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    End-Of-Life Care in the Time of COVID-19: Communication Matters More Than Ever

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    Author
    Ersek, M.
    Smith, D.
    Griffin, H.
    Carpenter, J.G.
    Feder, S.L.
    Shreve, S.T.
    Nelson, F.X.
    Kinder, D.
    Thorpe, J.M.
    Kutney-Lee, A.
    Date
    2021-01-05
    Journal
    Journal of Pain and Symptom Management
    Publisher
    Elsevier Inc.
    Type
    Article
    
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    See at
    https://doi.org/10.1016/j.jpainsymman.2020.12.024
    Abstract
    Context: The COVID-19 pandemic resulted in visitation restrictions across most health care settings, necessitating the use of remote communication to facilitate communication among families, patients and health care teams. Objective: To examine the impact of remote communication on families' evaluation of end-of-life care during the COVID-19 pandemic. Methods: Retrospective, cross-sectional, mixed methods study using data from an after-death survey administered from March 17-June 30, 2020. The primary outcome was the next of kin's global assessment of care during the Veteran's last month of life. Results: Data were obtained from the next-of-kin of 328 Veterans who died in an inpatient unit (i.e., acute care, intensive care, nursing home, hospice units) in one of 37 VA medical centers with the highest numbers of COVID-19 cases. The adjusted percentage of bereaved families reporting excellent overall end-of-life care was statistically significantly higher among those reporting Very Effective remote communication compared to those reporting that remote communication was Mostly, Somewhat, or Not at All Effective (69.5% vs. 35.7%). Similar differences were observed in evaluations of remote communication effectiveness with the health care team. Overall, 81.3% of family members who offered positive comments about communication with either the Veteran or the health care team reported excellent overall end-of-life care vs. 28.4% who made negative comments. Conclusions: Effective remote communication with the patient and the health care team was associated with significantly better ratings of the overall experience of end-of-life care by bereaved family members. Our findings offer timely insights into the importance of remote communication strategies. Copyright 2021 American Academy of Hospice and Palliative Medicine
    Keyword
    Communication
    COVID-19
    end-of-life care
    quality improvement
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/15277
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jpainsymman.2020.12.024
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    UMB Open Access Articles
    UMB Coronavirus Publications

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