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Last Updated: Sunday, 23 May, 2004, 23:06 GMT 00:06 UK
Listening 'key to terminal care'
Nurse
Staff must listen to what patients want, researchers say
Hospitals should have plans in place to help patients have a good death, researchers say.

A University of Toronto study in the BMC Palliative Care journal, found a quarter of terminally ill patients felt their care could have been better.

Their impressions improved after a doctor spent time talking to them.

The UK's Macmillan Cancer Relief said better training and support was needed to help NHS staff care for the terminally ill.

More training and support is needed for professionals to be able to deal with it, as well as support for patients and their carers
Macmillan Cancer Relief spokeswoman
The Canadian researchers talked to 36 seriously ill patients in a Toronto tertiary care hospital.

In initial interviews, more than a quarter said their overall care was less than very good or excellent.

A significant number also felt symptom control and levels of support could be better.

Patients and their families identified such areas for improvement as better control of pain and shortness of breath, better access to physicians and medical information, more help with daily living activities, improving the patient's environment and shorter waits for nursing care, diagnosis and treatment.

But after a doctor sat down and talked to the patients about how they felt about their care, satisfaction rates improved.

A third felt overall care was better and just under half were happier with symptom control and support levels.

'Doctors' priorities'

Dr Peter Singer, who led the research, said: "The moral of this study - insert into the busy world of medicine a process to systematically listen to dying patients and their families, and act on their concerns.

"The care - and the perception of care - gets better. It may not be rocket science, but it seems to make a difference.

"While the results should be further confirmed in a larger study with a control group, the intervention is so straightforward and simple we hope the publication will spur hospitals around the world to try this cheap, easy initiative to improve the care of dying patients."

Dr Jeff Powis, who also worked on the research, added: "Past attempts to improve end of life care have focused on specific outcomes deemed important to doctors and hospital staff. The results were disappointing.

"These results are important, showing that this approach is not only feasible but also has the potential to improve the quality of end-of-life care for many people. It's what we should be doing anyway."

A spokeswoman for Macmillan Cancer Relief in the UK said it was working with Marie Curie Cancer Care and the government to improve care for the terminally ill.

The government announced a 12m funding boost at the end of last year.

But she added: "Caring for a terminally ill patient is tough for everyone. It can be particularly hard for healthcare staff if a patient is admitted to hospital as an emergency when there may not be someone the with palliative care skills to deal with it."

She added: "More training and support is needed for professionals to be able to deal with it, as well as support for patients and their carers."


SEE ALSO:
12m pledged for terminally ill
26 Dec 03  |  Health
Millions dying in agony
16 Mar 03  |  Health


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