Palliative and End-of-Life Care in a Small Caribbean Country: A Mortality Follow-back Study of Home Deaths
| Autor: | Kenneth Chambaere, Luc Deliens, Joachim Cohen, Cheryl C. Macpherson, Nicholas Paul Jennings, Stacey Chamely |
|---|---|
| Přispěvatelé: | Faculty of Medicine and Pharmacy, End-of-life Care Research Group, Family Medicine and Chronic Care |
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Palliative care Declaration Developing country Context (language use) 03 medical and health sciences 0302 clinical medicine medicine Humans 030212 general & internal medicine General Nursing Service (business) Response rate (survey) Terminal Care business.industry Palliative Care Retrospective cohort study Home Care Services Anesthesiology and Pain Medicine Hospice Care Caregivers Caribbean Region 030220 oncology & carcinogenesis Family medicine Neurology (clinical) business End-of-life care |
| Zdroj: | Journal of pain and symptom management. 60(6) |
| ISSN: | 1873-6513 |
| Popis: | Context Empirical information on circumstances of dying from advanced illness in developing countries remains sparse. Evidence indicates that out-of-hospital end-of-life care can have significant benefits such as increased satisfaction for the patient and caregivers and cost-effective for a health-care system. Services that are aimed to deliver care at private homes may be a good model for low- and middle-income countries or other low-resourced settings. Objectives To examine specialized, generalist, and informal palliative care provision and to describe the end-of-life care goals and treatments received. Method A mortality follow-back study with data obtained from general practitioners certifying a random sample of death certificates of adult decedents who died between March and August 2018. The questionnaire inquired about the characteristics of care and treatment preceding death. Results Three hundred nine questionnaires were mailed, and the response rate was 31% (N = 96), of which 76% were nonsudden deaths. Of these cases, 27.4% received no palliative care, 39.7% received it from a general practitioner, and 6.8% from a specialized palliative care service. Comfort maximization (60.3%) was the main goal of care in the last week of life, and analgesics (53.4%) were the predominant treatment for achieving this goal. In addition, 60.3% received informal palliative care from a family member. Conclusion The largest part of end-of-life care at home in Trinidad and Tobago is provided by family members, whereas professional caregivers feature less prominently. To ensure quality in end-of-life care, better access to analgesics is needed, and adequate support and education for family members as well as general practitioners are highly recommended. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect