[Advanced knowledge of patient preferences for end-of-life care in national health service hospitals of the Murcia Region].
| Autor: | Franco Tovar B; Unidad de Medicina Preventiva y Salud Pública, Universidad de Murcia, Espinardo, Murcia, España. begoft@gmail.com, da Silva Gama ZA, Saturno Hernández PJ |
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| Jazyk: | Spanish; Castilian |
| Zdroj: | Revista de calidad asistencial : organo de la Sociedad Espanola de Calidad Asistencial [Rev Calid Asist] 2011 May-Jun; Vol. 26 (3), pp. 152-60. Date of Electronic Publication: 2011 Apr 01. |
| DOI: | 10.1016/j.cali.2010.11.013 |
| Abstrakt: | Background and Objective: Provision of unwanted end-of-life care is an adverse event that can be avoided and is regulated by law. One of the Safe Practices recommended by the National Quality Forum (NQF) is "Ensure that patient preferences regarding end-of-life care are known". Our objective is to assess compliance with this recommendation, and the associated socio-professional factors, in the National Health Service hospitals in the Murcia Region (Spain). Methods: Cross-sectional study in 8 hospitals. We measured structure (existence and characteristics of guidelines about advance directives) and process (frequency with which healthcare providers enquire about the preferences of terminally ill patients) indicators, constructed according to the NQF recommendation. The process indicator was measured using a questionnaire distributed to a sample of clinical personnel (n=3141). A descriptive analysis of the results was performed. The association of socio-professional variables with asking patient's preferences (dependent variable) was analysed using multivariate logistic regression. Results: One of the eight assessed hospitals has valid guidelines. Only 12% of professionals (n=607), (95% confidence interval [CI], 9.4-14.6), responded that they always enquire about the preferences of terminally ill patients in their departments. The existence of guidelines is significantly associated with this response (odds ratio [OR]=18.1; 95% CI, 2.28-143.83) and working in surgical departments with a negative response (OR=0.15; 95% CI, 0.04-0.65). Conclusions: There is a very low compliance with the NQF recommendation, evidenced by the lack of guidelines and the low frequency in which terminally ill patients are asked about their preferences for life-sustaining treatment. Implementation of guidelines may help to improve this situation, which is significantly worse in surgical services. (Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.) |
| Databáze: | MEDLINE |
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