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Cited by 140Palliative Care and End-of-Life IssuesPalliative and Oncologic CarePain Management and Opioid Use

Defining priorities for improving end-of-life care in Canada

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Heyland, D. K., Cook, D. J., Rocker, G. M., Dodek, P. M., Kutsogiannis, D. J., Skrobik, Y., Jiang, X., Day, A. G. +2 more·2010·Canadian Medical Association Journal
DOI 10.1503/cmaj.100131PMC PMC2972350
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Abstract

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.

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  • Communication and decision-making about the goals of care are identified by seriously ill hospitalized patients and their families as important targets for improvement, if the quality of EOL care is to be enhanced.

    “Communication and decision-making about the goals of care are identified by seriously ill hospitalized patients and their families as important targets for improvement, if the quality of EOL care is to be enhanced [2].”

    From A systematic review of the effects of advance care planning facilitators training programs. (2019) · cites this paper as [2]

    The Interpretation and Conclusion (pages not provided) identify communication, decision-making, and planning of end-of-life care as priorities for improvement from patients’ and families’ perspectives. However, the Participants section says the survey recruited from inpatient, outpatient, and home-care settings; the reported priorities are not specific to hospitalized patients and their families. (LLM, conf=0.86)

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Research works printed but not linked: 1

  1. [12]12. Heyland DK, Cohen R, Skrobik Y, et al. Content validity and acceptability of "CANHELP" satisfaction instruments for French speaking patients with end-stage medical disease or metastatic cancer. J Palliat Care 2006;22:153.

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Authors
Heyland, D. K., Cook, D. J., Rocker, G. M., Dodek, P. M., Kutsogiannis, D. J., Skrobik, Y., Jiang, X., Day, A. G., Cohen, S. R., & for the Canadian Researchers at the End of Life Network (CARENET)
Affiliations
  • Kingston General Hospital (CA)
  • University of British Columbia (CA)
ORCID
Venue
Canadian Medical Association Journal
Publisher
CMA Impact Inc.
Published
2010-10-04
Volume
182
Issue
16
Pages
E747-E752
ISSN
  • 0820-3946 (ISSN-L)
  • 1488-2329
DOI
10.1503/cmaj.100131
PMC
PMC2972350
OpenAlex
W2087463149
Cited by
140
References
27
Citations by year
2025: 2 · 2024: 5 · 2023: 6 · 2022: 6 · 2021: 11 · 2020: 13 · 2019: 13 · 2018: 9 · 2017: 8 · 2016: 10 · 2015: 17 · 2014: 12 · 2013: 12 · 2012: 12
FWCI
8.91
Type
journal article
Language
en
Open access
Locations
  • Canadian Medical Association Journal (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Heart and Stroke Foundation of Canada
  • Canadian Institutes of Health Research
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
end-of-life care, patient satisfaction, family caregivers, patient priorities, physician-patient communication, advance care planning, physician availability, palliative care
MeSH terms
Aged, Aged, 80 and over, Attitude to Death, Canada, Cross-Sectional Studies, Female, Humans, Male, Palliative Care, Professional-Family Relations, Quality of Life, Surveys and Questionnaires, Terminal Care, Caregivers, Hospice Care, Patient Satisfaction, Total Quality Management, Terminally Ill, Patient Preference

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