TY - JOUR
T1 - Last 3 months of life in home-ventilated patients
T2 - The family perception
AU - Vitacca, M.
AU - Grassi, M.
AU - Barbano, L.
AU - Galavotti, G.
AU - Sturani, C.
AU - Vianello, A.
AU - Zanotti, E.
AU - Ballerin, L.
AU - Potena, A.
AU - Scala, R.
AU - Peratoner, A.
AU - Ceriana, P.
AU - Di Buono, L.
AU - Clini, E.
AU - Ambrosino, N.
AU - Hill, N.
AU - Nava, S.
PY - 2010/5
Y1 - 2010/5
N2 - We studied the family's perception of care in patients under home mechanical ventilation during the last 3 months of life. In 11 respiratory units, we submitted a 35-item questionnaire to relatives of 168 deceased patients exploring six domains: symptoms, awareness of disease, family burden, dying, medical and technical problems. Response rate was 98.8%. The majority of patients complained respiratory symptoms and were aware of the severity and prognosis of the disease. Family burden was high especially in relation to money need. During hospitalisation, 74.4% of patients were admitted to the intensive care unit (ICU). 78 patients died at home, 70 patients in a medical ward and 20 in ICU. 27% of patients received resuscitation manoeuvres. Hospitalisations and family economical burden were unrelated to diagnosis and mechanical ventilation. Families of the patients did not report major technical problems on the use of ventilators. In comparison with mechanical invasively ventilated patients, noninvasively ventilated patients were more aware of prognosis, used more respiratory drugs, changed ventilation time more frequently and died less frequently when under mechanical ventilation. We have presented good points and bad points regarding end-of-life care in home mechanically ventilated patients. Noninvasive ventilation use and diagnosis have impact on this burden. Copyright
AB - We studied the family's perception of care in patients under home mechanical ventilation during the last 3 months of life. In 11 respiratory units, we submitted a 35-item questionnaire to relatives of 168 deceased patients exploring six domains: symptoms, awareness of disease, family burden, dying, medical and technical problems. Response rate was 98.8%. The majority of patients complained respiratory symptoms and were aware of the severity and prognosis of the disease. Family burden was high especially in relation to money need. During hospitalisation, 74.4% of patients were admitted to the intensive care unit (ICU). 78 patients died at home, 70 patients in a medical ward and 20 in ICU. 27% of patients received resuscitation manoeuvres. Hospitalisations and family economical burden were unrelated to diagnosis and mechanical ventilation. Families of the patients did not report major technical problems on the use of ventilators. In comparison with mechanical invasively ventilated patients, noninvasively ventilated patients were more aware of prognosis, used more respiratory drugs, changed ventilation time more frequently and died less frequently when under mechanical ventilation. We have presented good points and bad points regarding end-of-life care in home mechanically ventilated patients. Noninvasive ventilation use and diagnosis have impact on this burden. Copyright
KW - Chronic obstructive pulmonary disease
KW - Dyspnoea
KW - End-of-life
KW - Ethics
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U2 - 10.1183/09031936.00061009
DO - 10.1183/09031936.00061009
M3 - Article
C2 - 19717483
AN - SCOPUS:77951972088
VL - 35
SP - 1064
EP - 1071
JO - European Journal of Respiratory Diseases
JF - European Journal of Respiratory Diseases
SN - 0903-1936
IS - 5
ER -