Background
Person-related conditions
Organization-related conditions
Combination of person- and organization-related conditions
Methods
Design
Setting
Participants
Instruments
Procedure
Analysis
Results
Description of person- and organization-related conditions and patients’ perceptions of quality of palliative care
Person-related conditions |
n (%) | Missing |
Age (years) | 7 | |
Mean score (SD) | 66.80 (11.62) | |
Range | 41–94 | |
Gender | 3 | |
Female | 108 (57.4) | |
Male | 80 (42.6) | |
Education | 5 | |
Compulsory school or equivalent | 47 (25.3) | |
High school or equivalent | 72 (38.7) | |
University/university college | 67 (36.0) | |
Type of diagnosis | 1 | |
Malignant illness (cancer)/Mixed malignant and non-malignant illnesses | 159 (83.7) | |
Non-malignant illness (e.g. COPD, HF, MS, ALS, Parkinson’s disease) | 31 (16.3) | |
Number of diagnoses | 1 | |
One diagnosis | 132 (69.5) | |
Two or more diagnoses | 58 (30.5) | |
Living conditions | 1 | |
Living alone | 97 (51.1) | |
Living with a partner/Living with others | 82 (43.2) | |
Living with children aged <18 years | 11 (5.8) | |
The amount of contact with family or friends | 2 | |
Daily contact | 110 (58.2) | |
Less than daily contact | 79 (41.8) | |
Religious affiliation | 13 | |
No | 93 (52.2) | |
Yes | 85 (47.8) | |
Sense of coherence (SOC total) | 44 | |
Mean score (SD) | 62.52 (11.06) | |
Range | 29-91 | |
Physiological well-being | 21 | |
Poor/very poor | 20 (11.8) | |
Neither good or poor | 56 (32.9) | |
Good/very good | 94 (55.3) | |
Health-related quality of life (EQ - VAS) | 25 | |
Mean score (SD) | 47.92 (20.38) | |
Range | 0-90 | |
Time in care | 12 | |
3–7 days | 32 (17.9) | |
8-30 days | 52 (29.1) | |
31–182 days (1–6 months) | 48 (26.8) | |
> 183 (6 months) | 47 (26.3) | |
Organization - related conditions related to each patient | ||
Organizational model for physicians | 0 | |
Physician employed/available in the ward | 153 (80.1) | |
Physician as patient’s GP in community care | 38 (19.9) | |
Organizational model for nursing care | 0 | |
Team nursing | 63 (33.0) | |
Primary nursing | 128 (67.0) | |
Settings with physicians who have achieved palliative medicine as a subspeciality | 0 | |
Settings with physicians having subspecialty in palliative medicine | 101 (52.9) | |
Settings without physicians having subspecialty in palliative medicine | 90 (47.1) | |
Systematically assessment of symptoms (ESAS) | 0 | |
All or most patients | 150 (78.5) | |
Some or no patients | 41 (21.5) | |
Patients’ perceptions of palliative care quality | ||
Perceptions of care received (PR scale) [mean score (SD)] | ||
Medical–technical competence | 3.05 (0.70) | 5 |
Physical–technical conditions | 3.50 (0.59) | 5 |
Identity–oriented approach | 3.35 (0.50) | 2 |
Sociocultural atmosphere | 3.34 (0.52) | 6 |
Medical care (single item) | 3.57 (0.73) | 5 |
Personal hygiene (single item) | 3.51 (0.70) | 61 |
Atmosphere (single item) | 3.89 (0.33) | 68* |
Perceptions of subjective importance (SI scale) [mean score (SD)] | ||
Medical–technical competence | 3.17 (0.62) | 6 |
Physical–technical conditions | 3.49 (0.55) | 6 |
