Factors Associated with Perception of the Quality of Physicians' End-of-life Communication in Long-Term Care Facilities: PACE Cross-Sectional Study |
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| Institution: | 1. Unit for Research on Aging Society, Department of Sociology, Chair of Epidemiology and Preventive Medicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland;2. Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland;3. Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, the Netherlands;4. National Institute for Health and Welfare, Helsinki, Finland;5. Division of Health Research, Lancaster University, Lancaster, UK;6. Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy;7. Università Cattolica del Sacro Cuore, Rome, Italy;8. Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands;9. Department of Geriatric Medicine, Ghent University Hospital, Ghent, Belgium;10. Department of Family Medicine and Chronic Care, End-of- Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium;1. Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong;2. FrieslandCampina, LE Amersfoort, the Netherlands;3. Wageningen University, Division of Human Nutrition and Health, Wageningen, the Netherlands;1. Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Belgium;2. Institute of Health and Society, Université Catholique de Louvain, Belgium;3. Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom;1. Department of Cardiology, University Hospital Alvaro Cunqueiro, Vigo, Spain;2. Department of Cardiology, University Hospital of Leon, Spain;3. Department of Cardiology, University Hospital Juan Ramón Jiménez, Huelva, Spain;4. Department of Geriatric Medicine, University Hospital Alvaro Cunqueiro, Vigo, Spain;5. Directive Staff, University Hospital, Orense, Spain;6. Hospital Admission Department, University Hospital Alvaro Cunqueiro, Vigo, Spain;1. Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Jiangsu, China;2. The Second Clinical Medical School, Nanjing University of Chinese Medicine, Jiangsu, China;3. The Teaching and Research Department of Statistics, Nanjing Medical University, Jiangsu, China;4. Rehabilitation Center, The Second Affiliated Hospital of HaiNan Medical University, Hainan, China;5. The Rehabilitation Department, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Henan, China;6. The Acupuncture Rehabilitation Department, Jiangsu Province Hospital of Traditional Chinese Medicine, Jiangsu, China;7. Rehabilitation Center, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Heilongjiang, China;8. The Rehabilitation Department, Guangdong Provincial Traditional Chinese Medicine Hospital, Guangdong, China;9. The Rehabilitation Department, Tongji Medical College Huazhong University of Science & Technology, Hubei, China;10. The Neurological Rehabilitation Department, Shanghai University of Traditional Chinese Medicine, Shanghai, China;11. Rehabilitation Center, Xuzhou Central Hospital, Jiangsu, China;12. The Rehabilitation Department, The Affiliated Hospital of Xuzhou Medical University, Jiangsu, China;13. The Rehabilitation Department, Tianjin Medical University General Hospital, Tianjin, China;14. The Neurology Department, Nanjing Hospital of Traditional Chinese Medicine, Jiangsu, China;15. The Rehabilitation Department, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Hubei, China;p. The Rehabilitation Department, Dongguan Kanghua Hospital, Guangdong, China;q. School of Basic Medical Sciences, Nanjing Medical University, Jiangsu, China |
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| Abstract: | ObjectiveTo examine factors associated with perceived quality of communication with physicians by relatives of dying residents of long-term care facilities (LTCFs).DesignA cross-sectional retrospective study in a representative sample of LTCFs conducted in 2015. In each LTCF, deaths of residents during the 3 months before the researcher's visit were reported. Structured questionnaires were sent to the identified relatives of deceased residents.Settings and participantsA total of 736 relatives of deceased residents in 210 LTCFs (in Belgium, Finland, Italy, the Netherlands, and Poland).MethodsThe Family Perception of Physician-Family Communication scale (FPPFC) was used to assess the quality of end-of-life (EOL) communication with physicians as perceived by relatives. We applied multilevel linear regression models to find factors associated with the FPPFC score.ResultsThe quality of EOL communication with physicians was perceived by relatives as higher when the relative spent more than 14 hours with the resident in the last week of the resident's life (b = 0.205; P = .044), and when the treating physician visited the resident at least 3 times in the last week of the resident's life (b = 0.286; P = .002) or provided the resident with palliative care (b = 0.223; P = .003). Relatives with higher emotional burden perceived the quality of EOL communication with physicians as lower (b = ?0.060; P < .001). These results had been adjusted to countries and LTCF types with physicians employed on-site or off-site of the facility.ConclusionThe quality of EOL communication with physicians, as perceived by relatives of dying LTCF residents, is associated with the number of physician visits and amount of time spent by the relative with the resident in the last week of the resident's life, and relatives' emotional burden.ImplicationsLTCF managers should organize care for dying residents in a way that enables frequent interactions between physicians and relatives, and emotional support to relatives to improve their satisfaction with EOL communication. |
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| Keywords: | Quality of communication end-of-life care long-term care facility physician relative |
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