TY - JOUR
T1 - Factors Associated with Perception of the Quality of Physicians' End-of-life Communication in Long-Term Care Facilities: PACE Cross-Sectional Study
AU - The European Association For Palliative Care Onlus
AU - European Forum For Primary Care
AU - Age Platform Europe
AU - Alzheimer Europe
AU - Barańska, Ilona
AU - Kijowska, Violetta
AU - Engels, Yvonne
AU - Finne-Soveri, Harriet
AU - Froggatt, Katherine
AU - Gambassi, Giovanni
AU - Hammar, Teija
AU - Oosterveld-Vlug, Mariska
AU - Payne, Sheila
AU - van den Noortgate, Nele
AU - Smets, Tinne
AU - Deliens, Luc
AU - van den Block, Lieve
AU - Szczerbińska, Katarzyna
AU - Adang, Eddy
AU - Andreasen, Paula
AU - Collingridge Moore, Danni
AU - van Hout, Hein
AU - ten Koppel, Maud
AU - Mammarella, Federica
AU - Mercuri, Martina
AU - Onwuteaka-Philipsen, Bregje D.
AU - Pivodic, Lara
AU - Rossi, Paola
AU - Sowerby, Eleanor
AU - Stodolska, Agata
AU - Wichmann, Anne
AU - van der Steen, Jenny T.
AU - Vernooij-Dassen, Myrra
N1 - Funding Information: This work was supported by the European Union's Seventh Framework Programme ( FP7/2007e2013 ) under grant agreement 603111 (PACE project Palliative Care for Older People). The project was co-funded by the Polish Ministry of Science and Higher Education in 2014–2019 based on the decision no. 3202/7PR/2014/2 dated November 25, 2014. The benefactors had no role in study design, collection, analysis, or interpretation of the data, nor in writing and the decision to submit this article for publication. Funding Information: This work was supported by the European Union's Seventh Framework Programme (FP7/2007e2013) under grant agreement 603111 (PACE project Palliative Care for Older People). The project was co-funded by the Polish Ministry of Science and Higher Education in 2014?2019 based on the decision no. 3202/7PR/2014/2 dated November 25, 2014. The benefactors had no role in study design, collection, analysis, or interpretation of the data, nor in writing and the decision to submit this article for publication. The authors thank all long-term care facilities and their staff for participating in this project. The authors also thank other PACE collaborators not in the author list: Eddy Adang, Paula Andreasen, Danni Collingridge Moore, Hein van Hout, Maud ten Koppel, Federica Mammarella, Martina Mercuri, Bregje D Onwuteaka-Philipsen, Lara Pivodic, Paola Rossi, Eleanor Sowerby, Agata Stodolska, Anne Wichmann, Jenny T. van der Steen, Myrra Vernooij-Dassen, and the European Association for Palliative Care Onlus, European Forum for Primary Care, Age Platform Europe and Alzheimer Europe. Author Contributions: Study concept and design: all authors involved. Acquisition of data: Ilona Bara?ska, Violetta Kijowska, Yvonne Engels, Harriet Finne-Soveri, Katherine Froggatt, Giovanni Gambassi, Mariska Oosterveld-Vlug, Nele Van Den Noortgate, Tinne Smets. Data analysis plan developed by Ilona Bara?ska and Katarzyna Szczerbi?ska. Statistical analysis conducted by Ilona Bara?ska. Ilona Bara?ska drafted the manuscript under the supervision of Katarzyna Szczerbi?ska. All authors made substantial contribution to interpretation of data and several critical revisions of the manuscript. Publisher Copyright: © 2019 AMDA – The Society for Post-Acute and Long-Term Care Medicine Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Objective: To examine factors associated with perceived quality of communication with physicians by relatives of dying residents of long-term care facilities (LTCFs). Design: A 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 participants: A total of 736 relatives of deceased residents in 210 LTCFs (in Belgium, Finland, Italy, the Netherlands, and Poland). Methods: The 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. Results: The 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. Conclusion: The 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. Implications: LTCF 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.
AB - Objective: To examine factors associated with perceived quality of communication with physicians by relatives of dying residents of long-term care facilities (LTCFs). Design: A 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 participants: A total of 736 relatives of deceased residents in 210 LTCFs (in Belgium, Finland, Italy, the Netherlands, and Poland). Methods: The 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. Results: The 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. Conclusion: The 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. Implications: LTCF 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.
KW - Quality of communication
KW - end-of-life care
KW - long-term care facility
KW - physician
KW - relative
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85072016724&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31521539
U2 - https://doi.org/10.1016/j.jamda.2019.07.018
DO - https://doi.org/10.1016/j.jamda.2019.07.018
M3 - Article
C2 - 31521539
SN - 1525-8610
VL - 21
SP - 439.e1-439.e8
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 3
ER -