Trust in Physicians, Continuity and Coordination of Care, and Quality of Death in Patients with Advanced Cancer

• Published in: Journal of palliative medicine Vol. 20; no. 11; p. 1252
• Main Authors: Hamano, Jun, Morita, Tatsuya, Fukui, Sakiko, Kizawa, Yoshiyuki, Tunetou, Satoru, Shima, Yasuo, Kobayakawa, Makoto, Aoyama, Maho, Miyashita, Mitsunori
• Format: Journal Article
• Language: English
• Published: United States 01-11-2017
• Subjects: Aged; Aged, 80 and over; Family - psychology; Female; Hospice Care - statistics & numerical data; Hospices - statistics & numerical data; Humans; Japan; Male; Neoplasms - mortality; Quality of Health Care; Right to Die; Surveys and Questionnaires; Terminal Care - statistics & numerical data; Trust; coordination of care; quality of death; home care; patients with advanced cancer; trust in healthcare providers; continuity of care
• ISSN: 1557-7740
• DOI: 10.1089/jpm.2017.0049

Provider-centered factors contribute to unexplained variation in the quality of death (QOD). The relationship between healthcare providers (HCPs) and patients, bidirectional communication, and consistency of longitudinal care planning are important provider-centered factors.
To explore whether the level of trust in HCPs, the quality of continuity of care, and the level of coordination of care among home HCPs are associated with the QOD for cancer patients dying at home.
This study was a part of a nationwide multicenter questionnaire survey of bereaved family members of cancer patients evaluating the quality of end-of-life care in Japan.
We investigated 702 family members of cancer patients who died at home.
The QOD was evaluated from nine core domains of the short version of the Good Death Inventory (GDI). We measured five factors on a Likert scale, including patient and family trust in HCPs, continuity of care by home hospice and hospital physicians, and coordination of care among home hospice staff.
A total of 538 responses (77%) were obtained and 486 responses were analyzed. Trust in HCPs was correlated with the GDI score (r = 0.300-0.387, p < 0.001). The quality of care coordination was associated with the GDI score (r = 0.242, p < 0.001).
Trust of the patient and family in home hospice staff, as well as coordination of care among hospice staff, are associated with the QOD for cancer patients dying at home.