Patient choice regarding place of death

Pearse, Herman E.; Saxby, Carina; Hicks, Fiona; Kite, Suzanne

doi:10.1177/026921630501900221

Cited by 7 publications

(6 citation statements)

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“…home death is fulfilled. Public preference for home death has been widely reported (40)(41)(42)(43)(44)(45), with home death rates constituting one indicator of the quality of palliative care (46)(47)(48)(49). A lack of available physical resources in these rural areas also compromised the ability of providers to offer effective palliative care.…”

Section: Inadequate Physical Resourcesmentioning

confidence: 99%

Using A Quality Framework to Assess Rural Palliative Care

Goodridge

Duggleby

2010

J Palliat Care

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Introduction: High-quality palliative care may remain out of reach for rural people who are dying. The purpose of this study was to explore the opportunities and issues affecting the provision of high-quality palliative care from the perspective of nurses employed in two rural health regions. Method: Using an interpretive descriptive design, focus groups and in-depth individual interviews of 44 nurses were conducted. Results: Descriptions of challenges and opportunities fell into three themes: effectiveness and safety, patient-cen-tredness, and efficiency and timeliness. Patient-cen-tredness was seen as a major strength of rural palliative care. Major challenges included provision of adequate symptom management and support of home deaths. The scarcity of health human resources and the negative impact these shortages had on all dimensions of palliative care quality consistently underpinned the discussions. Conclusion: Implementing outcome measurements related to symptom management and home deaths may be a critical foundation for enhancing the quality of rural palliative care.

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Section: Inadequate Physical Resourcesmentioning

confidence: 99%

Using A Quality Framework to Assess Rural Palliative Care

Goodridge

Duggleby

2010

J Palliat Care

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“…12,13,29 Overall, the number of patients dying in their place of choice in Belgium is quite high compared with other studies, in which percentages between 30% and 94% are found, depending on the methodology used. 12,13,[30][31][32][33][34][35][36][37][38] Since congruence could only be measured for those patients whom GPs were informed about, it can be assumed that the high congruence found in the present study is probably an overestimation. The fact that patients died in hospital more often when GPs were not informed (58% as opposed to 16% where GPs were informed) confirms this hypothesis.…”

Section: Original Papers Original Papersmentioning

confidence: 99%

GPs' awareness of patients' preference for place of death

Meeussen

Block²,

Bossuyt³

et al. 2009

Br J Gen Pract

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BackgroundBeing able to die in one's place of choice is an indicator of the quality of end-of-life care. GPs may play a key role in exploring and honouring patients' preferences for place of death. AimTo examine how often GPs are informed about patients' preferred place of death, by whom and for which patients, and to study the expressed preferred place of death and how often patients die at their preferred place. Design of studyOne-year nationwide mortality retrospective study. SettingSentinel Network of GPs in Belgium, 2006. MethodGPs' weekly registration of all deaths (patients aged ≥1 year). ResultsA total of 798 non-sudden deaths were reported. GPs were informed of patients' preferred place of death in 46% of cases. GPs obtained this information directly from patients in 63%. GP awareness was positively associated with patients not being hospitalised in the last 3 months of life (odds ratio [OR] = 3.9; 95% confidence interval [CI] = 2.8 to 5.6), involvement of informal caregivers (OR = 3.3; 95% CI = 1.8 to 6.1), use of a multidisciplinary palliative care team (OR = 2.5; 95% CI = 1.8 to 3.5), and with presence of more than seven contacts between GP and patient or family in the last 3 months of life (OR = 3.0; 95% CI = 2.2 to 4.3). In instances where GPs were informed, more than half of patients (58%) preferred to die at home. Overall, 80% of patients died at their preferred place. ConclusionGPs are often unaware of their patients' preference for place of death. However, if GPs are informed, patients often die at their preferred location. Several healthcare characteristics might contribute to this and to a higher level of GP awareness. Keywordsadvance care planning; end-of-life care; general practitioner; palliative care; preferred place of death; terminal care.

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“…3 It has been found that many patients and their families learn about palliative care services from someone other than their physician, and most learn about valuable features of the service after they have enrolled. 4 Patients who had been newly referred to the SPCS based at St Raphael's Hospice were asked to complete a short questionnaire before their first visit from the community palliative care team (CPCT). The questionnaire sought to identify whether patients knew that they had been referred to SPCS, whether they were aware that the specialist palliative care team (SPCT) is based at the hospice, and whether they felt that they had been given enough information to consent to their referral.…”

mentioning

confidence: 99%

Letters to the editor: Patients' perceptions of palliative care: a pilot study

Parker¹

2007

Palliat Med

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Patient choice regarding place of death

Cited by 7 publications

References 1 publication

Using A Quality Framework to Assess Rural Palliative Care

Using A Quality Framework to Assess Rural Palliative Care

GPs' awareness of patients' preference for place of death

Letters to the editor: Patients' perceptions of palliative care: a pilot study

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