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Impact van vroegtijdige zorgplanning voor palliatieve zorg bij oudere patiënten - Detering, Hancock, Read, Silvester - Artikel
Een studie om de impact goed geplande zorg rond het levenseinde bij oudere patiënten te onderzoeken. Het was een prospectieve randomised controlled trial die is uitgevoerd in een ziekenhuis in Melbourne, Australië. Er deden 309 patiënten die ouder waren dan 80 jaar mee, die 6 maanden gevolgd werden, of totdat ze overleden. De deelnemers werden gerandomiseerd in 2 groepen: de reguliere zorg of uitgebreide zorgplanning waarbij geholpen werd met reflecteren op de doelen, waarden en het geloof van de patiënten, dit om de toekomstige zorgbehoeften vast te stellen en vast te leggen. De belangrijkste uitkomst was of de wensen van de patient kenbaar waren en gerespecteerd werden. Andere uitkomsten waren de tevredenheid van zowel patiënten als familie omtrent het verblijf in het ziekenhuis, het stressniveau, de angst en depressie.
Na de 6 maanden was bij 89% van de patiënten in de interventiegroep die overleden de wensen bekend en werden gerespecteerd, tegenover slechts 30% van de controlegroep. De mortaliteit tussen de twee groepen verschilde niet.
De patiënten, of familieleden wanneer de patiënten waren overleden, waren in de interventiegroep significant tevredener over de gang van zaken.
De familie van de patiënten die overleden werden na gemiddeld 104 dagen geïnterviewd. Vergeleken met de controlegroep had de familie van de interventiegroep minder symptomen van post-traumatisch stresssyndroom, depressieve klachten en angsten. Ook waren zij meer tevreden over de kwaliteit van het overlijden, zowel vanuit hun eigen perspectief als dat zij dachten dat hun familielid het overlijden had ervaren.
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