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首页> 外文期刊>BMC Palliative Care >Evaluating satisfaction with the quality and provision of end-of-life care for patients from diverse ethnocultural backgrounds
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Evaluating satisfaction with the quality and provision of end-of-life care for patients from diverse ethnocultural backgrounds

机译：对不同民族文化背景的患者的质量和终生保健的满意度评价

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Recently immigrated and ethnic minority patients in Ontario, Canada are more likely to receive aggressive life-prolonging treatment at the end of life in comparison to other patients. To explore this finding further, this survey-based observational study aimed to evaluate satisfaction with the quality of end-of-life care for patients from diverse ethnocultural backgrounds. The End-of-Life Satisfaction Survey was used to measure satisfaction with the quality of inpatient end-of-life care from the perspective of next-of-kin of recently deceased patients at Sunnybrook Health Sciences Centre in Toronto, Ontario (between March 2012 to May 2019). The primary outcome was the global rating of satisfaction. Associations with patient ethnicity, patient religion, level of religiosity/spirituality, language/communication barriers, and location of death were assessed using univariable and multivariable modified Poisson regression. Secondary outcomes included differences in satisfaction and rates of dying in intensive care units (ICU) among patient population subgroups, and identification of high priority areas for quality-of-care improvement. There were 1,543 respondents. Patient ethnicities included Caucasian (68.2%), Mediterranean (10.5%), East Asian (7.6%), South Asian (3.5%), Southeast Asian (2.1%) and Middle Eastern (2.0%); religious affiliations included Christianity (66.6%), Judaism (12.3%) and Islam (2.1%), among others. Location of death was most commonly in ICU (38.4%), hospital wards (37.0%) or long-term care (20.0%). The mean(SD) rating of satisfaction score was 8.30(2.09) of 10. After adjusting for other covariates, satisfaction with quality of end-of-life care was higher among patients dying in ICU versus other locations (relative risk [RR] 1.51, 95%CI 1.05-2.19, p=0.028), lower among those who experienced language/communication barriers (RR 0.49 95%CI 0.23-1.06, p=0.069), and lower for Muslim patients versus other religious affiliations (RR 0.46, 95%CI 0.21-1.02, p=0.056). Survey items identified as highest priority areas for quality-of-care improvement included communication and information giving; illness management; and healthcare provider characteristics such as emotional support, doctor availability and time spent with patient/family. Satisfaction with quality-of-care at the end of life was higher among patients dying in ICU and lower among Muslim patients or when there were communication barriers between families and healthcare providers. These findings highlight the importance of measuring and improving end-of-life care across the ethnocultural spectrum.
机译：最近在安大略省的最近移民和少数民族患者，加拿大更有可能在与其他患者相比的生活结束时获得积极的寿命。为了进一步探索这一发现，这项基于调查的观察研究旨在评估对来自不同的民族文化背景患者的生活质量的满意度。终身满意度调查用于衡量与在安大略省多伦多多伦多桑尼布鲁克健康科学中心的下一次患者的内外患者的住院生活质量的满意度到2019年5月）。主要结果是全球满意度的评级。使用单变量和多变量改性的泊松回归评估与患者种族，患者宗教，宗教，语言/灵性，语言/通信障碍和死亡的地点的关联。二次结果包括患者人口亚组（ICU）在重症监护单位（ICU）的满足和率的差异，以及鉴定护理质量改善的高优先级领域。有1,543名受访者。患者种族包括白种人（68.2％），地中海（10.5％），东亚（7.6％），南亚（3.5％），东南亚（2.1％）和中东（2.0％）;宗教隶属关系包括基督教（66.6％），犹太教（12.3％）和伊斯兰教（2.1％）等。死亡的位置最常见于ICU（38.4％），医院病房（37.0％）或长期护理（20.0％）。满意度评分的平均值（SD）为8.30（2.09）10。调整其他协变量后，在ICU与其他地点的患者中死亡的患者的患者患者患者的质量较高（相对风险[RR] 1.51 ，95％CI 1.05-2.19，P = 0.028），较低的人经历了语言/通信障碍（RR 0.49 95％CI 0.23-1.06，P = 0.069），穆斯林患者与其他宗教附属关系（RR 0.46）降低（RR 0.46 95％CI 0.21-1.02，P = 0.056）。调查项目确定为优先级的优先领域，包括沟通和信息给予;疾病管理;和医疗保健提供者特征，如情绪支持，医生可用性和与患者/家庭共度的时间。在ICU死亡和穆斯林患者中死亡的患者的患者中，或者在穆斯林患者中较低的患者，或者家庭和医疗保健提供者之间的通信障碍时，对生活质量的满意度较高。这些发现突出了在民族文化谱中测量和改善生活结束护理的重要性。

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