Factors affecting quality of end-of-life hospital care - a qualitative analysis of free text comments from the i-CODE survey in Norway

• DOI: 10.1186/s12904-020-00609-x
• Publication Date: 2020-07-07T16:04:07Z
• Authors: Marit Irene Tuen ...; Dagny Faksvåg Haugen; Katrin Ruth Sigur...; Anne Kvikstad; Catriona R. Mayland; Margrethe Aase Sc...; ; Dagny Faksvåg Haugen; Katrin Ruth Sigur...; Marit Irene Tuen ...; Karl Ove Hufthammer; Wojciech Leppert; Katarzyna Wolszczak; Eduardo Garcia Ya...; Vilma Tripodoro; Gabriel Goldraij; Martin Weber; Christina Gerlach; Lair Zambon; Juliana Nalin Pas...; Ivete Bredda Saad; John Ellershaw; Grace Ting; Catriona Mayland; Anne Kvikstad; Eva Gravdahl; Julia Bratke; Janet Bakken; Kristin Vassbotn ...
• Keywords: Pain medicine; End-of-Life Care; Code (set theory); Qualitative analysis

Abstract Background The ERANet-LAC CODE (Care Of the Dying Evaluation) international survey assessed quality of care for dying cancer patients in seven countries, by use i-CODE questionnaire completed bereaved relatives. aim this sub study was to explore which factors improve or reduce end-of-life (EOL) from Norwegian relatives’ point view, as expressed free text comments. Methods 194 relatives hospitals 6–8 weeks after bereavement; recruitment period 14 months; response rate 58%. Responders were similar non-responders terms demographic details.104 participants (58% spouse/partner) added comments, analyzed systematic condensation. Results 104 45% contained negative descriptions, 27% positive and 23% mixed. 78% described previous experiences, whereas 22% alluded last 2 days life. 64% comments represented medical/surgical/oncological wards 36% palliative units. Four main categories developed comments: 1) Participants how attentive towards practical needs promoted dignity at end life, could easily be lost when awareness missing. 2) They experienced that lack staff, continuity, professional competence healthcare service coordination caused uncertainty poor symptom alleviation. 3) Inadequate information patient family members generated unpredictable distressing final illness trajectories. 4) Availability support providers created safety enhanced coping a difficult situation. Conclusions Our findings suggest caring life their relatives, should systematically identify attend needs, well address important organizational issues. Education staff ought emphasize conduct communication fundamentally affect coping.