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Symptom assessment in the dying: family members versus healthcare professionals
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.ORCID iD: 0000-0003-4126-2675
Umeå University, Faculty of Medicine, Department of Nursing.ORCID iD: 0000-0003-1688-8991
Umeå University, Faculty of Medicine, Department of Nursing.ORCID iD: 0000-0002-1728-5722
2023 (English)In: BMJ Supportive & Palliative Care, ISSN 2045-435X, E-ISSN 2045-4368Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives: Symptom management and support of the family members (FMs) are consideredessential aspects of palliative care. During end of life, patients are often not able to self-reportsymptoms. There is little knowledge in the literature of how healthcare professionals(HCPs) assess symptoms compared with FMs.The objective was to compare the assessment ofsymptoms and symptom relief during the final week of life between what was reported by FMsand what was reported by HCPs.

Methods: Data from the Swedish Register of Palliative Care from 2021 and 2022 were usedto compare congruity of the assessments by the FMs and by HCPs regarding occurrence and reliefof three symptoms (pain, anxiety and confusion), using Cohen’s kappa.

Results: A total of 1131 patients were included. The agreement between FMs and HCPs was poorfor occurrence of pain and confusion (kappa 0.25 and 0.16), but fair for occurrence of anxiety(kappa 0.30). When agreeing on a symptom being present, agreement on relief of thatsymptom was poor (kappa 0.04 for pain, 0.10 for anxiety and 0.01 for confusion). The trendwas that HCPs more often rated occurrence of pain and anxiety, less often occurrence ofconfusion and more often complete symptom relief compared with the FMs.

Conclusions: The views of FMs and HCPs of the patients’ symptoms differ in the end-of-life context, but both report important information and their symptom assessments should beconsidered both together and individually. More communication between HCPs and FMs couldprobably bridge some of these differences.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2023.
Keywords [en]
family members, healthcare professional, palliative care, symptom management
National Category
Nursing
Identifiers
URN: urn:nbn:se:umu:diva-216845DOI: 10.1136/spcare-2023-004382PubMedID: 37973205Scopus ID: 2-s2.0-85178282975OAI: oai:DiVA.org:umu-216845DiVA, id: diva2:1812887
Available from: 2023-11-17 Created: 2023-11-17 Last updated: 2023-12-12

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Martinsson, LisaBrännström, MargaretaAndersson, Sofia

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