The 3 Wishes Program Improves Families' Experience of Emotional and Spiritual Support at the End of Life.
End of life
Intensive care unit
Palliative care
Journal
Journal of general internal medicine
ISSN: 1525-1497
Titre abrégé: J Gen Intern Med
Pays: United States
ID NLM: 8605834
Informations de publication
Date de publication:
01 2023
01 2023
Historique:
received:
04
12
2021
accepted:
22
04
2022
pubmed:
18
5
2022
medline:
21
1
2023
entrez:
17
5
2022
Statut:
ppublish
Résumé
The end-of-life (EOL) experience in the intensive care unit (ICU) is emotionally challenging, and there are opportunities for improvement. The 3 Wishes Program (3WP) promotes the dignity of dying patients and their families by eliciting and implementing wishes at the EOL. To assess whether the 3WP is associated with improved ratings of EOL care. In the 3WP, clinicians elicit and fulfill simple wishes for dying patients and their families. 2-hospital academic healthcare system. Dying patients in the ICU and their families. A modified Bereaved Family Survey (BFS), a validated tool for measuring EOL care quality, was completed by families of ICU decedents approximately 3 months after death. We compared patients whose care involved the 3WP to those who did not using three BFS-derived measures: Respectful Care and Communication (5 questions), Emotional and Spiritual Support (3 questions), and the BFS-Performance Measure (BFS-PM, a single-item global measure of care). Of 314 completed surveys, 117 were for patients whose care included the 3WP. Bereaved families of 3WP patients rated the Emotional and Spiritual Support factor significantly higher (7.5 vs. 6.0, p = 0.003, adjusted p = 0.001) than those who did not receive the 3WP. The Respectful Care and Communication factor and BFS-PM were no different between groups. The 3WP is a low-cost intervention that may be a feasible strategy for improving the EOL experience.
Sections du résumé
BACKGROUND
The end-of-life (EOL) experience in the intensive care unit (ICU) is emotionally challenging, and there are opportunities for improvement. The 3 Wishes Program (3WP) promotes the dignity of dying patients and their families by eliciting and implementing wishes at the EOL.
AIM
To assess whether the 3WP is associated with improved ratings of EOL care.
PROGRAM DESCRIPTION
In the 3WP, clinicians elicit and fulfill simple wishes for dying patients and their families.
SETTING
2-hospital academic healthcare system.
PARTICIPANTS
Dying patients in the ICU and their families.
PROGRAM EVALUATION
A modified Bereaved Family Survey (BFS), a validated tool for measuring EOL care quality, was completed by families of ICU decedents approximately 3 months after death. We compared patients whose care involved the 3WP to those who did not using three BFS-derived measures: Respectful Care and Communication (5 questions), Emotional and Spiritual Support (3 questions), and the BFS-Performance Measure (BFS-PM, a single-item global measure of care).
RESULTS
Of 314 completed surveys, 117 were for patients whose care included the 3WP. Bereaved families of 3WP patients rated the Emotional and Spiritual Support factor significantly higher (7.5 vs. 6.0, p = 0.003, adjusted p = 0.001) than those who did not receive the 3WP. The Respectful Care and Communication factor and BFS-PM were no different between groups.
DISCUSSION
The 3WP is a low-cost intervention that may be a feasible strategy for improving the EOL experience.
Identifiants
pubmed: 35581456
doi: 10.1007/s11606-022-07638-7
pii: 10.1007/s11606-022-07638-7
pmc: PMC9113739
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
115-121Informations de copyright
© 2022. The Author(s).
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