Quality of Care and Satisfaction With Care on Palliative Care Units

详细信息    查看全文

• 作者：Kirsten Wentlandt ; PhD ; MHSci ; MD^a ; ^b ; Dori Seccareccia ; MD ; MClSc^b ; ^c ; Nanor Kevork ; BSc^a ; Kevin Workentin ; MD^b ; ^d ; Susan Blacker ; MSW^e ; Daphna Grossman ; MD^b ; ^f ; Camilla Zimmermann ; MD ; PhD^a ; ^g ; ^h ; ^{camilla.zimmermann@uhn.on.ca" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Palliative care unit ; satisfaction with care ; quality of care ; inpatient ; caregiver ; focus group ; qualitative
• 刊名：Journal of Pain and Symptom Management
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：51
• 期：2
• 页码：184-192
• 全文大小：140 K

文摘

There is little research on quality of care specific to palliative care units (PCUs).

Objectives

To delineate important aspects of satisfaction with care and quality of care on a PCU, as described by inpatients, family caregivers, and health care professionals.

Methods

Qualitative interviews and focus groups were conducted across four Toronto PCUs, with a total of 46 patient/caregiver interviews and eight staff focus groups. Interviews and focus groups were semistructured to elicit comments about satisfaction with care and quality of care for inpatients and families on a PCU. Data were analyzed using a grounded theory method, with an inductive, constant comparison approach to identify themes, and were coded to saturation.

Results

Key elements of quality care and patient satisfaction on a PCU were grouped into six domains: 1) interprofessional team: a team of experts comprising multiple disciplines functioning as a unit; 2) communication: developing rapport, addressing expectations, providing information, listening actively, and facilitating end-of-life discussions; 3) attentive, personalized care: anticipatory and responsive compassionate care with tailored management of physical and nonphysical symptoms; 4) family-centered: support of patients and caregivers within a family; 5) accessible and consistent: appropriate resources and adequate staff to provide consistent care; and 6) supportive setting: a bright noninstitutionalized setting allowing both privacy and socialization.

Conclusion

The elements identified support the delivery of quality care. They may act as a guide for those planning to develop PCUs and form the basis for measures of satisfaction with care.