End-of-Life Care and Discussions in Japanese Geriatric Health Service Facilities: A Nationwide Survey of Managing Directors’ Viewpoints

2017 ◽  
Vol 35 (1) ◽  
pp. 83-91 ◽  
Author(s):  
Asako Kanoh ◽  
Yoshiyuki Kizawa ◽  
Satoru Tsuneto ◽  
Shoji Yokoya
Keyword(s):  
Health Service ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Workers ◽  
Care Facilities ◽  
Eol Care

Background: Geriatric health service facilities (GHSFs) play important roles as intermediate care facilities for elderly individuals temporarily when they need rehabilitation before returning home. However, the number of residents spending their end-of-life (EOL) period in such facilities is increasing. To improve the quality of EOL care, end-of-life discussions (EOLDs) are recommended by some guidelines and studies. Aim: This study aimed to clarify the current practice of EOL care and EOLDs in GHSFs in Japan. Methods: We conducted a nationwide cross-sectional survey by mailing questionnaires about EOL care and EOLDs to 3437 GHSF managing directors. The questionnaire was developed through a literature review and discussion among the researchers and experts. Descriptive statistics summarized the data. We also analyzed the factors related to GHSFs conducting EOLDs using Fisher exact tests. Results: The response rate was 20.7% (713 of 3437). Among the respondents, 75.2% (536 of 713) of GHSFs provided EOL care and 73.1% (521 of 713) conducted EOLDs. The most common reasons for difficulties in providing EOL care included the lack of EOL education for nurses and care workers, and their fear about caring for dying residents. End-of-life discussions were mostly initiated after the deterioration of a resident’s condition and were conducted with families by physicians. Statistically significant factors of GHSFs conducting EOLDs included providing EOL education for nurses and care workers, availability of private room for critically ill residents, emergency on-call doctors, and EOL care. Conclusion: Adequate practical staff education programs for EOL care including EOLDs may be crucial for quality of end-of-life care in aged care facilities.

scholarly journals End-of-life Care Preferences among Cancer Patients in Southern Thailand: A University Hospital-based Cross-Sectional Survey

2021 ◽  
Author(s):  
Jarurin Pitanupong ◽  
Sahawit Janmanee
Keyword(s):  
Quality Of Life ◽  
End Of Life ◽  
Cancer Patients ◽  
End Of Life Care ◽  
University Hospital ◽  
Life Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
At Home

Abstract Background: End-of-life care preferences may be highly individual, heterogenic, and variable according to culture and belief. This study aimed to explore preferences and factors associated with end-of-life care among Thai cancer patients with the goal of helping optimize their quality of life.Methods: A cross-sectional study surveyed cancer outpatients at Songklanagarind Hospital from August to November 2020. The questionnaires inquired about: 1) personal and demographic information, 2) experiences with end-of-life care received by relatives, and 3) end-of-life care preferences. To determine end-of life preferences, the data were analyzed using descriptive statistics. The data concerning patient demographics and end-of-life care preferences were compared using Fisher’s exact test. Results: The majority of the 96 cancer outpatients were female (65.6%), and the overall mean age was 55.8 ±11.6 years. More than half of them had an experience of observing someone die (68.8%), and they were predominantly satisfied with the care received by their relatives in passing away at home surrounded by family (47.0%) and being conscious until the time of death (68.2%). Most participants preferred receiving the full truth regarding their illness (99.0%), being free of uncomfortable symptoms (96.9%), having their loved ones around (93.8%), being mentally aware at the last hour (93.8%), and having the sense of being meaningful in life (92.7%). Their 3 most important end-of-life care wishes were receiving the full truth regarding their illness, disclosing the full truth regarding their illness to family members, and passing away at home. Conclusion: In order to optimize the quality of life of terminal patients, end-of-life care should ensure they receive the full truth regarding their illness, experience no distress symptoms, remain mentally aware at the last hour of life, feel meaningful in life, and pass away comfortably with loved ones around.

