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Perception of the quality of communication with physicians among relatives of dying residents of long-term care facilities in 6 European countries : PACE cross-sectional study

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Abstract
Objective: To examine how relatives evaluate the quality of communication with the treating physician of a dying resident in long-term care facilities (LTCFs) and to assess its differences between countries. Design: A cross-sectional retrospective study in a representative sample of LTCFs conducted in 2015. Relatives of residents who died during the previous 3 months were sent a questionnaire. Settings and participants: 761 relatives of deceased residents in 241 LTCFs in Belgium, England, Finland, Italy, the Netherlands, and Poland. Methods: The Family Perception of Physician-Family Communication (FPPFC) scale (ratings from 0 to 3, where 3 means the highest quality) was used to retrospectively assess how the quality of end-of-life communication with treating physicians was perceived by relatives. We applied multilevel linear and logistic regression models to assess differences between countries and LTCF types. Results: The FPPFC score was the lowest in Finland (1.4 +/- 0.8) and the highest in Italy (2.2 +/- 0.7). In LTCFs served by general practitioners, the FPPFC score differed between countries, but did not in LTCFs with onsite physicians. Most relatives reported that they were well informed about a resident's general condition (from 50.8% in Finland to 90.6% in Italy) and felt listened to (from 53.1% in Finland to 84.9% in Italy) and understood by the physician (from 56.7% in Finland to 85.8% in Italy). In most countries, relatives assessed the worst communication as being about the resident's wishes for medical treatment at the end of life, with the lowest rate of satisfied relatives in Finland (37.6%). Conclusion: The relatives' perception of the quality of end-of-life communication with physicians differs between countries. However, in all countries, physicians' communication needs to be improved, especially regarding resident's wishes for medical care at the end of life. Implications: Training in end-of-life communication to physicians providing care for LTCF residents is recommended.
Keywords
quality of communication, end-of-life care, long-term care facility, physician, relative, OF-LIFE CARE, NURSING-HOME RESIDENTS, PALLIATIVE CARE, FAMILY CAREGIVERS, END, HEALTH, ORGANIZATION, EDUCATION, DEMENTIA, FLANDERS

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MLA
Barańska, Ilona, et al. “Perception of the Quality of Communication with Physicians among Relatives of Dying Residents of Long-Term Care Facilities in 6 European Countries : PACE Cross-Sectional Study.” JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, vol. 21, no. 3, 2020, pp. 331–37.
APA
Barańska, I., Kijowska, V., Engels, Y., Finne-Soveri, H., Froggatt, K., Gambassi, G., … Szczerbińska, K. (2020). Perception of the quality of communication with physicians among relatives of dying residents of long-term care facilities in 6 European countries : PACE cross-sectional study. JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, 21(3), 331–337.
Chicago author-date
Barańska, Ilona, Violetta Kijowska, Yvonne Engels, Harriet Finne-Soveri, Katherine Froggatt, Giovanni Gambassi, Teija Hammar, et al. 2020. “Perception of the Quality of Communication with Physicians among Relatives of Dying Residents of Long-Term Care Facilities in 6 European Countries : PACE Cross-Sectional Study.” JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION 21 (3): 331–37.
Chicago author-date (all authors)
Barańska, Ilona, Violetta Kijowska, Yvonne Engels, Harriet Finne-Soveri, Katherine Froggatt, Giovanni Gambassi, Teija Hammar, Mariska Oosterveld-Vlug, Sheila Payne, Nele Van Den Noortgate, Tinne Smets, Luc Deliens, Lieve Van den Block, and Katarzyna Szczerbińska. 2020. “Perception of the Quality of Communication with Physicians among Relatives of Dying Residents of Long-Term Care Facilities in 6 European Countries : PACE Cross-Sectional Study.” JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION 21 (3): 331–337.
Vancouver
1.
Barańska I, Kijowska V, Engels Y, Finne-Soveri H, Froggatt K, Gambassi G, et al. Perception of the quality of communication with physicians among relatives of dying residents of long-term care facilities in 6 European countries : PACE cross-sectional study. JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION. 2020;21(3):331–7.
IEEE
[1]
I. Barańska et al., “Perception of the quality of communication with physicians among relatives of dying residents of long-term care facilities in 6 European countries : PACE cross-sectional study,” JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, vol. 21, no. 3, pp. 331–337, 2020.
@article{8622823,
  abstract     = {Objective: To examine how relatives evaluate the quality of communication with the treating physician of a dying resident in long-term care facilities (LTCFs) and to assess its differences between countries. 
Design: A cross-sectional retrospective study in a representative sample of LTCFs conducted in 2015. Relatives of residents who died during the previous 3 months were sent a questionnaire. 
Settings and participants: 761 relatives of deceased residents in 241 LTCFs in Belgium, England, Finland, Italy, the Netherlands, and Poland. 
Methods: The Family Perception of Physician-Family Communication (FPPFC) scale (ratings from 0 to 3, where 3 means the highest quality) was used to retrospectively assess how the quality of end-of-life communication with treating physicians was perceived by relatives. We applied multilevel linear and logistic regression models to assess differences between countries and LTCF types. 
Results: The FPPFC score was the lowest in Finland (1.4 +/- 0.8) and the highest in Italy (2.2 +/- 0.7). In LTCFs served by general practitioners, the FPPFC score differed between countries, but did not in LTCFs with onsite physicians. Most relatives reported that they were well informed about a resident's general condition (from 50.8% in Finland to 90.6% in Italy) and felt listened to (from 53.1% in Finland to 84.9% in Italy) and understood by the physician (from 56.7% in Finland to 85.8% in Italy). In most countries, relatives assessed the worst communication as being about the resident's wishes for medical treatment at the end of life, with the lowest rate of satisfied relatives in Finland (37.6%). 
Conclusion: The relatives' perception of the quality of end-of-life communication with physicians differs between countries. However, in all countries, physicians' communication needs to be improved, especially regarding resident's wishes for medical care at the end of life. Implications: Training in end-of-life communication to physicians providing care for LTCF residents is recommended.},
  author       = {Barańska, Ilona and Kijowska, Violetta and Engels, Yvonne and Finne-Soveri, Harriet and Froggatt, Katherine and Gambassi, Giovanni and Hammar, Teija and Oosterveld-Vlug, Mariska and Payne, Sheila and Van Den Noortgate, Nele and Smets, Tinne and Deliens, Luc and Van den Block, Lieve and Szczerbińska, Katarzyna},
  issn         = {1525-8610},
  journal      = {JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION},
  keywords     = {quality of communication,end-of-life care,long-term care facility,physician,relative,OF-LIFE CARE,NURSING-HOME RESIDENTS,PALLIATIVE CARE,FAMILY CAREGIVERS,END,HEALTH,ORGANIZATION,EDUCATION,DEMENTIA,FLANDERS},
  language     = {eng},
  number       = {3},
  pages        = {331--337},
  title        = {Perception of the quality of communication with physicians among relatives of dying residents of long-term care facilities in 6 European countries : PACE cross-sectional study},
  url          = {http://dx.doi.org/10.1016/j.jamda.2019.05.003},
  volume       = {21},
  year         = {2020},
}

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