Making the End Easier

Asking terminally ill their opinions improves palliative care in hospital

MONDAY, May 24, 2004 (HealthDayNews) -- Asking the opinions of dying hospital patients and their families on how to improve end-of-life medical care could improve the final months and weeks of life for those who are terminally ill.

That observation appears in a new study by researchers at the Joint Centre for Bioethics at the University of Toronto.

The study, in the May 24 issue of BMC Palliative Care, found that when hospitals focus on issues that are deemed important by dying patients and their families, there's a significant improvement in how those patients perceive the care they receive.

Researchers assessed how the perceptions of care changed among 36 seriously ill patients after a medical resident was assigned to ask them about their concerns and to relay that information to the doctors and nurses treating the patients.

In initial interviews, more than a quarter of the patients rated their care as "good", "fair" or "poor," while 72 percent reported their care as "very good" or "excellent."

The patients and their families identified a number of areas that needed improvement, including: better control of pain and shortness of breath; better access to doctors and medical information; more help with daily activities; shorter waits for nursing care, diagnosis and treatment; and improved patient environment.

Follow-up interviews were conducted after the medical resident was assigned to relay patient concerns to the treatment staff. Those interviews found that 32 percent of the patients said their overall care was better, 44 percent said their symptom control was better, and 40 percent said they received better support from hospital medical staff.

"The moral of this study -- insert into the busy world of medicine a process to systematically listen to dying patients and their families and act on their concerns. The care -- and the perception of care -- gets better. It may not be rocket science, but it seems to make a difference," Dr. Peter Singer, director of the Joint Centre for Bioethics, said in a prepared statement.

More information

The U.S. National Cancer Institute has more about end-of-life care.

SOURCE: University of Toronto, news release, May 24, 2004
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