Improving the Quality of End-of-Life Care

Virani, Rose; Sofer, Dalia

doi:10.1097/00000446-200305000-00020

Cited by 13 publications

(6 citation statements)

References 2 publications

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“…How good it made me feel!" 16 "Because taking care of these patients is not just about relieving the pain . .…”

Section: Gratitudementioning

confidence: 99%

“…15 "Un lugar donde te escuchan: comparte tu estado emocional "de verdad," se preocupan como el que más de la salud del enfermo pero también por la de los acompañantes" (SA #12). 16 "¡cuántas preguntas!, ¡cuántas respuestas! y ¡Dios mío, qué bien me quedaba"!…”

Section: Notesunclassified

“…The search also included equivalents, such as: thanks, appreciation, family, caregiver, hospice, terminally ill, and palliative medicine. Only three articles were identified: the authors of two of them recounted personal experiences and thanked PC providers for their assistance (16,17); the authors of the third one described the work of a PC team and mentioned receiving thank-you letters (18). No studies were found that considered information provided freely and spontaneously by service users.…”

Section: Introductionmentioning

confidence: 99%

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Letters from Relatives: A Source of Information Providing Rich Insight into the experience of the Family in Palliative Care

et al. 2010

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Studies on the effectiveness and efficiency of palliative care (PC) services that use a methodology similar to that used by studies in other medical specialties face serious limitations, since the goals of PC are substantially different. Qualitative research methods can make an important contribution to our understanding of the features of palliative care (PC) that are most relevant to patients and their relatives. The goal of this study was to understand the reasons behind the gratitude shown in letters from bereaved relatives sent to two PC units, one in Spain and one in Portugal. A thematic analysis of the content of the letters was independently carried out by three researchers, who later collaborated to write up the results. Relatives appeared grateful primarily for the humane attitude, professional treatment, and emotional support that their loved ones received from the PC team; they thanked the team for creating a special atmosphere and offering holistic care, and they talked about the contrast between PC and other forms of care. The unsolicited gratitude expressed in their letters constitutes a valid and particularly rich source of information about the contribution that a PC team can make.

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“…How good it made me feel!" 16 "Because taking care of these patients is not just about relieving the pain . .…”

Section: Gratitudementioning

confidence: 99%

Section: Notesunclassified

Section: Introductionmentioning

confidence: 99%

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Letters from Relatives: A Source of Information Providing Rich Insight into the experience of the Family in Palliative Care

et al. 2010

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“…[6,7] To answer these clarion calls, researchers, scholars and practitioners have endorsed a multi-focal campaign targeting various levels of change, ranging from individual attitudes and behaviors to professional education and policy. [8,9] However, to improve the quality of dying and death, we must first understand what contributes to a good versus bad death.…”

Section: Introductionmentioning

confidence: 99%

Correlates of a good death and the impact of hospice involvement: findings from the national survey of households affected by cancer

Cagle

Pek

Clifford

et al. 2014

Support Care Cancer

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Purpose Knowing how to improve the dying experience for patients with end-stage cancer is essential for cancer professionals. However, there is little evidence on the relationship between clinically relevant factors and quality of death. Also, while hospice has been linked with improved outcomes, our understanding of factors that contribute to a “good death” when hospice is involved remains limited. This study (1) identified correlates of a good death; and, (2) provided evidence on the impact of hospice on quality of death. Methods Using data from a survey of US households affected by cancer (N=930, response rate 51%), we fit regression models with a subsample of 158 respondents who had experienced the death of a family member with cancer. Measures included quality of death (good/bad) and clinically relevant factors including: hospice involvement, symptoms during treatment, whether wishes were followed, provider knowledge/expertise and compassion. Results Respondents were 60% female, 89% White, and averaged 57 years old. Decedents were most often a respondent's spouse (46%). While 73% of respondents reported a good death, Hispanics were less likely to experience good death (p=.007). Clinically relevant factors, including hospice, were associated with good death (p<.05) -- an exception being whether the physician said the cancer was curable/fatal. With adjustments, perceptions of provider knowledge/expertise was the only clinical factor that remained associated with good death. Conclusions Enhanced provider training/communication, referrals to hospice and greater attention to symptom management may facilitate improved quality of dying. Additionally, the cultural relevance of the concept of a “good death” warrants further research.

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“…In 1997, The American Geriatric Society released a report entitled "Measuring Quality of Life at the End of Life: A Statement of Principles," (Lynn, 1997), which listed nine factors, including helping the family's grief, supporting the patient's autonomy, protecting the patient against unsuitable aggressive care during a period near death, and maintaining the QOL of the patient despite decreasing physical health. The report was endorsed by more than 30 professional organizations including the American Association of Critical-Care Nurses, American Cancer Society, American Pain Society, and Oncology Nursing Society (Virani & Sofer, 2003).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Home Healthcare on Quality of Life in Patients Diagnosed With Gastrointestinal Cancer

Nural

Hintistan

Gürsoy

et al. 2009

Gastroenterology Nursing

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This study was undertaken to determine the effect of home healthcare on the quality of life (QOL) in patients diagnosed with gastrointestinal cancer. A total of 42 patients, who met eligibility criteria, were enrolled in the study and randomly assigned to either a control group or an experimental group. Control group patients received "usual care" defined as pain control and management through the pain clinic. Experimental group patients received pain control through the clinic plus three home visits. During the home visits, their nursing care was guided by an evidence-based protocol developed by the research team. Data were collected on pain, performance, symptoms, and QOL by using previously developed and validated instruments.Significant differences were found between the two groups on physiological function, psychological concerns, and total stress. In the experimental group, there was a significant decrease in pain and increase in performance from baseline to the final data collection period. For the control group, a significant decrease in QOL over the study period was observed. There were no significant differences between the two groups on pain, performance, QOL, and QOL subscales at the final visit.

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Improving the Quality of End-of-Life Care

Cited by 13 publications

References 2 publications

Letters from Relatives: A Source of Information Providing Rich Insight into the experience of the Family in Palliative Care

Letters from Relatives: A Source of Information Providing Rich Insight into the experience of the Family in Palliative Care

Correlates of a good death and the impact of hospice involvement: findings from the national survey of households affected by cancer

The Effect of Home Healthcare on Quality of Life in Patients Diagnosed With Gastrointestinal Cancer

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