This preprint is under consideration at BMC Palliative Care. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
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Research Article
Filippo Binda
Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico
Corresponding Author
License:
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BACKGROUND
In the last decade, access to national palliative care programs have improved, however a large proportion of patients continued to die in hospital, particularly within internal medicine wards.
OBJECTIVES
To describe how adult patients die in the medical and surgical wards of a large tertiary-level university teaching hospital in the north of Italy, comparing the care and treatments between patients whose death was rated as highly, moderately or not expected by nurses.
METHODS
Single-centre cross-sectional study. Data on nursing interventions and diagnostic procedure in proximity of death were collected after interviewing the nurse and the physician responsible for the patient. Relationship between qualitative variables involving nursing procedures was summarized by means of multiple correspondence analysis (MCA).
RESULTS
Death was highly expected by nurses in 108 out of 187 patients included, whose primary diagnosis was respiratory (33.7%). Symptoms control was inadequate for the most severely ill patients: the most prevalent were asthenia (88.3%), mild or severe pain (69.0%), urinary incontinence (66.3%) and respiratory fatigue (64.8%). Physicians rated more frequently than nurses the quality of dying as good or very good, respectively 78.6% and 57.8%. The best quality of dying seems associated to the number of nursing interventions (mostly related to ensure comfort and to prevent pressure ulcers), female sex and low Norton scoring, as suggested by MCA.
CONCLUSION
Staff in medical and surgical wards still deal inadequately with the needs of dying people. Presence of hospital-based specialist palliative care could lead to improvements in the patients’ quality of life
Keywords
end-of-life, hospital death, symptom control, quality of death, palliative care.
Figure 1
No competing interests reported.
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CURRENT STATUS: Under Review
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Posted 25 Mar, 2021
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On 26 Mar, 2021
Editor invited
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On 24 Mar, 2021
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Subject Areas
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This preprint is under consideration at BMC Palliative Care. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Filippo Binda
Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 25 Mar, 2021
No community comments so far
Reviewers invited
Invitations sent on 26 Mar, 2021
Editor assigned
On 26 Mar, 2021
Editor invited
On 24 Mar, 2021
Submission checks complete
On 24 Mar, 2021
First submitted
On 19 Mar, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Anesthesiology & Pain Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
BACKGROUND
In the last decade, access to national palliative care programs have improved, however a large proportion of patients continued to die in hospital, particularly within internal medicine wards.
OBJECTIVES
To describe how adult patients die in the medical and surgical wards of a large tertiary-level university teaching hospital in the north of Italy, comparing the care and treatments between patients whose death was rated as highly, moderately or not expected by nurses.
METHODS
Single-centre cross-sectional study. Data on nursing interventions and diagnostic procedure in proximity of death were collected after interviewing the nurse and the physician responsible for the patient. Relationship between qualitative variables involving nursing procedures was summarized by means of multiple correspondence analysis (MCA).
RESULTS
Death was highly expected by nurses in 108 out of 187 patients included, whose primary diagnosis was respiratory (33.7%). Symptoms control was inadequate for the most severely ill patients: the most prevalent were asthenia (88.3%), mild or severe pain (69.0%), urinary incontinence (66.3%) and respiratory fatigue (64.8%). Physicians rated more frequently than nurses the quality of dying as good or very good, respectively 78.6% and 57.8%. The best quality of dying seems associated to the number of nursing interventions (mostly related to ensure comfort and to prevent pressure ulcers), female sex and low Norton scoring, as suggested by MCA.
CONCLUSION
Staff in medical and surgical wards still deal inadequately with the needs of dying people. Presence of hospital-based specialist palliative care could lead to improvements in the patients’ quality of life
Figure 1
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