Quality End-of-Life Care

Abstract

CONTEXT: Quality 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. OBJECTIVE: To identify and describe elements of quality end-of-life care from the patient's perspective. DESIGN: Qualitative study using in-depth, open-ended, face-to-face interviews and content analysis. SETTING: Toronto, Ontario. PARTICIPANTS: A 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 MEASURES: Participants' views on end-of-life issues. RESULTS: Participants 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. CONCLUSION: These domains, which characterize patients' perspectives on end-of-life care, can serve as focal points for improving the quality of end-of-life care.