Perception of the Quality of Communication With Physicians Among Relatives of Dying Residents of Long-term Care Facilities in 6 European Countries: PACE Cross-Sectional Study

Ilona Barańska, Violetta Kijowska, Yvonne Engels, Harriet Finne-Soveri, Katherine Froggatt, Giovanni Gambassi, Teija Hammar, Mariska Oosterveld-Vlug, Sheila Payne, Nele van den Noortgate, Tinne Smets, Luc Deliens, Lieve van den Block, Katarzyna Szczerbińska, Eddy Adang, Paula Andreasen, Danni Collingridge Moore, Hein van Hout, Maud ten Koppel, Federica MammarellaMartina Mercuri, Bregje D. Onwuteaka-Philipsen, Lara Pivodic, Paola Rossi, Eleanor Sowerby, Agata Stodolska, Anne Wichmann, Jenny T. van der Steen, Myrra Vernooij-Dassen, the European Association for Palliative Care Onlus, European Forum for Primary Care, Age Platform Europe, Alzheimer Europe

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Abstract

Objective: To examine how relatives evaluate the quality of communication with the treating physician of a dying resident in long-term care facilities (LTCFs) and to assess its differences between countries. Design: A cross-sectional retrospective study in a representative sample of LTCFs conducted in 2015. Relatives of residents who died during the previous 3 months were sent a questionnaire. Settings and participants: 761 relatives of deceased residents in 241 LTCFs in Belgium, England, Finland, Italy, the Netherlands, and Poland. Methods: The Family Perception of Physician-Family Communication (FPPFC) scale (ratings from 0 to 3, where 3 means the highest quality) was used to retrospectively assess how the quality of end-of-life communication with treating physicians was perceived by relatives. We applied multilevel linear and logistic regression models to assess differences between countries and LTCF types. Results: The FPPFC score was the lowest in Finland (1.4 ± 0.8) and the highest in Italy (2.2 ± 0.7). In LTCFs served by general practitioners, the FPPFC score differed between countries, but did not in LTCFs with on-site physicians. Most relatives reported that they were well informed about a resident's general condition (from 50.8% in Finland to 90.6% in Italy) and felt listened to (from 53.1% in Finland to 84.9% in Italy) and understood by the physician (from 56.7% in Finland to 85.8% in Italy). In most countries, relatives assessed the worst communication as being about the resident's wishes for medical treatment at the end of life, with the lowest rate of satisfied relatives in Finland (37.6%). Conclusion: The relatives' perception of the quality of end-of-life communication with physicians differs between countries. However, in all countries, physicians' communication needs to be improved, especially regarding resident's wishes for medical care at the end of life. Implications: Training in end-of-life communication to physicians providing care for LTCF residents is recommended.
Original languageEnglish
JournalJournal of the American Medical Directors Association
DOIs
Publication statusPublished - 1 Jan 2019

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