Table 3. Communication with the health-care team (HCT) and overall impressions: comparison of bereaved relatives' views in the hospice as opposed to the hospitala.
| |
Hospice (1), (n=109) |
Hospital+LCP (2), (n=78) |
Hospital−LCP (3), (n=68) |
|
||||||
|---|---|---|---|---|---|---|---|---|---|---|
| n | % | 95% CI | n | % | 95% CI | n | % | 95% CI | P-valueb | |
|
Did any of the doctors or nurses discuss with you the appropriateness of giving fluids through a ‘drip' in the last 2 days of life? (missing n=13, 5.1%) | ||||||||||
| Yes | 29 | 26.6 | 19.0–35.4 | 22 | 29.3 | 19.1–38.9 | 16 | 25.0 | 14.7–34.6 | NS |
| No | 66 | 60.6 | 51.2–69.4 | 47 | 62.7 | 49.2–70.6 | 46 | 71.9 | 56.0–77.9 | |
| Do not know |
8 |
7.3 |
3.5–13.4 |
6 |
8.0 |
3.3–15.2 |
2 |
3.1 |
0.6–9.1 |
|
|
If no: would these types of discussion have been helpful? (missing n=19, 7.5%) | ||||||||||
| Yes | 20 | 18.3 | 12.0–26.4*,† | 33 | 42.3 | 31.8–53.4 | 33 | 48.5 | 36.9–60.3 | 0.003 |
| No |
35 |
32.1 |
23.9–41.3* |
11 |
14.1 |
7.7–23.1 |
8 |
11.8 |
5.7–21.0 |
|
|
Before she/he died, were you told she/he was likely to die? (missing n=11, 4.3%) | ||||||||||
| Yes | 83 | 76.1 | 67.5–83.4 | 61 | 78.2 | 68.1–86.2 | 46 | 67.6 | 56.0–77.9 | NS |
| No |
20 |
18.5 |
12.0–26.4 |
13 |
16.7 |
9.7–26.1 |
21 |
30.9 |
20.9–42.5 |
|
|
Was it the first time you were aware she/he was dying? (NA response n=43, 19.9% missing n=18, 7.1%) | ||||||||||
| Yes | 10 | 12.2 | 6.4–20.3†,* | 26 | 42.6 | 30.8–55.1 | 17 | 37.0 | 24.1–51.4 | 0.004 |
| No | 66 | 80.5 | 69.9–87.1†,* | 33 | 54.1 | 41.7–66.2 | 25 | 54.3 | 40.1–68.1 | |
| Do not know |
2 |
2.4 |
0.5–7.5 |
0 |
0.0 |
0.0–4.0 |
2 |
2.4 |
0.9–13.2 |
|
|
Did you have enough privacy when you were told? (NA response n=46, 18.0% missing n=16, 6.3%) | ||||||||||
| Yes | 74 | 89.2 | 81.2–94.5 | 49 | 80.3 | 69.1–88.8 | 37 | 80.4 | 67.3–89.9 | NS |
| No | 3 | 3.6 | 1.0–9.3 | 8 | 13.1 | 6.4–23.2 | 7 | 15.2 | 7.1–27.6 | |
| Do not know |
2 |
2.4 |
0.5–7.5 |
2 |
3.3 |
0.7–10.1 |
0 |
0.0 |
0.0–5.3 |
|
|
Were you told in a sensitive manner? (NA response n=46, 18.0% missing n=23, 9.0%) | ||||||||||
| Yes | 75 | 90.4 | 82.6–95.3 | 53 | 86.9 | 76.8–93.6 | 40 | 86.9 | 75.1–94.4 | NS |
| No |
0 |
0.0 |
0.0–3.0 |
4 |
6.6 |
2.3–14.8 |
3 |
6.5 |
1.9–16.4 |
|
|
Did a member of the HCT talk to you about what would happen at the time of his/her death? (missing n=10) | ||||||||||
| Yes | 44 | 40.4 | *31.5–49.7 | 22 | 28.8 | 19.1–38.9 | 11 | 16.2 | 8.9–26.3 | 0.002 |
| No |
61 |
56.0 |
*46.6–65.0 |
52 |
66.7 |
55.8–76.4 |
55 |
80.9 |
70.4–88.8 |
|
|
If no: would this type of discussion have been useful? (NA response n=69, 3.9% missing n=21, 8.2%) | ||||||||||
| Yes | 26 | 23.9 | *16.6–32.5 | 25 | 32.1 | 22.5–42.9** | 42 | 61.8 | 49.9–72.6 | |
| No |
28 |
25.7 |
18.2–34.5 |
24 |
30.8 |
21.4–41.6 |
10 |
14.7 |
7.8–24.5 |
0.001 |
|
How much of the time was she/he treated with dignity and respect by the HCT? (missing n=2, 0.8%) | ||||||||||
| Always | 97 | 89.0 | 82.1–93.8†,* | 45 | 57.7 | 46.6–68.2 | 29 | 42.6 | 31.4–54.4 | <0.0001 |
| Most of the time | 11 | 10.1 | 5.5–16.8†,* | 24 | 30.8 | 21.4–41.6 | 24 | 35.3 | 27.7–47.1 | |
| Some of the time/never | 0 | 0.0 | 0.0–2.3†,* | 8 | 10.3 | 5.0–18.4 | 13 | 19.1 | 11.2–29.6 | |
| Do not know |
0 |
0.0 |
0.0–2.3 |
1 |
1.3 |
0.1–5.8 |
1 |
1.5 |
0.2–6.7 |
|
|
Overall, in your opinion, were you adequately supported by the HCT? (missing n=20, 7.8%) | ||||||||||
| Yes | 95 | 88.0 | 79.9–92.4†,* | 52 | 67.5 | 55.8–76.4 | 35 | 52.2 | 39.7–63.1 | <0.0001 |
| No | 7 | 6.5 | 2.9–12.2†,* | 19 | 24.7 | 15.9–34.7 | 27 | 40.3 | 28.7–51.5 | |
Abbreviations: CI=confidence interval; LCP=Liverpool Care Pathway for the Dying Patient.
a
Confidence intervals with † indicate significant differences between columns 1 and 2; confidence intervals with * indicate significant differences between columns 1 and 3; confidence intervals with ** indicate significant differences between columns 2 and 3; percentages do not always add up to 100% due to missing responses (total number of missing responses stated within table).
b
Comparisons between groups were conducted using χ2 testing and additional testing using the Cochran–Mantel–Haenszel test if question had ordinal response options. Bold values indicate the statistically significant results.