 bereaved people; 69% (n = 514) had a death in hospital and 31% (n = 220) at home.
The COVID-19 public health measures influenced people's decision to die at home. Compared to hospital deaths, the home death group had higher levels of grief severity and grief-related functional impairment. Only 37% of bereaved people received information about bereavement and support services. 38% of participants who were at least 12 months postdeath scored at a level suggestive of possible prolonged grief disorder. Levels of depression and anxiety between the two groups were not significantly different.
These findings highlight the need for health services to recognize bereavement as fundamental to palliative and health care and provide pre- and post death grief and bereavement care to ensure supports are available particularly for those managing end-of-life at home, and that such supports are in place prior to as well as at the time of the death.
澳大利亚 COVID-19 公共卫生措施减少了人们与医疗保健专业人员交流和在亲人/朋友去世时在场的机会。
了解在 COVID-19 大流行期间，是否因大流行而产生的特殊挑战和公共卫生措施，如果死亡得到姑息治疗的支持，发生在医院或家中，对临终和丧亲体验产生不同的影响。
2020-2022 年期间，通过横断面在线调查完成了丧亲的成年人。分析比较了姑息治疗住院和门诊死亡和丧亲结局。额外的分析比较了被确定为责任人或近亲的人在健康沟通方面的结果。
地点/参与者：在 744 名丧亲者中；69%（n=514）的死亡发生在医院，31%（n=220）发生在医院。
COVID-19 公共卫生措施影响了人们选择在家中死亡的决定。与医院死亡相比，在家死亡组的悲痛严重程度和与悲痛相关的功能障碍程度更高。只有 37%的丧亲者收到了有关丧亲支持服务的信息。至少在死亡后 12 个月，38%的参与者的得分表明可能存在长期悲伤障碍。两组之间的抑郁和焦虑水平没有显著差异。
这些发现强调卫生服务部门需要认识到丧亲是姑息治疗和医疗保健的基础，并提供死亡前和死亡后的悲伤和丧亲护理，以确保提供支持，特别是那些在家中管理临终关怀的人，并且在死亡前和死亡时都有这些支持。
