Universität zu Köln

Schippel, Nicolas ORCID: 0000-0001-5612-8482, Dust, Gloria, von Reeken, Christian, Voltz, Raymond, Strupp, Julia and Rietz, Christian (2022). Can we determine burdensome transitions in the last year of life based on time of occurrence and frequency? An explanatory mixed-methods study. Palliat. Support Care, 20 (5). S. 637 - 646. NEW YORK: CAMBRIDGE UNIV PRESS. ISSN 1478-9523

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Abstract

Objective Burdensome transitions are typically defined as having a transition in the last three days or multiple hospitalizations in the last three months of life, which is seldom verified with qualitative accounts from persons concerned. This study analyses types and frequencies of transitions in the last year of life and indicators of burdensome transitions from the perspective of bereaved relatives. Method Cross-sectional explanatory mixed-methods study with 351 surveyed and 41 interviewed bereaved relatives in a German urban area. Frequencies, t-tests, and Spearman correlations were computed for quantitative data. Qualitative data were analyzed using content analysis with provisional and descriptive coding/subcoding. Results Transitions rise sharply during the last year of life. 8.2% of patients experience a transition in the last three days and 7.8% three or more hospitalizations in the last three months of life. An empathetic way of telling patients about the prospect of death is associated with fewer transitions in the last month of life (r = 0.185, p = 0.046). Professionals being aware of the preferred place of death corresponds to fewer hospitalizations in the last three months of life (1.28 vs. 0.97, p = 0.021). Qualitative data do not confirm that burden in transitions is linked to having transitions in the last three days or multiple hospitalizations in the last three months of life. Burden is associated with (1) late and non-empathetic communication about the prospect of death, (2) not coordinating care across settings, and (3) not considering patients' preferences. Significance of results Time of occurrence and frequency appear to be imperfect proxies for burdensome transitions. The subjective burden seems to be associated rather with insufficient information, preparation, and management of transitions.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schippel, Nicolas UNSPECIFIED orcid.org/0000-0001-5612-8482 UNSPECIFIED Dust, Gloria UNSPECIFIED UNSPECIFIED UNSPECIFIED von Reeken, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Voltz, Raymond UNSPECIFIED UNSPECIFIED UNSPECIFIED Strupp, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Rietz, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-665540
DOI:	10.1017/S1478951521001395
Journal or Publication Title:	Palliat. Support Care
Volume:	20
Number:	5
Page Range:	S. 637 - 646
Date:	2022
Publisher:	CAMBRIDGE UNIV PRESS
Place of Publication:	NEW YORK
ISSN:	1478-9523
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NURSING-HOME RESIDENTS; CARE SETTINGS; OLDER-ADULTS; OF-LIFE; END; HEALTH; CANCER; DEATH; HOSPITALIZATIONS; PLACE Multiple languages Health Policy & Services Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66554