Original Title: Estudio de satisfacción y de identificación de factores de la atención hospitalaria que los familiares de personas fallecidas consideran importantes en la fase final de la vida

Authors' objectives: The aim of this study was to determine the importance for the family members of patients at the end of their lives of different aspects of the attention received, as well as their level of satisfaction, in three short stay hospitals and three medium and long stay hospitals in the Basque Country.

Authors' results and conclusions: A 54.1% response rate was obtained (555 questionnaires). Families showed a preference for two aspects relating to the direct care provided to the hospitalised person (speed of response from health personnel, and relief of symptoms). The possibility of receiving spiritual support and of maintaining contact with the hospital after the death came last on the list of preferences. Facilities to accompany the patient and the inclusion of the family in decision-making activities were also considered to be very important. Nevertheless, they gave less importance to the patient receiving information in order to take part in decision-making processes. Differences between types of hospital were only found in the importance given to spiritual support, which was greater in medium and long stay hospitals. Treatment, friendliness and the respect received obtained the highest levels of satisfaction, followed by the availability of nursing staff for the family, the relief of pain in the patient, and the response of hospital staff. At the opposite end came referrals to specialists, information on secondary effects, facilities to accompany the family in hospital and the time required to make the diagnosis. In 18 out of 23 questions, the degree of satisfaction was lower in short-stay hospitals.

Authors' recommendations: A high degree of satisfaction was obtained in those factors considered by families to be priority issues. These were the speed of response from health personnel and the relief of symptoms. However, the importance given to facilities for accompanying the patient did not correspond to the level of satisfaction. This discrepancy pointed to this aspect as a possible area for improvement in planning structural resources. The availability of medical personnel in short stay hospitals also represents an area for improvement, as well as support at the time of death. The drop in waiting times for the performance of diagnoses is a request repeated time and time again by many families and this issue obtained one of the lowest levels of satisfaction, another crucial area for improvement in our health system. It would be recommendable to provide the time required to improve communications with the family and the patient. Likewise, family-oriented structural resources should be increased (rooms, bathrooms, etc.). Also, the appropriate physical spaces should be provided to receive information to allow the family to take part in decision-making processes and to provide an atmosphere of intimacy. It would also be recommendable to draw up protocols for action at the time of death. This study assesses, in a very general manner, different aspects of health care, and it would therefore be a priority issue to examine these findings in depth and to favour complementary lines of research such as the contribution of specific palliative care teams and the needs of persons with non oncological pathologies.

Authors' methods: A prospective study was carried out through the use of a postal questionnaire, to identify the preferences and assess the level of satisfaction of family members of patients who had died in hospital. The period studied ran from April 15 to June 30 2004. The population under study was made up of patients of more than 18 years of age who died from any of the selected causes. In order to estimate the level of satisfaction, an adaptation of 23 items from the validated FAMCARE questionnaire was used. The responses were based on a Likert type scale of five points varying from very satisfied to very unsatisfied. The preferences of the patients were studied by means of a questionnaire drawn up by the research team (13 questions), with responses that were also graduated. The degree of importance and satisfaction was estimated by means of the absolute and relative frequencies of the 5 responses categories, and by means of the mean value. In order to assess whether there was a casual relationship between sociodemographic variables and the degree of satisfaction and importance, linear regression multivariant models were drawn up. A qualitative analysis was made with the freely expressed comments of those persons taking part.

Project Status: Completed

Year Published: 2006

URL for published report: https://www.euskadi.eus/contenidos/informacion/2006_osteba_publicacion/es_def/adjuntos/2006/d_06-04_satisfaccion.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Basque Office for Health Technology Assessment

Contact Address: C/ Donostia – San Sebastián, 1 (Edificio Lakua II, 4ª planta) 01010 Vitoria - Gasteiz

Contact Name: Lorea Galnares-Cordero

Contact Email: lgalnares@bioef.eus

Copyright: <p>Basque Office for Health Technology Assessment, Health Department Basque Government (OSTEBA)</p>