OTTAWA (February 28, 2006) How Canadians die is far more important than where they die, according to a new Canadian Institutes of Health Research (CIHR) funded study on the quality of end-of-life care.
"Patients are telling us they don't want to be a burden on their families, whether they die at home or in hospital," says Dr. Daren Heyland, a research director in the Department of Medicine at Kingston General Hospital (KGH) and a Queen's University Professor of Medicine. According to Dr. Heyland, dying patients and their families need to feel they can trust their attending physicians. "It's not that patients don't care at all about where they die, they just rated that factor as less important than having confidence in the doctors looking after them."
The study sheds light on the opinions of elderly patients suffering from chronic, terminal diseases and what they consider to be key elements of quality end-of-life care. The study is published today in the Canadian Medical Association Journal (CMAJ).
"This is the first study of its kind to look into the interventions that really make a difference in the last days of seriously-ill patients with diseases or ailments other than cancer," says Dr. Bruce McManus, Scientific Director with the CIHR Institute of Circulatory and Respiratory Health. "The more we can understand about this period of life, the greater the dignity and comfort we can provide to all patients."
The results may cast doubt on current efforts to support more patients dying at home, according to the research team that conducted the study. At present, seven out of every 10 Canadians die in hospital.
Out of 28 factors describing quality care, patients and family members rated "to have trust and confidence in the doctors looking after you" and "not to be kept alive on life supports when there is little hope for a meaningful recovery" as most important. "To be able to die in the location of your choice, e.g. home or hospital," rated 24th of 28 from the patient's perspective and 14th of 26 from the family member's perspective.
The study also questions whether doctors receive adequate training in and understanding of the significance of communications in dealing with patients and their families. The patients and families surveyed reported that adequate interactions with and honest communication from doctors were additional key determinants to quality care at the end-of-life.
The survey involved 434 seriously-ill, elderly patients and 160 family members.
The study was conducted in hospitals in Kingston, Vancouver, Halifax, Toronto and Edmonton between November 2001 and June 2003.To view the complete article, visit http://www.cmaj.ca/
Canadian Institutes of Health Research (CIHR)The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency for health research. CIHR's mission is to create new scientific knowledge and to catalyze its translation into improved health, more effective health services and products, and a strengthened Canadian health care system. Composed of 13 Institutes, CIHR provides leadership and support to close to 10,000 health researchers and trainees across Canada.
CIHR Institute of Circulatory and Respiratory Health is devoted to funding research and researchers focused on etiology, mechanisms, prevention, detection, treatment, rehabilitation, and palliation of diseases of heart, lung, blood vessel (including stroke), blood, sleep, and critical care.
Kingston General HospitalAffiliated with Queen's University, Kingston General Hospital is a 456-bed teaching hospital that serves more than 500,000 people in southeastern Ontario and is the community hospital for the Kingston area. KGH provides an array of specialized acute and ambulatory clinical services including trauma, cardiac, stroke, pediatric, perinatal, end stage renal and stem cell transplants. Home to the Cancer Centre of Southeastern Ontario, KGH is dedicated to compassionate, high quality health care in a dynamic academic research environment. It features a robust research program and provides hands-on skill training for 1,600 health-care students annually. For more information, visit the web site.
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Backgrounder
Media contacts:
Marie-France PoirierCIHR Media RelationsPhone: (613) 941-4563Cell: (613) 447-4794mediarelations@cihr-irsc.gc.ca
Karen SmithKGH Public Affairs549-6666 ext. 6345
