Symptom alleviation profiles during the last week of life. A register based quality of end-of-life study

• Aims: To examine symptom alleviation profiles as quality indicators that reflect care and wellbeing of patients during the last week of life and improve understanding of patterns. Methods: A cross-sectional design was chosen using data from the Swedish Palliative Care Registry, a national register for all deaths that contains professionals’ retrospectively-reported data about quality indicators reflecting care and wellbeing of patients during the last week of life. All deceased adults (>18 years) with expected deaths, registered in the register in 2012 and 2013 (approximately 60% of the total death population in Sweden each year) were included. Descriptive statistical analysis of the sample and a preliminary latent class analysis have been performed to identify symptom alleviation profiles, including alleviation of pain, nausea, anxiety, shortness of breath, confusion, and breathing rattles. Analyses of demographic and health-related characteristics predictive of latent class membership are ongoing. Results: 38766 men and 49117 women were included. 65% were 18-59 years of age, 19.0% were 60-79 years of age, and 16.0% were 80-110 years of age. Neoplasms (36.7%), cardiovascular diseases (31.1 %) and dementia (12.4%) were the most common underlying causes of death. Nursing home (39,7%), hospital wards (27,7%), hospice and specialised palliative care in-patient units (11,5%), municipality short-term facilities (8,8%) and specialised palliative home care (6,8%) were the most common locations of care. The most frequent symptoms were pain (70.9%), breathing rattles (52.4%), anxiety (46.1%), confusion (29.0%), and shortness of breath (25.2%). Total symptom relief was reported for 52.4% of patients experiencing pain, 23.7% of those experiencing breathing rattles, 8.5% of those experiencing anxiety, 5.1% experiencing confusion and 9.0% experiencing breathlessness. Preliminary results suggest 5 latent classes that represent unique symptom alleviation profiles, with class sizes ranging from 9% to 33%. Conclusion: Symptom alleviation is a quality indicator for palliative care that is of significant importance to the wellbeing of people during their last week of life. A better understanding of profiles and predictors of symptom alleviation can inform the development of care quality for the purpose of enhanced quality of end-of-life across different diagnoses and locations of care.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Omvårdnad (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Nursing (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Annan medicin och hälsovetenskap -- Övrig annan medicin och hälsovetenskap (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Other Medical and Health Sciences -- Other Medical and Health Sciences not elsewhere specified (hsv//eng)

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