Patient-physician communication about end-of-life care for patients with severe COPD

被引:186
作者
Curtis, JR
Engelberg, RA
Nielsen, EL
Au, DH
Patrick, DL
机构
[1] Univ Washington, Harborview Med Ctr, Div Pulm & Crit Care Med, Dept Med,Sch Med, Seattle, WA 98104 USA
[2] Univ Washington, Dept Hlth Serv, Sch Publ Hlth & Community Med, Seattle, WA 98104 USA
[3] Dept Vet Affairs, Hlth Serv Res & Dev, Seattle, WA USA
关键词
chronic obstructive pulmonary disease communication; death; dying; end-of-life care; palliative care;
D O I
10.1183/09031936.04.00010104
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Since patients with chronic obstructive pulmonary disease (COPD) infrequently discuss treatment preferences about end-of-life care with physicians, the goal of the present study was to identify which specific areas of communication about end-of-life care occur between patients with severe COPD and their physicians, and how patients rate the quality of this communication. A total of 115 patients with oxygen-dependent COPD, identified in pulmonary clinics in three hospitals and through an oxygen delivery company, were enrolled in this study. A 17-item quality of communication questionnaire (QOC) was administered to patients, along with other measures, including satisfaction with care. The patients reported that most physicians do not discuss how long the patients have to live, what dying might be like or patients' spirituality. Patients rated physicians highly at listening and answering questions. Areas patients rated relatively low included discussing prognosis, what dying might be like and spirituality/religion. Patients' assessments of physicians' overall communication and communication about treatment correlated well with the QOC. Patients' overall satisfaction with care also correlated significantly with the QOC. In conclusion, this study identifies areas of communication that physicians do not address and areas that patients rate poorly, including talking about prognosis, dying and spirituality. These areas may provide targets for interventions to improve communication about end-of-life care for patients with chronic obstructive pulmonary disease. Future studies should determine the responsiveness of these items to interventions, and the effect such interventions have on patient satisfaction and quality of care.
引用
收藏
页码:200 / 205
页数:6
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