Yoichi Shimizu1, Mitsunori Miyashita2, Tatsuya Morita3, Kazuki Sato2, Satoru Tsuneto4, Yasuo Shima5. 1. Department of Nursing, National Cancer Center Hospital, Tokyo, Japan. Electronic address: yoshimiz-tky@umin.ac.jp. 2. Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan. 3. Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara Hospital, Hamamatsu, Japan. 4. Department of Palliative Medicine, Osaka University Graduate School of Medicine, Osaka, Japan. 5. Department of Palliative Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan.
Abstract
CONTEXT: Bereaved family members witnessing a patient's death rattle often experience distress. However, the benefits of specific care measures aimed at decreasing death rattle-associated family distress have not yet been evaluated. OBJECTIVES: To clarify death rattle-related emotional distress levels among family members and their perceptions of the need for death rattle care improvement and explore the factors influencing both these issues. METHODS: A cross-sectional questionnaire survey of bereaved family members of cancer patients was conducted in 95 palliative care units in June 2007. RESULTS: Six hundred sixty-three questionnaires were mailed out, and 390 (61%) responses were analyzed. Among these, 181 (46%) respondents experienced death rattle. Of these, 66% reported high distress levels and 53% perceived a strong need for improved death rattle care. Factors influencing high distress levels were the gender (female) of family members, unawareness about death rattle being a natural phenomenon, and their fear and distressing interpretations of death rattle. Factors influencing perceptions of a strong need for improved care were the gender (male) of family members, severity of death rattle, death rattle-associated discomfort to patients, family members' experiences of inadequate nursing care (e.g., repositioning) and insufficient consultation about suctioning, and their perception of uncomfortable smells. CONCLUSION: To decrease family-perceived distress, medical staff should alleviate patient symptoms and suffering with a comprehensive care strategy, try to decrease uncomfortable smells, and communicate with family members to address distressing interpretations and fears.
CONTEXT: Bereaved family members witnessing a patient's death rattle often experience distress. However, the benefits of specific care measures aimed at decreasing death rattle-associated family distress have not yet been evaluated. OBJECTIVES: To clarify death rattle-related emotional distress levels among family members and their perceptions of the need for death rattle care improvement and explore the factors influencing both these issues. METHODS: A cross-sectional questionnaire survey of bereaved family members of cancerpatients was conducted in 95 palliative care units in June 2007. RESULTS: Six hundred sixty-three questionnaires were mailed out, and 390 (61%) responses were analyzed. Among these, 181 (46%) respondents experienced death rattle. Of these, 66% reported high distress levels and 53% perceived a strong need for improved death rattle care. Factors influencing high distress levels were the gender (female) of family members, unawareness about death rattle being a natural phenomenon, and their fear and distressing interpretations of death rattle. Factors influencing perceptions of a strong need for improved care were the gender (male) of family members, severity of death rattle, death rattle-associated discomfort to patients, family members' experiences of inadequate nursing care (e.g., repositioning) and insufficient consultation about suctioning, and their perception of uncomfortable smells. CONCLUSION: To decrease family-perceived distress, medical staff should alleviate patient symptoms and suffering with a comprehensive care strategy, try to decrease uncomfortable smells, and communicate with family members to address distressing interpretations and fears.
Authors: Harriëtte J van Esch; Lia van Zuylen; Eric C T Geijteman; Esther Oomen-de Hoop; Bregje A A Huisman; Heike S Noordzij-Nooteboom; Renske Boogaard; Agnes van der Heide; Carin C D van der Rijt Journal: JAMA Date: 2021-10-05 Impact factor: 56.272
Authors: Harriëtte J van Esch; Lia van Zuylen; Esther Oomen-de Hoop; Agnes van der Heide; Carin C D van der Rijt Journal: BMC Palliat Care Date: 2018-09-07 Impact factor: 3.234
Authors: Harriëtte J van Esch; Martine E Lokker; Judith Rietjens; Lia van Zuylen; Carin C D van der Rijt; Agnes van der Heide Journal: BMC Psychol Date: 2020-06-12