Identity– oriented approach | 3.50 (0.47) | 3 |
Sociocultural atmosphere | 3.40 (0.49) | 5 |
Medical care (single item) | 3.75 (0.53) | 5 |
Personal hygiene (single item) | 3.47 (0.71) | 54 |
Atmosphere (single item) | 3.79 (0.43) | 72* |
Patients’ perceptions of the care quality
The relationships between the combination of person- and organization-related conditions and patients’ perceptions of care quality
Significant relationships for the PR scale
Perceived reality
| ||||||||
---|---|---|---|---|---|---|---|---|
Medical–technical competence
|
Physical–technical conditions
|
Identity-oriented approach
|
Sociocultural atmosphere
| |||||
F
(df, error)
|
p
|
F
(df, error)
|
p
|
F
(df, error)
|
p
|
F
(df, error)
|
p
| |
Person - related conditions
| ||||||||
Age
|
1.27 (1,99)
|
0.263
|
0.07 (1,99)
|
0.933
|
4.78 (1,100)
|
0.031*
|
2.74 (1,99)
|
0.101
|
Gender
|
0.03 (1,99)
|
0.857
|
1.57 (1,99)
|
0.213
|
0.03 (1,99)
|
0.956
|
3.28 (1,99)
|
0.073
|
Education
|
0.65 (2,99)
|
0.523
|
0.91 (2,99)
|
0.404
|
0.45 (2,99)
|
0.642
|
0.27 (2,99)
|
0.762
|
Type of illness
|
0.35 (1,99)
|
0.558
|
0.78 (1,99)
|
0.378
|
1.26 (1,99)
|
0.264
|
0.17 (1,99)
|
0.681
|
Number of illness
|
0.85 (1,99)
|
0.359
|
1.61 (1,99)
|
0.207
|
0.04 (1,99)
|
0.843
|
0.02 (1,99)
|
0.883
|
Time in care
|
0.29 (3,99)
|
0.830
|
0.04 (3,99)
|
0.988
|
2.02 (3,99)
|
0.116
|
1.38 (3,99)
|
0.254
|
Living conditions
|
0.90 (2,99)
|
0.409
|
0.51 (2,99)
|
0.605
|
0.95 (2,99)
|
0.390
|
0.78 (2,99)
|
0.462
|
The amount of contact with family or friends
|
0.49 (1,99)
|
0.486
|
0.03 (1,99)
|
0.867
|
3.05 (1,99)
|
0.084
|
2.53 (1,99)
|
0.115
|
Religious affiliation
|
0.60 (1,99)
|
0.440
|
0.14 (1,99)
|
0.710
|
0.07 (1,99)
|
0.788
|
0.11 (1,99)
|
0.738
|
Sense of coherence
|
4.47 (1,99)
|
0.037*
|
14.92 (1,99)
|
<0.001*
|
5.56 (1,100)
|
0.020*
|
10.26 (1,100)
|
0.002*
|
Physiological wellbeing
|
0.16 (2,99)
|
0.855
|
0.66 (2,99)
|
0.520
|
0.74 (2,99)
|
0.480
|
1.06 (12,99)
|
0.352
|
Health-related quality of life
|
1.55 (1,99)
|
0.216
|
0.44 (1,99)
|
0.507
|
1.59 (1,99)
|
0.210
|
0.21 (1,99)
|
0.647
|
Organization - related conditions
| ||||||||
Organizational model for physicians
|
0.06 (1,99)
|
0.811
|
1.99 (1,99)
|
0.161
|
0.25 (1,99)
|
0.618
|
3.47 (1,99)
|
0.065
|
Organizational model for nurses
|
0.13 (1,99)
|
0.716
|
0.78 (1,99)
|
0.379
|
0.09 (1,99)
|
0.762
|
1.45 (1,99)
|
0.232
|
Subspecialty in palliative medicine (physicians)
|
1.80 (1,99)
|
0.183
|
0.75 (1,99)
|
0.390
|
1.79 (1,99)
|
0.184
|
0.18 (1,99)
|
0.673
|
Systematic assessment of symptoms (ESAS)
|
0.08 (1,99)
|
0.775
|
1.14 (1,99)
|
0.289
|
0.01 (1,99)
|
0.940
|
0.15 (1,99)
|
0.699
|
R
2
|
0.243
|
0.223
|
0.295
|
0.278
|
Direction of the relationships for the PR scale
Perceived reality
| ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Medical–technical competence
|
Physical–technical conditions
|
Identity-oriented approach
|
Socio-cultural atmosphere
| |||||||||
B
|
t
|
p
|
B
|
t
|
p
|
B
|
t
|
p
|
B
|
t
|
p
| |
Person- related conditions
| ||||||||||||
Age
|
−0.010
|
−2.170
|
0.032
| |||||||||
Sense of coherence
|
0.015
|
2.102
|
0.038
|
0.025
|
3.993
|
<0.001
|
0.011
|
2.341
|
0.021
|
0.016
|
