Identifying Core Domains to Assess the “Quality of Death”: A Scoping Review

Bhadelia, Afsan; Oldfield, Leslie E.; Cruz, Jennifer L.; Singh, Ratna; Finkelstein, Eric A.

doi:10.1016/j.jpainsymman.2021.11.015

Cited by 7 publications

(3 citation statements)

References 245 publications

(510 reference statements)

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“…First, we undertook an extensive scoping review that identified the core domains of end-of-life care that matter most to patients, and caregivers (Bhadelia, A et al, 2021 forthcoming). 12 Second, we developed a discrete choice experiment (DCE) survey to produce preference weights associated with each of the key indicators of EOL care identified in the scoping review (Gonzalez-Sepulveda, JM 2021 forthcoming). 13 Finally, as reported in this article, we developed, and fielded a survey for country-experts around the world who were qualified to assess the quality of EOL care within their country.…”

Section: Methodsmentioning

confidence: 99%

Cross Country Comparison of Expert Assessments of the Quality of Death and Dying 2021

Finkelstein

Bhadelia

Goh

et al. 2022

Journal of Pain and Symptom Management

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102

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Section: Methodsmentioning

confidence: 99%

Cross Country Comparison of Expert Assessments of the Quality of Death and Dying 2021

Finkelstein

Bhadelia

Goh

et al. 2022

Journal of Pain and Symptom Management

Self Cite

102

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“…Building on a recently published scoping review that identifies core domains and sub-domains of EOL care, 10 we developed a candidate list of EOL care indicators. These indicators were refined with the help of palliative-care experts.…”

Section: Methodsmentioning

confidence: 99%

What is a Good Death? A Choice Experiment on Care Indicators for Patients at End of Life

Gonzalez¹,

Baid²,

Finkelstein³

2022

Journal of Pain and Symptom Management

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“… 15 Through family member evaluation of the QODD frequency component, we previously identified 4 distinct QODD classes (high, moderate, poor to uncertain, and worst) characterized by patients’ physical symptom control, emotional preparedness for death, and amount of life-sustaining treatments (LSTs) received, 22 reflecting the core domains for quality of death. 23 …”

Section: Introductionmentioning

confidence: 99%

Factors Associated With Quality-of-Dying-and-Death Classes Among Critically Ill Patients

Wen,

Chou,

Huang

et al. 2024

JAMA Netw Open

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ImportanceImproving end-of-life care in the intensive care unit (ICU) is a priority, but clinically modifiable factors of quality of dying and death (QODD) are seldom identified.ObjectivesTo comprehensively identify factors associated with QODD classes of dying ICU patients, emphasizing clinically modifiable factors based on the integrative framework of factors associated with for bereavement outcomes.Design, Setting, and ParticipantsThis observational cohort study was conducted at medical ICUs of 2 Taiwanese medical centers from January 2018 to March 2020 with follow-up through December 2022. Eligible participants included primary family surrogates responsible for decision making for critically ill ICU patients at high risk of death (Acute Physiology and Chronic Health Evaluation II score &gt;20) but who survived more than 3 days after ICU admission. Data analysis was conducted from July to September 2023.Main Outcomes and MeasuresQODD was measured by the 23-item ICU-QODD questionnaire. Factors associated with patient membership in 4 previously determined QODD classes (high, moderate, poor to uncertain, and worst) were examined using a 3-step approach for latent class modeling with the high QODD class as the reference category.ResultsA total of 309 family surrogates (mean [SD] age, 49.83 [12.55] years; 184 women [59.5%] and 125 men [40.5%]) were included in the study. Of all surrogates, 91 (29.4%) were the patients’ spouse and 66 (53.7%) were the patients’ adult child. Patient demographics were not associated with QODD class. Two family demographics (age and gender), relationship with the patient (spousal or adult-child), and length of ICU stay were associated with QODD classes. Patients of surrogates perceiving greater social support were less likely to be in the poor to uncertain (adjusted odds ratio [aOR], 0.89; 95% CI, 0.83-0.94) and worst (aOR, 0.92; 95% CI, 0.87-0.96) QODD classes. Family meetings were associated with the poor to uncertain QODD class (aOR, 8.61; 95% CI, 2.49-29.74) and worst QODD class (aOR, 7.28; 95% CI, 1.37-38.71). Death with cardiopulmonary resuscitation was associated with the worst QODD class (aOR, 7.51; 95% CI, 1.12-50.25). Family presence at patient death was uniformly negatively associated with the moderate QODD class (aOR, 0.16; 95% CI, 0.05-0.54), poor to uncertain QODD class (aOR, 0.21; 95% CI, 0.05-0.82), and worst QODD class (aOR, 0.08; 95% CI, 0.02-0.38). Higher family satisfaction with ICU care was negatively associated with the poor to uncertain QODD class (aOR, 0.93; 95% CI, 0.87-0.98) and worst QODD class (aOR, 0.86; 95% CI, 0.81-0.92).Conclusions and RelevanceIn this cohort study of critically ill patients and their family surrogates, modifiable end-of-life ICU-care characteristics played a more significant role in associations with patient QODD class than did immutable family demographics, preexisting family health conditions, patient demographics, and patient clinical characteristics, thereby illuminating actionable opportunities to improve end-of-life ICU care.

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Identifying Core Domains to Assess the “Quality of Death”: A Scoping Review

Cited by 7 publications

References 245 publications

Cross Country Comparison of Expert Assessments of the Quality of Death and Dying 2021

Cross Country Comparison of Expert Assessments of the Quality of Death and Dying 2021

What is a Good Death? A Choice Experiment on Care Indicators for Patients at End of Life

Factors Associated With Quality-of-Dying-and-Death Classes Among Critically Ill Patients

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