Quality End-of-Life Care

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Abstract
Review from JAMA — Quality End-of-Life Care — Patients' Perspectives — ContextQuality end-of-life care is increasingly recognized as an ethical obligation of health care providers, both clinicians and organizations. However, this concept has not been examined from the perspective of patients.ObjectiveTo identify and describe elements of quality end-of-life care from the patient's perspective.DesignQualitative study using in-depth, open-ended, face-to-face interviews and content analysis.SettingToronto, Ontario.ParticipantsA total of 126 participants from 3 patient groups: dialysis patients (n = 48), people with human immunodeficiency virus infection (n = 40), and residents of a long-term care facility (n = 38).Outcome MeasuresParticipants' views on end-of-life issues.ResultsParticipants identified 5 domains of quality end-of-life care: receiving adequate pain and symptom management, avoiding inappropriate prolongation of dying, achieving a sense of control, relieving burden, and strengthening relationships with loved ones.ConclusionThese domains, which characterize patients' perspectives on end-of-life care, can serve as focal points for improving the quality of end-of-life care.

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