What do bereaved relatives of cancer patients dying in hospital want to tell us? Analysis of free-text comments from the International Care of the Dying Evaluation (i-CODE) survey: a mixed methods approach



Gerlach, Christina, Baus, Miriam, Gianicolo, Emilio, Bayer, Oliver, Haugen, Dagny Faksvag, Weber, Martin, Mayland, Catriona ORCID: 0000-0002-1440-9953 and ERANet, LACCODE Core Sci Grp
(2023) What do bereaved relatives of cancer patients dying in hospital want to tell us? Analysis of free-text comments from the International Care of the Dying Evaluation (i-CODE) survey: a mixed methods approach. SUPPORTIVE CARE IN CANCER, 31 (1). 81-.

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Abstract

<h4>Purpose</h4>We conducted an international survey of bereaved relatives of cancer patients dying in hospitals in seven countries, with the aim to assess and improve the quality of care. The survey used the i-CODE (International Care of the Dying Evaluation) questionnaire. Here, we report findings from the free-text comments submitted with the questionnaires. We explored for topic areas which would potentially be important for improving the quality of care. Further, we examined who reported free-texts and in what way, to reduce bias without ignoring the function the free-texts may have for those contributing.<h4>Methods</h4>We used a combined qualitative-quantitative approach: logistic regression analysis to study the effect of respondents' socio-demographic characteristics on the probability of free-texts contributions and thematic analysis to understand the free-text meaning. The primary survey outcomes, (1) how frequently the dying person was treated with dignity and respect and (2) support for the relative, were related to free-text content.<h4>Results</h4>In total, 914 questionnaires were submitted; 457/914 (50%) contained free-text comments. We found no socio-demographic differences between the respondents providing free-texts and those who did not. We discovered different types of free-texts ("feedback," "narrative," "self-revelation") containing themes of which "continuity of care," "the one person who can make a difference," and "the importance of being a companion to the dying" represent care dimensions supplementing the questionnaire items. A free-text type of grateful feedback was associated with well perceived support for the relative.<h4>Conclusion</h4>Bereaved relatives used the free-texts to report details related to i-CODE items and to dimensions otherwise not represented. They highlighted the importance of the perceived support from human interaction between staff and the dying patient and themselves; and that more than professional competence alone, personal, meaningful interactions have profound importance.

Item Type: Article
Uncontrolled Keywords: (MeSH):End of life care, Palliative care, Qualitative research, Quality of healthcare, Gratitude, Supportive care, Narrative medicine
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences > School of Medicine
Depositing User: Symplectic Admin
Date Deposited: 19 May 2023 09:00
Last Modified: 19 May 2023 09:00
DOI: 10.1007/s00520-022-07490-9
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3170534