Factors affecting quality of end-of-life hospital care - a qualitative analysis of free text comments from the i-CODE survey in Norway

作者：Marit Irene Tuen Hansen, Dagny Faksvåg Haugen, Katrin Ruth Sigurdardottir, Anne Kvikstad, Catriona R Mayland, Margrethe Aase Schaufel, on behalf of the ERANet-LAC CODE project group, Dagny Faksvåg Haugen, Katrin Ruth Sigurdardottir, Marit Irene Tuen Hansen, Karl Ove Hufthammer, Wojciech Leppert, Katarzyna Wolszczak, Eduardo García Yanneo, Vilma Tripodoro, Gabriel Goldraij, Martin R. Weber, Christina Gerlach, Lair Zambon, Juliana Nalin Passarini, Ivete Bredda Saad, John Ellershaw, Grace Ting, Catriona R Mayland, Anne Kvikstad, Eva Gravdahl, Julia Bratke, Janet Bakken, Kristin Vassbotn Guldhav · 发表于：BMC Palliative Care · 年份：2020 · DOI：10.1186/s12904-020-00609-x · 被引用次数：14 · 研究领域：Palliative Care and End-of-Life Issues、Patient Dignity and Privacy、Cancer survivorship and care

BACKGROUND: The ERANet-LAC CODE (Care Of the Dying Evaluation) international survey assessed quality of care for dying cancer patients in seven countries, by use of the i-CODE questionnaire completed by bereaved relatives. The aim of this sub study was to explore which factors improve or reduce quality of end-of-life (EOL) care from Norwegian relatives' point of view, as expressed in free text comments. METHODS: 194 relatives of cancer patients dying in seven Norwegian hospitals completed the i-CODE questionnaire 6-8 weeks after bereavement; recruitment period 14 months; response rate 58%. Responders were similar to non-responders in terms of demographic details.104 participants (58% spouse/partner) added free text comments, which were analyzed by systematic text condensation. RESULTS: Of the 104 comments, 45% contained negative descriptions, 27% positive and 23% mixed. 78% described previous experiences, whereas 22% alluded to the last 2 days of life. 64% of the comments represented medical/surgical/oncological wards and 36% palliative care units. Four main categories were developed from the free text comments: 1) Participants described how attentive care towards the practical needs of patients and relatives promoted dignity at the end of life, which could easily be lost when this awareness was missing. 2) They experienced that lack of staff, care continuity, professional competence or healthcare service coordination caused uncertainty and poor symptom alleviation. 3) Inadeq...