scholarly journals End-of-life care preferences among cancer patients in Southern Thailand: a university hospital-based cross-sectional survey

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Jarurin Pitanupong ◽  
Sahawit Janmanee
Keyword(s):  
Quality Of Life ◽  
End Of Life ◽  
Cancer Patients ◽  
End Of Life Care ◽  
University Hospital ◽  
Life Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
At Home

Abstract Background End-of-life care preferences may be highly individual, heterogenic, and variable according to culture and belief. This study aimed to explore preferences and factors associated with end-of-life care among Thai cancer patients. Its findings could help optimize the quality of life of palliative cancer patients. Methods A cross-sectional study surveyed palliative cancer outpatients at Songklanagarind Hospital from August to November 2020. The questionnaires inquired about: (1) personal and demographic information, (2) experiences with end-of-life care for their relatives, and (3) end-of-life care preferences. To determine end-of life preferences, the data were analyzed using descriptive statistics. The data concerning patient demographics and end-of-life care preferences were compared using Fisher’s exact test. Results The majority of the 96 palliative cancer outpatients were female (65.6 %), and the overall mean age was 55.8 ± 11.6 years. More than half of them had an experience of observing someone die (68.8 %), and they were predominantly being conscious until the time of death (68.2 %). Most participants preferred receiving the full truth satisfied with the care their relatives had received in passing away at home surrounded by family (47.0 %) and regarding their illness (99.0 %), being free of uncomfortable symptoms (96.9 %), having their loved ones around (93.8 %), being mentally aware at the last hour (93.8 %), and having the sense of being meaningful in life (92.7 %). Their 3 most important end-of-life care wishes were receiving the full truth regarding their illness, disclosing the full truth regarding their illness to family members, and passing away at home. Conclusions In order to optimize the quality of life of palliative cancer patients, end-of-life care should ensure they receive the full truth regarding their illness, experience no distressing symptoms, remain mentally aware at the last hour of life, feel meaningful in life, and pass away comfortably with loved ones around.

scholarly journals Associations between Length of Stay in Long Term Care Facilities and End of Life Care. Analysis of the PACE Cross-Sectional Study

2020 ◽  
Vol 17 (8) ◽  
pp. 2742 ◽  
Author(s):  
Danni Collingridge Moore ◽  
Sheila Payne ◽  
Thomas Keegan ◽  
Luc Deliens ◽  
Tinne Smets ◽  
...  
Keyword(s):  
Quality Of Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Life Care ◽  
Cross Sectional ◽  
Term Care ◽  
Care Facilities

Long term care facilities (LTCFs) are increasingly a place of care at end of life in Europe. Longer residence in an LTCF prior to death has been associated with higher indicators of end of life care; however, the relationship has not been fully explored. The purpose of this analysis is to explore associations between length of stay and end of life care. The analysis used data collected in the Palliative Care for Older People in care and nursing homes in Europe (PACE) study, a cross-sectional mortality follow-back survey of LTCF residents who died within a retrospective 3-month period, conducted in Belgium, England, Finland, Italy, the Netherlands and Poland. Primary outcomes were quality of care in the last month of life, comfort in the last week of life, contact with health services in the last month of life, presence of advance directives and consensus in care. Longer lengths of stay were associated with higher scores of quality of care in the last month of life and comfort in the last week of life. Longer stay residents were more likely to have advance directives in place and have a lasting power of attorney for personal welfare. Further research is needed to explore the underlying reasons for this trend, and how good quality end of life care can be provided to all LTCF residents.

scholarly journals Caregiver evaluation of the quality of end-of-life care (CEQUEL) scale: The caregiver’s perception of patient care near death.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6573-6573
Author(s):  
Philip C Higgins ◽  
Holly Gwen Prigerson
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Convergent Validity ◽  
Risk Indicator ◽  
Life Care ◽  
Trauma Symptoms ◽  
Prospective Longitudinal Study ◽  
Eol Care ◽  
Prospective Longitudinal

