Publication details

It matters how it ends: The quality of end-of-life care and communication from the perspective of bereaved family members

Authors

SLEZÁČKOVÁ Alena DVOŘÁČKOVÁ Kristýna ČERMÁKOVÁ Libuše RUSINOVÁ Kateřina KOPECKÝ Ondřej

Year of publication 2021
Type Appeared in Conference without Proceedings
MU Faculty or unit

Faculty of Medicine

Citation
Description High-quality care for hospitalised patients at the end of life requires health care teams to involve patients and their families in communication and decision-making about optimal care. As the issue of end-of-life (EoL) communication in the hospitals has been under-investigated in the Czech Republic, the main purpose of this study is to provide insight into the quality of care and communication at the end of life of the patient from the perspective of bereaved family members. Open-ended questions were used within a survey asking family members about their satisfaction with EoL care for their relatives and quality of communication in a large hospital in Prague. Responses from 300 relatives of decedents (64% female, mean age 53.9 years) were analyzed using a content analysis. The analysis resulted in the identification of three main categories related to the experience of EoL care: quality of communication, quality of health care, and system issues. Among most frequently reported shortcomings and difficulties were mentioned inadequate, insufficient communication of doctors and nurses, inappropriate health care, and unsatisfactory environment such as lack of privacy. The most frequently mentioned positive aspects were helpful, kind, and clear communication from physicians and nurses, satisfaction with provided health care, and good and supportive environment (including a possibility to say goodbye). We were also interested in what was considered the most important by relatives. The most important aspects of EoL care were friendly, helpful and commmunicative staff, possibility to be with the dying relative until the end, and considerate and respectful environment enabling dignified dying. The results pointed at the challenges that family members encounter when faced with EoL care in hospital. The participants identified the importance of quality communication that can better meet the needs of patient and family members and improve the process of the EoL care. High-quality care for hospitalised patients at the end of life requires health care teams to involve patients and their families in communication and decision-making about optimal care. As the issue of end-of-life (EoL) communication in the hospitals has been under-investigated in the Czech Republic, the main purpose of this study is to provide insight into the quality of care and communication at the end of life of the patient from the perspective of bereaved family members. Open-ended questions were used within a survey asking family members about their satisfaction with EoL care for their relatives and quality of communication in a large hospital in Prague. Responses from 300 relatives of decedents (64% female, mean age 53.9 years) were analyzed using a content analysis. The analysis resulted in the identification of three main categories related to the experience of EoL care: quality of communication, quality of health care, and system issues. Among most frequently reported shortcomings and difficulties were mentioned inadequate, insufficient communication of doctors and nurses, inappropriate health care, and unsatisfactory environment such as lack of privacy. The most frequently mentioned positive aspects were helpful, kind, and clear communication from physicians and nurses, satisfaction with provided health care, and good and supportive environment (including a possibility to say goodbye). We were also interested in what was considered the most important by relatives. The most important aspects of EoL care were friendly, helpful and commmunicative staff, possibility to be with the dying relative until the end, and considerate and respectful environment enabling dignified dying. The results pointed at the challenges that family members encounter when faced with EoL care in hospital. The participants identified the importance of quality communication that can better meet the needs of patient and family members and improve the process of the EoL care.
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