How do healthcare professionals on non-palliative care wards perceive quality of care in the dying phase? Personal and organizational predictors identified in a cross-sectional study.

BACKGROUND

Most people in European countries die in hospitals outside of specialist palliative care wards. Healthcare professionals of all disciplines are therefore often involved in the care for dying patients. Healthcare professionals' perception of quality of care in the dying phase as well as its predictors are of interest to improve quality of care on non-palliative care hospital wards.

AIM: Identification of personal and organizational predictors of healthcare professionals' perceived quality of care in the dying phase.

METHODS

Cross-sectional online survey with healthcare professionals of ten non-palliative care hospital wards of two university medical centers. Descriptive statistics were used to describe the data. A hierarchical linear regression model with ten theoretically derived personal (gender, age, profession, palliative care training, spirituality, two self-care items, general self-efficacy, thanatophobia, burden factors when caring for dying patients) and two organizational predictors (type of ward, interprofessional patient-centered teamwork) was developed. The dependent variable was an eleven-point Likert-scaled item (0 = extremely bad, 10 = ideal) measuring the quality of care in the dying phase at the respective ward, perceived by healthcare professionals. Predictors were categorized as modifiable and non-modifiable.

RESULTS

Most of the n = 201 participants were female (64.7%), nurses (57.2%) and 30-50 years old (53.2%). The regression model was statistically significant (p < 0.001) and explained 30.7% of the total variance. Lower perceived quality of care in the dying phase was associated with younger age (β = 0.15, ρ = 0.020), being a nurse (β = 0.29, ρ < 0.001), and lower perception of interprofessional patient-centered teamwork on their ward (β = 0.37, ρ < 0.001).

DISCUSSION: Perceived quality of interprofessional patient-centered teamwork was the most clinically relevant predictor in this model, as it had the strongest association and was modifiable. Age and profession were significant, non-modifiable predictors but can be considered when implementing interventions. As improving the perceived quality of care in the dying phase could be beneficial for dying patients, interventions strengthening interprofessional patient-centered teamwork should be implemented on non-palliative care hospital wards.