Severely Ill Patients: Some Issues of Palliative Care Organization

Abstract

The objective of the research was to study the opinion of severely ill patients regarding some aspects of providing palliative care to determine the direction of its improvement. Materials and methods. The sociological survey was performed by interviewing 146 severely ill patients treated in different in-patient health care facilities in Ivano-Frankivsk. The calculation of each factor rates per 100 respondents, the standard error of rates, and Chi-Square Test (χ2) for comparing group differences were used for statistical data analysis. Results. Most respondents (66.4%) have been ill for several years. Throughout the year, every tenth patient (10.6%) was hospitalized more than four times. Only 49.4% of patients were admitted to the hospital with the referral from physicians. Every fifth respondent (20.5%) was delivered to the hospital by an ambulance, others (17.9%) -by self-referral. Fewer than half of respondents confirmed that their opinion was considered when choosing a medical facility (42.0%), physician (41.3%), place for care (31.9%) and methods of treatment (23.9%). The level of deontological and legal needs of incurably ill patients was found to be 2-6 times higher than the degree of their satisfaction. Conclusions. High multiplicity of inpatient cases among palliative patients and the importance of improving the criteria and ways of their hospitalization were determined considering the high proportion of their hospitalization by emergency medical services and self-referral. The necessity of developing the standards of palliative care for patients and their families at the level of primary medical care was shown.