Voices that matter… Bereaved relatives - their experience of care

Background Four in ten (43%) of all deaths in Ireland occur in acute hospitals. Studies have reported on excellent end of life care (EOLC) provided in acute hospital settings in Ireland, however, others have found... [ view full abstract ]

Background
Four in ten (43%) of all deaths in Ireland occur in acute hospitals. Studies have reported on excellent end of life care (EOLC) provided in acute hospital settings in Ireland, however, others have found deficiencies. Two large acute teaching hospitals and their academic partners undertook a collaborative research project to assess quality of care from the bereaved relatives’ perspective, using an adapted version of the VOICES survey tool – Voices MaJam.

Aim and Objectives
Study aim was to assess quality of care and family support, as perceived by bereaved relatives. Objectives were to establish how hospitals are meeting the needs of dying patients and to test the usefulness of Voices MaJam post bereavement survey in acute hospitals in Ireland. This poster is based on combined qualitative data for both hospitals. Ethics board approval was granted for each hospital.

Method
This post-bereavement postal study gathered data retrospectively from bereaved relatives, between June and August 2015. A 39-item questionnaire was developed and distributed to 781 bereaved relatives 3-9 months after the death of their relative. 356 questionnaires were returned – response rate of 45.6%.

Qualitative data were coded using NVivo. Inter-rater reliability tests were conducted indicating a kappa score of 0.62. Data were analysed thematically using a template analysis framework approach. Eight key themes emerged: person-centred care; physical care environment; symptom management; staff skills; patient care needs; family support; patient preferences and communication.

Findings
Findings help to contextualise quantitative findings and highlight the crucial importance of eliciting qualitative feedback from bereaved relatives on their experiences of EOLC.

Conclusions and Implications
The study offers both hospitals the potential to enhance EOLC for future patients and their relatives. The VOICES MaJam survey of bereaved relatives is a useful tool in ascertaining the quality of care at end of life in an acute hospital setting. Data confirms the need to further invest in end of life care in acute hospitals.