Relatives Key To Quality of Dying in Hospitals

F.E. (Erica) Witkamp RN MSc Senior lecturer University of Applied Sciences Erasmus MC and Erasmus MC Cancer Institute Rotterdam, The Netherlands.MedicalResearch.com Interview with:
F.E. (Erica) Witkamp RN MSc
Senior lecturer University of Applied Sciences
Erasmus MC and Erasmus MC Cancer Institute
Rotterdam, The Netherlands.


Medical Research: What are the main findings of the study?

Response: We investigated the experiences of 249 bereaved relatives (response 51%) of patients who had died in the hospital, after a hospitalization of at least six hours. The main outcome measure was their global score of the quality of dying (QOD) on a 0-10 scale, with zero being “very poor” and ten “almost perfect”. Further, we assessed multiple experiences in the last days of life, such as symptom burden, preparedness for life closure, awareness of impending death, and care in the last days of life. We analyzed which of these factors was related to the quality of dying score, and subsequently whether the related factors represented specific domains of the dying phase.

Relatives rated the overall score of QOD on average at 6.3 (sd 2.7) with a range from 0-10.

During the last day(s) of life, 26% of the patients, and 49% of the relatives had been fully aware of imminent death. In the end 39% of the patients and 50% of the relatives had said goodbye; 77% of the patients had died in the presence of a relative.

According to relatives patients had suffered moderately to severely from on average 7 out of 22 symptoms.

In 53% relatives reported that in the last 24 hours symptoms had sufficiently been alleviated; efforts to control symptoms had been sufficient in 75%. In 64% relatives had been informed by the physician about the imminence of death, and in 70% they were satisfied about their involvement in decision making. In 55% relatives had experienced sufficient attention to individual preferences and wishes, and in 70% hospital facilities had been sufficient. Patients had been sufficiently affirmed as a person in 63%.

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