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

70 Background: Improving quality of death (QOD) is a key goal in palliative care. No instruments to measure QOD have been validated in Spanish. The goal of this study was to validate the Spanish version of the quality of death and dying questionnaire (QODD) and to develop a shortened version of this instrument suitable to be completed by phone interview. Methods: Translation/back-translation and adaptation of the QODD was performed following established standards. One question was removed due to cultural inadequacy. We enrolled caregivers (CGs) of consecutive deceased cancer patients from a single palliative care clinic in Santiago, Chile. CGs were contacted by phone between 4 and 12 weeks after patients’ death. Participating CGs completed the adapted QODD (QODD-ESP) by phone interview. A global rating question assessing quality of life (QOL) during the last week of life was included. A shortened version of the QODD (QODD-ESP-12) based on the model by Downey et al. (J Pain Sympt Manage 2010;39) was created. Measures of reliability (Cronbach-alpha), convergent validity (correlation with global rating question) and construct validity (factorial analysis [FA]) were estimated for both versions of the instrument. Results: 150 (50%) out of 302 CGs completed the QODD-ESP. Patients mean (standard deviation [SD]) age was 67 (14), 71 (47%) female and 131 (87%) died at home. CGs mean (SD) age was 51 (13), 128 (85%) female. Mean QODD-ESP score was 69 (range 35-96) with an alpha = .829. Correlation with last week QOL was .434 (p < .01). Kaiser-Meyer-Olkin measure of sampling adequacy was .585, not supporting the existence of a unique underlying construct. Mean QODD-ESP-12 score was 69 (range 31-97) with a alpha = .728. Correlation with last week QOL was .306 (p < .01). Confirmatory FA of QODD-ESP-12 showed that data fitted well Downey’s model (Chi2 4.85 (60), p = .311 Comparative Fit ndex = .98; Tuker-Lewis Index = .977 and root mean square error of approximation (RMSEA) = .023 (CI: 0-.056). Conclusions: QODD-ESP-12 is a reliable and valid instrument with good psychometric properties and can be used to assess QOD in a Spanish speaking cancer palliative care population by phone interview.

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PHP41 EXAMINING THE QUALITY OF HEALTH ECONOMIC ANALYSES SUBMITTED TO THE REIMBURSEMENT AGENCIES IN SWEDEN AND FINLAND—A CROSS COUNTRY COMPARISON

Value in Health ◽

10.1016/s1098-3015(10)67741-8 ◽

2005 ◽

Vol 8 (6) ◽

pp. A193

Author(s):

A Engstrom ◽

A Kivioja

Keyword(s):

Health Economic ◽

Country Comparison ◽

Cross Country ◽

Economic Analyses

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Cluster-randomised trial of a nurse-led advance care planning session in patients with COPD and their loved ones

Thorax ◽

10.1136/thoraxjnl-2018-211943 ◽

2019 ◽

Vol 74 (4) ◽

pp. 328-336 ◽

Cited By ~ 6

Author(s):

Carmen H M Houben ◽

Martijn A Spruit ◽

Hans Luyten ◽

Herman-Jan Pennings ◽

Vivian E M van den Boogaart ◽

...

Keyword(s):

End Of Life ◽

End Of Life Care ◽

Death And Dying ◽

Intervention Group ◽

Control Group ◽

Life Care ◽

Quality Of Death ◽

Advance Care

RationaleAdvance care planning (ACP) is uncommon in patients with chronic obstructive pulmonary disease (COPD).ObjectivesTo assess whether a nurse-led ACP-intervention can improve quality of patient-physician end-of-life care communication in patients with COPD. Furthermore, the influence of an ACP-intervention on symptoms of anxiety and depression in patients and loved ones was studied. Finally, quality of death and dying was assessed in patients who died during 2-year follow-up.MethodsA multicentre cluster randomised-controlled trial in patients with advanced COPD was performed. The intervention group received an 1.5 hours structured nurse-led ACP-session. Outcomes were: quality of patient-physician end-of-life care communication, prevalence of ACP-discussions 6 months after baseline, symptoms of anxiety and depression in patients and loved ones and quality of death and dying.Results165 patients were enrolled (89 intervention; 76 control). The improvement of quality of patient-physician end-of-life care communication was significantly higher in the intervention group compared with the control group (p<0.001). The ACP-intervention was significantly associated with the occurrence of an ACP-discussion with physicians within 6 months (p=0.003). At follow-up, symptoms of anxiety were significantly lower in loved ones in the intervention group compared with the control group (p=0.02). Symptoms of anxiety in patients and symptoms of depression in both patients and loved ones were comparable at follow-up (p>0.05). The quality of death and dying was comparable between both groups (p=0.17).ConclusionOne nurse-led ACP-intervention session improves patient-physician end-of-life care communication without causing psychosocial distress in both patients and loved ones.

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