How Safe Do Dying People Feel at Home? Patients' Perception of Safety While Receiving Specialist Community Palliative Care.
Anna J Pedrosa Carrasco, Alexandra Bezmenov, Ulf Sibelius and 1 others
PMID 36396608WHAT IT FOUND
20% of palliative care patients at home felt unsafe.
Physical disability (60%), physical symptoms (30%) and psychological symptoms (26%) were common concerns; higher symptom scores and feeling unsafe were linked to shorter survival.
Key findings
0120% of patients reported that their overall safety was compromised.
02Physical disabilities (60%), physical symptoms (30%) and psychological symptoms (26%) were the most frequently reported causes of impaired safety.
03Median survival was 34.5 days among patients who perceived impaired safety and 61.5 days among those who did not.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
Recruitment was not consecutive, and patients who felt unsafe may have been more likely to refuse, so participants may not represent all patients. The care team judged whether patients were too weak or stressed to take part, which may have excluded the most distressed patients. The safety questionnaire was developed for this study and was not validated, so measurement error is possible. Patients were not separately screened for each safety problem before being asked how it affected safety, so some contributors to feeling unsafe may have been missed. The study was done in one German community palliative care service, so results may not transfer to other services or countries.
Declared interests
The authors declared no potential conflicts of interest and received no financial support.
The easy way to misread this
Do not read the median survival times of 34.5 days and 61.5 days as evidence that feeling unsafe shortens life. The study was observational, the questionnaire was not validated, and safety concerns may have reflected approaching end of life.