Relatives' perceived quality of palliative care: comparisons between care settings in which patients die
Relatives' perceived quality of palliative care: comparisons between care settings in which patients die
复制标题
DOI：
10.1186/s12904-017-0224-x
复制
发表时间：
2017-08-16
影响因子：
3.1
通讯作者：
Francke, Anneke L.
中科院分区：
文献类型：
--
作者：
de Boer, Dolf;Hofstede, Jolien M.;Francke, Anneke L.
背景：在首选环境中死亡是良好姑息治疗质量的一个指标。大多数人宁愿死在家里。但是，他们的亲属所认为的护理质量是否因死亡地点的护理环境而异？目的是比较（从亲属的角度）人们死亡的环境之间的姑息治疗质量是否存在感知差异。方法：使用现有数据集进行多元线性回归分析，该数据集包含使用亲属版本收集的信息消费者质量指数（CQ指数）姑息治疗。该数据集包括1368名患有各种疾病的患者的亲属，这些患者在不同地点死亡：家中，医院，老人院，临终关怀，姑息治疗单位或其他机构（例如智障人士机构或精神卫生保健机构）。亲属是第一次接触（家庭成员或其他人接近病人），他们接受了调查6周和6个月后的丧亲之痛。结果：根据原始数据，不同地点之间的感知质量的护理最初出现不一致。然而，多变量回归分析显示，在家中死亡的人的亲属通常对患者和他们自己在患者死亡时接受的姑息治疗最积极。收容所提供的护理也得到了相对较好的评价。在医院和住宅环境中的老年人的护理，护理评价不高的relatives.Conclusions：从亲属的角度来看，经验丰富的姑息治疗的质量是最高的，当病人死在家里或在临终关怀。这是一个论点，让人们死在家里，如果他们愿意，尽可能和可行。
Background: Dying in the preferred setting is an indicator of good palliative care quality. Most people prefer to die at home. But does the quality of care as perceived by their relatives vary depending on the care setting that is the place of death? The aim is to compare (from the relatives perspective) whether there are perceived differences in the quality of palliative care between the settings in which people die.Methods: Multivariate linear regression analyses have been carried out using an existing dataset containing information collected using the relatives' version of the Consumer Quality Index (CQ-index) Palliative Care. The dataset includes 1368 relatives of patients with a wide variety of conditions who died in various locations: at home, in hospital, in residential care for the elderly, a hospice, palliative care unit or in another institution (e.g. institutions for people with intellectual disabilities or mental healthcare institutions). The relatives were the first contacts (family members or other people close to the patient) and they received the survey between 6 weeks and 6 months after the bereavement.Results: Based on the raw data, differences between locations in terms of the perceived quality of care initially appeared inconsistent. The multivariate regression analyses however showed that relatives of people who died at home were generally the most positive about the palliative care that the patient and they themselves received when the patient was dying. The care provided by hospices also received a relatively good rating. In hospitals and in residential settings for care of the elderly, the care was rated less highly by the relatives.Conclusions: The quality of palliative care as experienced from the relatives' perspective is highest when the patient dies at home or in a hospice. This is an argument for letting people die at home, if they so wish, as far as possible and feasible.