3.103
|
0.002
|
Organization - related conditions
|
Significant relationships for the SI scale
Subjective importance
| ||||||||
---|---|---|---|---|---|---|---|---|
Medical–technical competence
|
Physical–technical conditions
|
Identity-oriented approach
|
Sociocultural atmosphere
| |||||
F
(df, error)
|
p
|
F
(df, error)
|
p
|
F
(df, error)
|
p
|
F
(df, error)
|
p
| |
Person - related conditions
| ||||||||
Age
|
1.00 (1,99)
|
0.321
|
0.18 (1,99)
|
0.671
|
1.39 (1,100)
|
0.241
|
0.26 (1,100)
|
0.611
|
Gender
|
5.63 (1,99)
|
0.020
|
4.60 (1,99)
|
0.035*
|
5.04 (1,100)
|
0.027*
|
3.17 (1,100)
|
0.078
|
Education
|
0.71 (2,99)
|
0.401
|
1.35 (2,99)
|
0.264
|
0.12 (2,100)
|
0.897
|
0.15 (2,100)
|
0.864
|
Type of illness
|
0.02 (1,99)
|
0.901
|
0.12 (1,99)
|
0.730
|
0.44 (1,100)
|
0.511
|
0.04 (1,100)
|
0.844
|
Number of illness
|
0.02 (1,99)
|
0.890
|
1.03 (1,99)
|
0.313
|
0.15 (1,100)
|
0.700
|
0.12 (1,100)
|
0.729
|
Time in care
|
0.28 (3,99)
|
0.839
|
1.19 (399)
|
0.319
|
1.94 (3,100)
|
0.128
|
1.04 (3,100)
|
0.378
|
Living conditions
|
0.03 (2,99)
|
0.967
|
0.70 (2,99)
|
0.500
|
0.43 (2,100)
|
0.653
|
0.19 (2,100)
|
0.829
|
The amount of contact with family or friends
|
5.32 (1, 99)
|
0.023*
|
2.79 (1,99)
|
0.098
|
11.65 (1,100)
|
0.001*
|
12.89 (1,100)
|
0.001*
|
Religious affiliation
|
0.99 (1,99)
|
0.323
|
0.07 (1,99)
|
0.795
|
0.02 (1,100)
|
0.887
|
0.06 (1,100)
|
0.598
|
Sense of coherence
|
2.09 (1,99)
|
0.151
|
1.80 (1,99)
|
0.182
|
2.02 (1,100)
|
0.158
|
0.83 (1,100)
|
0.336
|
Physiological wellbeing
|
0.61 (2,99)
|
0.544
|
0.35 (2,99)
|
0.707
|
0.14 (2,100)
|
0.869
|
0.51 (2,100)
|
0.603
|
Health-related quality of life
|
0.03 (1,99)
|
0.865
|
0.97 (1,99)
|
0.327
|
4.83 (1,100)
|
0.030*
|
1.23 (1,100)
|
0.271
|
Organization -related conditions
| ||||||||
Organizational model for doctors
|
1.34 (1,99)
|
0.249
|
0.04 (1,99)
|
0.853
|
0.35 (1,100)
|
0.555
|
0.95 (1,100)
|
0.334
|
Organizational model for nurses
|
0.03 (1,99)
|
0.867
|
0.24 (1,99)
|
0.624
|
0.77 (1,100)
|
0.382
|
2.19 (1,100)
|
0.142
|
Subspecialty in palliative medicine (physicians)
|
0.71 (1,99)
|
0.401
|
0.67 (1,99)
|
0.417
|
0.01 (1,100)
|
0.919
|
1.84 (1,100)
|
0.178
|
Systematic assessment of symptoms (ESAS)
|
1.44 (1,99)
|
0.233
|
0.00 (1,99)
|
0.952
|
0.51 (1,100)
|
0.478
|
0.49 (1,100)
|
0.486
|
R
2
|
0.179
|
0.184
|
0.296
|
0.238
|
Direction of the relationships for the SI scale
Subjective importance
| ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Medical–technical competence
|
Physical–technical conditions
|
Identity-oriented approach
|
Socio-cultural atmosphere
| |||||||||
B
|
t
|
p
|
B
|
t
|
p
|
B
|
t
|
p
|
B
|
t
|
p
| |
Person - related conditions
| ||||||||||||
Gender
| ||||||||||||
Woman
|
0.304
|
2.373
|
0.020
|
0.245
|
2.144
|
0.035
|
0.195
|
2.245
|
0.023
| |||
Man
|
0
a
|
0
a
|
0
a
| |||||||||
The amount of contact with family or friends
| ||||||||||||
Daily contact
|
0.316
|
2.307
|
0.023
|
0.317
|
3.413
|
0.001
|
0.369
|
3.590
|
0.001
| |||
Less than daily contact
|
0
a
|
0
a
|
0
a
| |||||||||
Health-related quality of life
|
−0.005
|
−2.198
|
0.030
| |||||||||
Organization - related conditions
|