Rights statement: The final, definitive version of this article has been published in the Journal, Palliative Medicine, 32 (10), 2018, © SAGE Publications Ltd, 2018 by SAGE Publications Ltd at the Palliative Medicine page: http://journals.sagepub.com/PMJ on SAGE Journals Online: http://journals.sagepub.com/
Accepted author manuscript, 423 KB, PDF document
Available under license: CC BY-NC: Creative Commons Attribution-NonCommercial 4.0 International License
Final published version
Licence: CC BY-NC: Creative Commons Attribution-NonCommercial 4.0 International License
Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
}
TY - JOUR
T1 - Quality of dying and quality of end-of-life care of nursing home residents in six countries
T2 - an epidemiological study
AU - Pivodic, Lara
AU - Smets, Tinne
AU - Van Den Noortgate, Nele
AU - Onwuteaka-Philipsen, Bregje D
AU - Engels, Yvonne
AU - Szczerbińska, Katarzyna
AU - Finne-Soveri, Harriet
AU - Froggatt, Katherine Alison
AU - Gambassi, Giovanni
AU - Deliens, Luc
AU - Van den Block, Lieve
N1 - The final, definitive version of this article has been published in the Journal, Palliative Medicine, 32 (10), 2018, © SAGE Publications Ltd, 2018 by SAGE Publications Ltd at the Palliative Medicine page: http://journals.sagepub.com/PMJ on SAGE Journals Online: http://journals.sagepub.com/
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Background:Nursing homes are among the most common places of death in many countries. Aim:To determine the quality of dying and end-of-life care of nursing home residents in six European countries.Design:Epidemiological survey in a proportionally stratified random sample of nursing homes. We identified all deaths of residents of the preceding 3-month period. Main outcomes: quality of dying in the last week of life (measured using End-of-Life in Dementia Scales – Comfort Assessment while Dying (EOLD-CAD)); quality of end-of-life care in the last month of life (measured using Quality of Dying in Long-Term Care (QoD-LTC) scale). Higher scores indicate better quality.Setting/participants:Three hundred and twenty-two nursing homes in Belgium, Finland, Italy, the Netherlands, Poland and England. Participants were staff (nurses or care assistants) most involved in each resident’s care.Results:Staff returned questionnaires regarding 1384 (81.6%) of 1696 deceased residents. The End-of-Life in Dementia Scales – Comfort Assessment while Dying mean score (95% confidence interval) (theoretical 14–42) ranged from 29.9 (27.6; 32.2) in Italy to 33.9 (31.5; 36.3) in England. The Quality of Dying in Long-Term Care mean score (95% confidence interval) (theoretical 11–55) ranged from 35.0 (31.8; 38.3) in Italy to 44.1 (40.7; 47.4) in England. A higher End-of-Life in Dementia Scales – Comfort Assessment while Dying score was associated with country (p = 0.027), older age (p = 0.012), length of stay ⩾1 year (p = 0.034), higher functional status (p < 0.001). A higher Quality of Dying in Long-Term Care score was associated with country (p < 0.001), older age (p < 0.001), length of stay ⩾1 year (p < 0.001), higher functional status (p = 0.002), absence of dementia (p = 0.001), death in nursing home (p = 0.033).Conclusion:The quality of dying and quality of end-of-life care in nursing homes in the countries studied are not optimal. This includes countries with high levels of palliative care development in nursing homes such as Belgium, the Netherlands and England.
AB - Background:Nursing homes are among the most common places of death in many countries. Aim:To determine the quality of dying and end-of-life care of nursing home residents in six European countries.Design:Epidemiological survey in a proportionally stratified random sample of nursing homes. We identified all deaths of residents of the preceding 3-month period. Main outcomes: quality of dying in the last week of life (measured using End-of-Life in Dementia Scales – Comfort Assessment while Dying (EOLD-CAD)); quality of end-of-life care in the last month of life (measured using Quality of Dying in Long-Term Care (QoD-LTC) scale). Higher scores indicate better quality.Setting/participants:Three hundred and twenty-two nursing homes in Belgium, Finland, Italy, the Netherlands, Poland and England. Participants were staff (nurses or care assistants) most involved in each resident’s care.Results:Staff returned questionnaires regarding 1384 (81.6%) of 1696 deceased residents. The End-of-Life in Dementia Scales – Comfort Assessment while Dying mean score (95% confidence interval) (theoretical 14–42) ranged from 29.9 (27.6; 32.2) in Italy to 33.9 (31.5; 36.3) in England. The Quality of Dying in Long-Term Care mean score (95% confidence interval) (theoretical 11–55) ranged from 35.0 (31.8; 38.3) in Italy to 44.1 (40.7; 47.4) in England. A higher End-of-Life in Dementia Scales – Comfort Assessment while Dying score was associated with country (p = 0.027), older age (p = 0.012), length of stay ⩾1 year (p = 0.034), higher functional status (p < 0.001). A higher Quality of Dying in Long-Term Care score was associated with country (p < 0.001), older age (p < 0.001), length of stay ⩾1 year (p < 0.001), higher functional status (p = 0.002), absence of dementia (p = 0.001), death in nursing home (p = 0.033).Conclusion:The quality of dying and quality of end-of-life care in nursing homes in the countries studied are not optimal. This includes countries with high levels of palliative care development in nursing homes such as Belgium, the Netherlands and England.
KW - Nursing home
KW - terminal care
KW - palliative care
KW - quality of health care
KW - epidemiologic research design
U2 - 10.1177/0269216318800610
DO - 10.1177/0269216318800610
M3 - Journal article
VL - 32
SP - 1584
EP - 1595
JO - Palliative Medicine
JF - Palliative Medicine
SN - 0269-2163
IS - 10
ER -