Exploring whether the needs of dying patients in private sector hospitals are being met

Master Thesis

2003

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University of Cape Town

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As palliative medicine is an area only beginning to develop as a speciality in South Africa, it was felt that an investigation into the situation with regard to dying patients in our own private sector hospitals was needed. The objectives were to ascertain whether patient and family needs are met as a means of an index of quality of care and to identify domains of care where improvement is needed most. The validated 'After death Bereaved Family Member interview' from the questionnaire for hospital purposes, as part of the Toolkit of instruments to Measure End-of-life Care (T.l.M.E.), was used as research instrument with the permission of the author Dr JM Teno. Domains that were investigated include the following: physical comfort and emotional support of the patient; focused attention on the individual patient; encouragement of advanced care planning; information and promotion of shared decision-making re care plan; provision of coordinated care of health professions; emotional and spiritual support of the family; and an overall rating for patient focused, family centred care. As a descriptive study with limited numbers this study cannot make any conclusive claims with regard to the care that all terminal patients receive in private hospitals in Port Elizabeth. Results indicate that the single domain with most opportunity to improve for both the oncology group and the general group is attention to the family. The model of patient-focused family-centred care, which is applicable to palliative care, makes this an urgent opportunity for improvement in the care of the dying patients in private hospitals. Control of pain and other symptoms remains an important medical and ethical issue, indicated in this research as needing attention. Information and promotion of shared decision-making is the other domain that warrants attention.
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Includes bibliographical references.

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