RT Journal Article
SR Electronic
T1 Defining priorities for improving end-of-life care in Canada
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP E747
OP E752
DO 10.1503/cmaj.100131
VO 182
IS 16
A1 Daren K. Heyland
A1 Deborah J. Cook
A1 Graeme M. Rocker
A1 Peter M. Dodek
A1 Demetrios J. Kutsogiannis
A1 Yoanna Skrobik
A1 Xuran Jiang
A1 Andrew G. Day
A1 S. Robin Cohen
A1 for the Canadian Researchers at the End of Life Network (CARENET)
YR 2010
UL http://www.cmaj.ca/content/182/16/E747.abstract
AB Background: High-quality end-of-life care should be the right of every Canadian. The objective of this study was to identify aspects of end-of-life care that are high in priority as targets for improvement using feedback elicited from patients and their families. Methods: We conducted a multicentre, cross-sectional survey involving patients with advanced, life-limiting illnesses and their family caregivers. We administered the Canadian Health Care Evaluation Project (CANHELP) questionnaire along with a global rating question to measure satisfaction with end-of-life care. We derived the relative importance of individual questions on the CANHELP questionnaire from their association with a global rating of satisfaction, as determined using Pearson correlation coefficients. To determine high-priority issues, we identified questions that had scores indicating high importance and low satisfaction. Results: We approached 471 patients and 255 family members, of whom 363 patients and 193 family members participated, with response rates of 77% for patients and 76% for families. From the perspective of patients, high-priority areas needing improvement were related to feelings of peace, to assessment and treatment of emotional problems, to physician availability and to satisfaction that the physician took a personal interest in them, communicated clearly and consistently, and listened. From the perspective of family members, similar areas were identified as high in priority, along with the additional areas of timely information about the patient’s condition and discussions with the doctor about final location of care and use of end-of-life technology. Interpretation: End-of-life care in Canada may be improved for patients and their families by providing better psychological and spiritual support, better planning of care and enhanced relationships with physicians, especially in aspects related to communication and decision-making.