6573 Background: End-of-life (EOL) measures are limited in capturing caregiver assessment of the quality of EOL care. None include caregiver perception of patient suffering and prolongation of death. We developed and validated the Caregiver Evaluation of Quality of End-of-Life Care (CEQUEL) scale, a more comprehensive measure of caregiver-perceived quality of EOL care. Methods: Data were derived from Coping with Cancer (CwC), a multisite, prospective, longitudinal study of advanced cancer patients and their caregivers (N=275 dyads). Caregivers were assessed before and after patient deaths. CEQUEL’s factor structure was examined; reliability was evaluated using Cronbach’s α, and convergent validity by the strength of associations between CEQUEL scores and key EOL outcomes. Results: Factor analysis revealed four distinct factors: Prolongation of Death, Perceived Suffering, Shared Decision-Making, and Preparation for the Death. Each item loaded strongly on only a single factor. The 13-item CEQUEL and its subscales showed moderate to acceptable Cronbach’s α (range: 0.52-0.78). 53% of caregivers reported patients suffering more than expected. Higher CEQUEL scores were positively associated with therapeutic alliance (r=.13; p≤.05) and hospice enrollment (z=-2.09; p≤.05), and negatively associated with bereaved caregiver regret (r=-.36, p≤.001) and trauma symptoms (z=-2.06; p≤.05). Conclusions: CEQUEL is a brief, valid measure of quality of EOL care from the caregiver’s perspective. It is the first scale to include perceived suffering and prolongation of death. If validated in future work, it may prove a useful quality indicator for the delivery of EOL care and a risk indicator for poor bereavement adjustment.

scholarly journals Preferences for Advance Directives in Korea

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
So-Sun Kim ◽  
Won-Hee Lee ◽  
JooYoung Cheon ◽  
Jung-Eun Lee ◽  
KiSun Yeo ◽  
...  
Keyword(s):  
End Of Life ◽  
Advance Directives ◽  
End Of Life Care ◽  
Healthcare Providers ◽  
Tube Feeding ◽  
Life Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Korean People ◽  
End Stage

Background. The goal of advance directives is to help patients retain their dignity and autonomy by making their own decisions regarding end-stage medical treatment. The purpose of this study was to examine preferences of advance directives among general population in Korea.Method. A descriptive cross-sectional survey was performed from October 2007 to June 2008 in Seoul, Korea. A total of 336 city-dwelling adults self-administered the questionnaire and returned it via mail. Data analyses were conducted using SPSS 17.0.Results. Subjects reported the need for healthcare providers' detailed explanations and recommendations regarding end-of-life care. When there is no hope of recovery and death is imminent, most subjects did not want to receive cardiopulmonary resuscitation nor an IV or tube feeding. However, most of the subjects wanted pain management care.Conclusions. The present study showed that many Korean people have an interest in advance directives. The results show that the autonomy and dignity of patient have increased in importance. To provide better end-of-life care, there is a need to educate patients on the definition and intent of an advance directive. Additional proactive communication between patients and their caregivers should be educated to healthcare providers.

scholarly journals Are registered nurses ready to take care at the end-of-life: crossectional survey

2020 ◽  
Author(s):  
Aurelija Blazeviciene ◽  
Lina Laurs ◽  
Jamesetta A Newland
Keyword(s):  
Registered Nurses ◽  
End Of Life ◽  
End Of Life Care ◽  
Spiritual Needs ◽  
Life Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Healthcare Settings ◽  
Correlational Design ◽  
Inadequate Knowledge

Abstract Background: End-of-life care is provided in a variety of healthcare settings, not just palliative care hospitals. This is one reason it is very important to assess all the obstacles to end-of-life care and to provide safe and quality services to patients. The main purpose of this study was to examine attitudes faced by registered nurses in providing end-of-life care and to explore obstacles and supportive behaviors for nurses. Methods: A descriptive, correlational design was applied in this study. Cross‐sectional survey of 1320 registered nurses within 7 hospitals in Lithuania. Results: Registered nurses working in the three different profiles emphasized safe and effective care andthe importance of meeting the patient's spiritual needs at the end of life. The main obstacles assigned by nurses caring for patients at the end of life were angry family membersthe inadequate understanding of nursing care by the patient's relatives; family members' inadequate knowledge about the situation and lack of time to talk to patients about their wishes, lack of nursing knowledge to deal with the bereaved patient's family, lack of evaluation of nurses' opinions, and the evasion by physicians to talk about the diagnosis and their over-optimistic view of the situation. Conclusions: Spiritual needs were identified by nurses as the primary needs of patients at the end of life. Family-related obstacles remain one of the main obstacles to end-of-life care. Also, the behavior of physicians and their relationship with nurses remains one of the most sensitive issues in end-of-life care.

scholarly journals Attitudes of registered nurses about the end – of – life care in multi-profile hospitals: a cross sectional survey

2020 ◽  
Author(s):  
Aurelija Blazeviciene ◽  
Lina Laurs ◽  
Jamesetta A Newland
Keyword(s):  
Registered Nurses ◽  
End Of Life ◽  
Family Involvement ◽  
Nursing Care ◽  
End Of Life Care ◽  
Spiritual Needs ◽  
Life Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Healthcare Settings

Abstract Background: End-of-life care is provided in a variety of healthcare settings, not just palliative care hospitals. This is one reason why it is very important to assess all barriers to end-of-life care and to provide safe and quality services to patients. This study was aimed at describing nurses' attitudes in providing end-of-life care and exploring barriers and facilitating behaviors of nurses in multi-profile hospitals in Eastern Europe.Methods: A descriptive, correlational design was applied in this study, using a cross-sectional survey of 1,320 registered nurses within 7 hospitals in Lithuania. Results: Registered nurses working in the three different profiles emphasized safe and effective care and the importance of meeting the patient's spiritual needs at the end of life. The main barriers assigned by nurses caring for patients at the end of life were angry family members, inadequate understanding of nursing care by the patient's relatives; lack of time to talk to patients, lack of nursing knowledge to deal with the bereaved patient's family, lack of evaluation of nurses' opinions, and the evasion by physicians to talk about the diagnosis and their over-optimistic view of the situation. The main facilitating behaviors to improve nursing care were end-of-life training, volunteering, and family involvement.Conclusions: Spiritual needs were identified by nurses as the primary needs of patients at the end of life. Family-related barriers remain one of the main barriers to end-of-life care. Also, the behavior of physicians and their relationship with nurses remains one of the most sensitive issues in end-of-life care.

scholarly journals Competency in End-of-Life Care among ENT – HNS Consultants and Residents: A Multi-Center Study

2008 ◽  
Vol 23 (2) ◽  
pp. 5-13
Author(s):  
Arnelle Y. Quiambao ◽  
Flordelina E. Pio-Gulapan
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Neck Surgery ◽  
Life Care ◽  
Cross Sectional Survey ◽  
Knowledge Domain ◽  
Cross Sectional ◽  
Metro Manila ◽  
Tertiary Hospitals ◽  
Multi Center Study

Objectives: To determine the competency in end of life care of Ear, Nose, Throat – Head and Neck Surgery (ENT-HNS) consultants and residents using the domains of knowledge, skills and attitudes as measures of competency and to identify opportunities for improvement in end of life care education   Method: Design:  Cross- sectional survey Setting:  Five tertiary hospitals in Metro Manila Subjects: 52 ENT-HNS consultants and residents   Results: The majority of the respondents scored low across the knowledge, attitude and skills domains. Majority the respondents (67%) were low in the knowledge domain. More than half of the respondents (58%) demonstrated negative attitudes towards end- of-life care while majority of the respondents (56%) had low skills scores. Similarly, more than half (67%) of the respondents showed low over-all competence in end of life care.   Conclusion: The majority of the respondents scored low across all three domains that were used to measure the competency in end of life care. These findings may suggest a need to strengthen the ENT- HNS practitioners’ education in end-of-life care.   Keywords: end of life care, palliative care, terminal care

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